Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review

M. Ellen Kuenzig, Stephen G. Fung, Luba Marderfeld, Joyce W.y. Mak, Gilaad G. Kaplan, Siew C. Ng, David C. Wilson, Fiona Cameron, Paul Henderson, Paulo G. Kotze, Jasmine Bhatti, Vixey Fang, Samantha Gerber, Evelyne Guay, Supun Kotteduwa Jayawarden, Leo Kadota, Fernando Maldonado D., Jessica Amankwah Osei, Ryan Sandarage, Amanda StantonMelissa Wan, Eric I. Benchimol, Jasmine Bhatti, Samantha Gerber, Evelyne Guay, Supun K. Jayawarden, Leo Kadota, Fernando Maldonado, Emma Maltus, Shoumak Bhattacharya, Jessica Osei, Ryan Sandarage, Amanda Stanton, Melissa Wan

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background & aims: The incidence of inflammatory bowel disease (IBD) is increasing internationally, particularly in nations with historically low rates. Previous reports of the epidemiology of pediatric-onset IBD identified a paucity of data. We systematically reviewed the global trends in incidence and prevalence of IBD diagnosed in individuals <21 years old over the first 2 decades of the 21st century.

Methods: We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from January 2010 to February 2020 to identify population-based studies reporting the incidence and/or prevalence of IBD, Crohn's disease, ulcerative colitis, and/or IBD-unclassified. Data from studies published before 2000 were derived from a previously published systematic review. We described the geographic distribution and trends in children of all ages and limiting to very early onset (VEO) IBD.

Results: A total of 131 studies from 48 countries were included. The incidence and prevalence of pediatric-onset IBD is highest in Northern Europe and North America and lowest in Southern Europe, Asia, and the Middle East. Among studies evaluating trends over time, most (31 of 37, 84%) studies reported significant increases in incidence and all (7 of 7) reported significant increases in prevalence. Data on the incidence and prevalence of VEO-IBD are limited to countries with historically high rates of IBD. Time trends in the incidence of VEO-IBD were visually heterogeneous.

Conclusions: Rates of pediatric-onset IBD continue to rise around the world and data are emerging from regions where it was not previously reported; however, there remains a paucity of data on VEO-IBD and on pediatric IBD from developing and recently developed countries.
Original languageEnglish
Pages (from-to)1147-1159.e4
Issue number4
Publication statusPublished - 4 Jan 2022


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