Past, current, and future trends in the prevalence of primary sclerosing cholangitis and inflammatory bowel disease across England (2015–2027): a nationwide, population-based study

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2024-07-10 DOI:10.1016/j.lanepe.2024.101002

Hannah Crothers , James Ferguson , Mohammed Nabil Quraishi , Rachel Cooney , Tariq H. Iqbal , Palak J. Trivedi

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引用次数: 0

Abstract

Background

Primary sclerosing cholangitis (PSC) is one of the leading indications for liver transplantation in Europe, and a major risk factor for cancer in inflammatory bowel disease (IBD). However, it is not known how the epidemiology of PSC will change as that of IBD evolves. The aim of this study is to provide nationwide statistics on the past and current prevalence of PSC and IBD across England, and forecast how this is likely to change over time.

Methods

We accessed and analysed a nationwide population-based administrative healthcare registry, which houses prospectively accrued data since April 1st 2001. In so doing, the past and current prevalence of PSC-IBD and IBD alone was determined among 18–60-year-olds in England, alongside average annual percentage change rates (AAPC), between the 1st of January 2015 and 2020. Past and current prevalence data, alongside trends in incidence and event-free survival rates, were then used to forecast future prevalence between 2021 and 2027.

Findings

In 2015, the prevalence of PSC with prior IBD diagnosis was 5.0 per 100,000 population, rising to 5.7 when including those with IBD diagnosed after PSC. In 2020, prevalence increased to 7.6 (8.6 accounting for IBD developing after PSC), yielding an AAPC of 8.8. In 2027, PSC-IBD prevalence is forecast to be 11.7 (95% prediction interval [PI]: 10.8–12.7), and 13.3 when accounting for IBD developing after PSC (AAPC: 6.4; 95% PI: 5.3–7.5). Comparatively, the prevalence of IBD alone rose among 18–60-year-olds from 384.3 in 2015 to 538.7 in 2020 (AAPC 7.0), and forecast to increase to 742.5 by 2027 (95% PI: 736.4–748.0; AAPC: 4.7, 95% PI: 4.6–4.8).

Interpretation

The rate of growth in PSC-IBD is predicted to exceed IBD-alone. Further research is needed to understand changes in disease epidemiology, including aetiological drivers of developing (invariably progressive) liver disease in IBD, and the implications of rising case burden on health care resources.

Funding

This study was supported by an unrestricted grant provided by Gilead Sciences.

查看原文本刊更多论文

英格兰原发性硬化性胆管炎和炎症性肠病患病率的过去、现在和未来趋势（2015-2027 年）：一项基于人口的全国性研究

背景原发性硬化性胆管炎（PSC）是欧洲肝移植的主要适应症之一，也是炎症性肠病（IBD）致癌的主要危险因素。然而，随着 IBD 的发展，PSC 的流行病学将如何变化尚不得而知。本研究的目的是提供有关英格兰地区过去和现在PSC和IBD患病率的全国性统计数据，并预测随着时间的推移这种情况可能会发生怎样的变化。方法我们访问并分析了全国范围内以人口为基础的行政医疗登记，其中包含自2001年4月1日以来的前瞻性数据。在此过程中，我们确定了英格兰 18-60 岁人群过去和现在的 PSC-IBD 患病率，以及 2015 年 1 月 1 日至 2020 年期间的年均百分比变化率 (AAPC)。研究结果2015年，每10万人中有5.0人患有先天性脊髓空洞症并诊断出IBD，如果包括那些在患有先天性脊髓空洞症后诊断出IBD的人，患病率将上升到5.7人。到 2020 年，患病率将上升到 7.6（PSC 后确诊的 IBD 患者的患病率为 8.6），AAPC 为 8.8。2027 年，PSC-IBD 患病率预计为 11.7（95% 预测区间 [PI]：10.8-12.7），如果考虑 PSC 后发展的 IBD，则为 13.3（AAPC：6.4；95% PI：5.3-7.5）。相比之下，18-60 岁人群中单纯 IBD 患病率从 2015 年的 384.3 人上升至 2020 年的 538.7 人（AAPC：7.0），预计到 2027 年将上升至 742.5 人（95% PI：736.4-748.0；AAPC：4.7，95% PI：4.6-4.8）。需要进一步研究以了解疾病流行病学的变化，包括 IBD 肝病（无一例外均为进展性）的病因驱动因素，以及病例负担增加对医疗资源的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.

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