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First Prospective, Population-Based Inflammatory Bowel Disease Incidence Study in Mainland of China: The Emergence of “Western” Disease

Zhao, Jie MD1,2; Ng, Siew C. PhD3; Lei, Yuan MD4; Yi, Fengming MD4; Li, Jin MD1; Yu, Limin MD5; Zou, Kaifang MD6; Dan, Zili MD7; Dai, Meng MD2; Ding, Yijuan MD8; Song, Min MD9; Mei, Qingtao MD10; Fang, Xiangming MD11; Liu, Huimin MD12; Shi, Zhaohong MD13; Zhou, Rui MD1,3; Xia, Ming MD14; Wu, Qingming MD15; Xiong, Zhifan MD16; Zhu, Wencheng MD17; Deng, Langiong MD18; Kamm, Michael A. MD19,20; Xia, Bing MD1,3

doi: 10.1097/MIB.0b013e31828a6551
Original Clinical Articles

Background: Previously a disease of the West and rarely seen in China, inflammatory bowel disease (IBD) is now increasing in incidence in China. However, its true incidence is unknown. The incidence of IBD in Wuhan, a major city in central China, was investigated using population-based methods.

Methods: A prospective, population-based IBD incidence study was conducted between January 1, 2010, and December 31, 2010. New IBD cases were identified by gastroenterologists and from hospital case records in 17 central hospitals covering the health care service of central Wuhan. Cases were confirmed by follow-up and assessed by a specialist IBD group every 3 months. The population at risk was 6,085,556.

Results: Overall, 131 new cases of IBD were identified during the 1-year period, including 97 cases of ulcerative colitis (UC) and 34 cases of Crohn's disease (CD). The age-adjusted incidence for all IBD, UC, and CD were 1.96 per 100,000 (95% confidence interval [CI], 1.62–2.30 per 100,000), 1.45 (95% CI, 1.16–1.75), and 0.51 (95% CI, 0.33–0.68), respectively. CD affected the small bowel only in 15%, colon only in 24%, and ileocolonic in 61%. CD often presented with complicated phenotype: inflammatory (44%), stricturing (29%), and penetrating (24%). Among patients with UC, complications included proctitis (34.5%), left-sided colitis (44.6%), and extensive colitis (19.5%).

Conclusions: There is a substantial incidence of IBD in China. Although still lower than in the West, the emergence of IBD will necessitate specific health care planning and education and offers the possibility of identifying causative factors in a population with a rapidly increasing incidence.

Article first published online 10 May 2013Supplemental Digital Content is Available in the Text.

1Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China,

2Department of Oncology, Guangzhou Military Command Wuhan General Hospital, Wuhan, China,

3Department of Medicine & Therapeutics, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China,

4Hubei Clinical Center and Key Laboratory for Intestinal & Colorectal Diseases, Wuhan, China,

5Department of Gastroenterology, The Eighth Hospital of Wuhan, Wuhan, China,

6Department of Gastroenterology, Union Hospital of Huazhong Science & Technology University, Wuhan, China,

7Department of Gastroenterology, Tong Ji Hospital of Huazhong Science & Technology University, Wuhan, China,

8Department of Gastroenterology, Renming Hospital of Wuhan University, Wuhan, China,

9Department of Gastroenterology, The General Hospital of Wuhan, Wuhan, China,

10Department of Gastroenterology, WISCO General Hospital, Wuhan, China,

11Department of Gastroenterology, The Third Hospital of Wuhan, Wuhan, China,

12Department of Gastroenterology, The Fifth Hospital of Wuhan, Wuhan, China,

13Department of Gastroenterology, The First Hospital of Wuhan, Wuhan, China,

14Department of Gastroenterology, 161 Hospital, Wuhan, China,

15Department of Gastroenterology, Tianyou Hospital of Wuhan Scicence and Technology University, Wuhan, China,

16Department of Gastroenterology, Liyuan Hospital of Huazhong Science and Technology University, Wuhan, China,

17Department of Gastroenterology, Zhongshan Hospital of Hubei Province, Wuhan, China,

18Department of Gastroenterology, Hubei Traditional Chinese Medicine Hospital, Wuhan, China,

19Department of Gastroenterology, St Vincent's Hospital and University of Melbourne, Melbourne, Australia, and

20Imperial College London, London, United Kingdom.

Reprints: Bing Xia, MD, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, China (e-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Supported by grants from the Hubei Clinical Center and Key Laboratory of Intestinal & Colorectal Diseases (2008BCC002) and the Ministry of Public Health of China (200802156, 201002020). Database entry of Epicom and maintenance fee was sponsored by Xian Janssen Pharmaceutical Ltd, China.

J. Zhao and S.C. Ng have contributed equally.

The authors have no conflicts of interest to disclose.

Received November 22, 2012

Accepted January 29, 2013

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