Epidemiology of Crohn's disease in Québec, Canada

Authors

  • Anne-Marie Lowe MSc,

    1. Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
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  • Pierre-Olivier Roy MD, MSc,

    1. Groupe de recherche en épidémiologie des zoonoses et sante publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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  • Michel B.-Poulin DVM, PhD,

    1. Groupe de recherche en épidémiologie des zoonoses et sante publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
    2. Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
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  • Pascal Michel DVM, PhD,

    1. Groupe de recherche en épidémiologie des zoonoses et sante publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
    2. Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
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  • Alain Bitton MD,

    1. Faculty of Medicine, Division of Gastroenterology, McGill University Health Center (MUHC), Montréal, Québec, Canada
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  • Laurie St-Onge MSc,

    1. Groupe de recherche en épidémiologie des zoonoses et sante publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
    2. Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
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  • Paul Brassard MD, MSc

    Corresponding author
    1. Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
    2. Faculty of Medicine, Division of Clinical Epidemiology, McGill University Health Center (MUHC), Montréal, Québec, Canada
    • Division of Clinical Epidemiology, McGill University Health Center (MUHC), Royal-Victoria Hospital, 687 Pine Ave. West, R4-29, Montréal, Québec, Canada, H3A 1A1
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Abstract

Background: Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD). We aimed to determine the prevalence and incidence of CD in Québec and characterize the demographic and health-related factors associated with this disease.

Methods: We identified CD cases in the provincial administrative databases for the years 1993–2002. The CD prevalence and incidence rates were estimated respectively for the periods 1993–2002 and 1998–2000. We validated the identified cases using clinically confirmed IBD cases. Predictor variables of CD were analyzed using the Poisson regression model to explain the variation in CD incidence rates across Québec.

Results: In all, 21,172 patients fulfilled the CD case definition for the period. The age and sex standardized average prevalence rate for 1993–2002 was 189.7 cases / 100,000 population and the age and sex standardized incidence rate of CD for the 1998–2000 period was 20.2 cases / 100,000 person-years. The female/male cases ratio among incident cases was 0.74 for the 0–14-year-old group, 1.30 for the 15–64-year-old group, and 1.77 for the cases older than 65 years old. After adjustment, independent predictors of CD incidence were: incidence of 5 reportable enteric diseases, proportion of individuals of Jewish ethnicity, and proportion of immigrant people.

Conclusions: The identified predictors of CD explained 20% of the regional variance in the incidence rate of CD in the Québec population. Other factors such as genetic susceptibility to CD or the effect of an environmental cause should be taken into consideration in the models to explain the residual variance.

(Inflamm Bowel Dis 2008)

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