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Keywords:

  • colonoscopy;
  • Crohn's disease;
  • epidemiology of inflammatory bowel disease;
  • ethnic variation;
  • geographic variation;
  • practice patterns;
  • ulcerative colitis

Abstract

Background:

The aim was too describe the demographic characteristics of patients with inflammatory bowel disease (IBD) undergoing colonoscopy.

Methods:

The Clinical Outcomes Research Initiative (CORI) maintains a database of endoscopic procedures in diverse clinical practices distributed throughout the US. The data from 2000–2007 were used to analyze the demographic characteristics of patients with Crohn's disease (CD) and ulcerative colitis (UC).

Results:

During the period 2000–2007, 4631 patients with CD and 6619 patients with UC were compared to a control population of 826,207 patients without IBD. CD and UC patients were significantly (P < 0.0001) younger than controls: 41.7 ± 18.4, 47.3 ± 17.4, 59.2 ± 14.0 years, respectively. CD and UC were less common among nonwhite than white endoscopy patients: odds ratio (OR) = 0.64 (0.58–0.70) for CD and OR = 0.71 (0.66–0.77) for UC. Endoscopy for IBD was only slightly less common among female than male CD patients (0.94, 0.89–1.00), but significantly less common among female than male UC patients (0.72, 0.68–0.75). Compared with community/private practices, relatively more endoscopies were performed among IBD patients in academic institutions: OR = 1.68 (1.56–1.81) for CD and OR = 1.27 (1.19–1.36) for UC. The race-, sex-, and age-adjusted rates of CD and UC were both significantly higher in the northern than southern regions of the US, with a significant correlation of r = 0.89, degrees of freedom = 4, P = 0.017 between the geographic distributions of the two diagnoses.

Conclusions:

The endoscopy patterns of IBD patients may be influenced in part by the epidemiology of these two diagnoses, as well as by underlying trends in the utilization of colonoscopy. (Inflamm Bowel Dis 2011;)