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Inflammatory Bowel Disease Prevalence by Age, Gender, Race, and Geographic Location in the U.S. Military Health Care Population

Betteridge, John D. MD; Armbruster, Steven P. MD; Maydonovitch, Corinne BS; Veerappan, Ganesh R. MD

doi: 10.1097/MIB.0b013e318281334d
Original Clinical Article

Background: There is limited data examining the prevalence of inflammatory bowel disease (IBD) in a diverse North American population.

Methods: Using International Classification of Diseases, Ninth Revision codes, patients with Crohn's disease (CD) and ulcerative colitis (UC) seen within the military health care system (Tricare) from October 1, 2008 to September 30, 2009 were identified. This database comprised all active duty military, retirees, and dependents. The overall prevalence of IBD, UC, and CD was calculated, and the prevalence by age, gender, race, and geographic location.

Results: A total of 35,404 cases of IBD were identified in 10.2 million military health care beneficiaries establishing a prevalence of total IBD, UC, and CD of 348, 202, and 146 per 100,000, respectively. IBD was more prevalent in females compared with males (417 versus 284 per 100,000; relative risk, 1.53; 95% confidence interval, 1.50–1.57). There was an increased prevalence of IBD with each decade of life. IBD was more common in Caucasians (324 per 100,000) compared with blacks, Asians, Hispanics, and American Indians (239, 162, 147, and 224 per 100,000, respectively; relative risk, 1.60; 95% confidence interval, 1.53–1.67). There was no difference in prevalence when comparing Northern versus Southern states (339 versus 333 per 100,000, respectively, P = 0.114).

Conclusions: This large population study establishes a prevalence of IBD, UC, and CD (348, 202, and 146 per 100,000, respectively) in the military health care population. The prevalence of IBD, UC, and CD was higher in females and with increasing age, whereas IBD was most common in whites compared with other ethnicities in our patient population.

Article first published online 20 March 2013

Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland.

Reprints: John D. Betteridge, MD, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 (e-mail:

The authors have no conflicts of interest to disclose.

Disclosure: The opinions are solely those of the authors and do not represent an endorsement by the Department of Defense. This is a U.S. Government work. There are no restrictions on its use.

The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Army, Department of the Navy, Department of Defense, or the U.S. Government.

Received August 14, 2012

Accepted September 9, 2012

© Crohn's & Colitis Foundation of America, Inc.
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