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Incidence, Clinical Presentation and Location at Diagnosis of Pediatric Inflammatory Bowel Disease: A Prospective Population-Based Study in Northern France (1988-1999)

Auvin, Stéphane*; Molinié, Florence†; Gower-Rousseau, Corinne†; Brazier, Franck¶; Merle, Véronique§; Grandbastien, Bruno§; Marti, Raymond‡; Lerebours, Eric∥; Dupas, Jean-Louis¶; Colombel, Jean-Frédéric‡; Salomez, Jean-Louis†; Cortot, Antoine‡; Turck, Dominique*

Journal of Pediatric Gastroenterology & Nutrition:
Original Articles: Gastroenterology
Abstract

Objective: To assess the incidence and location at diagnosis of inflammatory bowel disease in children and adolescents in northern France between 1988 and 1999.

Methods: A 12-year prospective population-based study was conducted by gastroenterologists and pediatric gastroenterologists of northern France (1,312,141 children <17 years of age).

Results: From 1988 to 1999, 509 cases of childhood inflammatory bowel disease were recorded (7.2% of all inflammatory bowel disease cases in Northern France): 367 Crohn disease, 122 ulcerative colitis and 20 indeterminate colitis. The mean standardized incidence was 3.1/105 for inflammatory bowel disease as a whole (2.3 for Crohn disease, 0.8 for ulcerative colitis and 0.12 for indeterminate colitis). Crohn disease location at diagnosis was: small bowel and colon (71%), colon only (10%) and small bowel only (19%). Location of initial ulcerative colitis was: proctitis (11%), left colitis (57%) and pancolitis (32%). Although ulcerative colitis incidence remained stable (0.8), Crohn disease incidence increased from 2.1 in 1988 to 1990 to 2.6 in 1997 to 1999 (P = 0.2).

Conclusions: The incidence of Crohn disease in the children of northern France showed an increasing trend (20%; not significant) during the 12-year period while the incidence of ulcerative colitis remained stable. In the entire population(children and adults)the incidence of Crohn disease increased significantly (+23%; P < 0.001), while the incidence of ulcerative colitis decreased (−17%; P < 0.0001).

Author Information

*Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, †Department of Epidemiology and Public Health, and ‡Department of Gastroenterology, Lille University Hospital, Lille, France; §Department of Epidemiology and Public Health, and ∥Department of Gastroenterology, Rouen University Hospital, Rouen, France; and ¶Department of Gastroenterology, Amiens University Hospital, Amiens, France

Received March 1, 2004; accepted March 3, 2005.

EPIMAD is organized under an agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Direction Générale de la Santé (DGS) and the Institut National de Veille Sanitaire (InVS), and is also supported by the François Aupetit Association, the Ferring Laboratories, IRMAD (ASTRA Company), the Observatoire Régional de la Santé du Nord - Pas-de-Calais, the Caisse Régionale d'Assurance Maladie de Nord Picardie and the Lille University Hospital.

Address correspondence and reprint requests to Dominique Turck, Unité de Gastro-entérologie, Hépatologie et Nutrition, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, 2, Avenue Oscar Lambret, 59037 Lille cedex, France. (e-mail: dturck@chru-lille.fr).

© 2005 Lippincott Williams & Wilkins, Inc.