Current global trends in the incidence of pediatric-onset inflammatory bowel disease

Table 1 Summary of included pediatric-onset inflammatory bowel disease incidence studies stratified by continent and geographical areas

Country/Region/Province	Age (yr)	Study period	IBD incidence	CD incidence	UC incidence	IBDU incidence	Setting	Year of publication	First author /reference	Representativeness of the case
Western and North Europe
Austria/Styria	< 18	1997-2007		6.7 a	4.8a		R	2013	Petritsch W et al[122]	B
Denmark/Eastern	< 15	1998-2000	4.3.	2.3.	1.8.	0.2	R	2002	Urne et al[108]	B
Denmark	< 17	1995-2013					P	2016	Larsen et al[109]	A
		2013		9.7a	6.7a
Denmark/Eastern	< 15	1998-2009	6.4a	3.2a,b	3.1a,b	0.2a	R	2011	Jakobsen et al[110]	B
Denmark	< 15	1995-2012		3.1a	2.7a		P	2014	Norgard et al[111]	A
Denmark/Eastern	< 15	1998-2000	4.3a	2.3a	1.8a	0.2a	P	2008	Jakobsen et al[33]	B
		2002-2004	6.1	3.1	2.7	0.3
Denmark	< 15	1980-2013		2.4a	3.3a		P	2017	Lophaven et al[103]	A
Denmark/Copenhagen County	< 19	1962-1987			8.6-13.3a		P	1991	Langholz et al[106]	B
Denmark/Copenhagen County	< 14	1962-1987	2.2a	0.2a	2.0a		P	1997	Langholz et al[105]	B
Denmark/Copenhagen County	< 14	1962-1987			0.2		R	1992	Munkholm et al[62]	B
Denmark/Copenhagen County	< 15	1962-1987		0.2-3.1a	2 - 1.6a		P	2009	Jakobsen et al[34]	B
Denmark	< 15	1981-1992		0.8a	2.5a		P	1997	Fonager et al[107]	A
Denmark/Northern	< 14	1978-2002		1.5	2.7		P	2006	Jacobsen et al[104]	B
Denmark/Copenhagen County	< 17	2003-2005		4.4	5.5		P	2006	Vind et al[102]	B
Finland	< 18	1987-2003	5a	2a	4a		P	2011	Lehtinen et al[65]	A
		2003	15	5	9.1
Finland	< 17	1987-2003					P	2006	Turunen et al[64]	A
		1987	3.9a	1.7a	2.2a
		2003	7	3.6	4.8	1
Finland	< 17	1986-1992		1.0a			R	1998	Pebody et al[88]	A
Finland	< 18	1987-2003	6.5	2.1	4.1		P	2016	Lehtinen et al[89]	A
Finland	< 19	1987-2014	7-23a	6-8a	10-15a		R	2017	Virta et al[66]	A
	< 16	2011-2014	13		8
France	< 17	1988-2011	3.1-6.3a				P	2016	Bequet et al[126]	A
France/Northern	< 17	1998-1999	3.1a	2.3a	0.8a	0.12a	P	2005	Auvin et al[43]	B
France/Northern	< 17	1988-2011	4.4a	3.2a	1.1a	0.1a	P	2017	Ghione et al[131]	B
France/Brittany	< 17	1994-1997	2.5	1.6	0.57		P	2000	Tourtelier et al[131]	B
France/Northern	< 19	1988-2007		3.4-5.9a			P	2011	Chouraki et al[32]	B
France/Northern	< 17	1988-2002		2.6			P	2008	Vernier-Massouille et al[127]	B
France/Northern	< 19	1988-2008		6.5-12.9a			P	2013	Gower-Rousseau et al[125]	B
France/Corsica	< 19	2002-2003		12.3	6.2		P	2007	Abakar-Mahamat et al[128]	B
France/Nord-Pas-de-Calais	< 17	1988-1989	3.1	2.1	0.5		P	1991	Gottrand et al[130]	B
The Farose Islands	< 19	1960-2014	9.02a	2.52a	52a	1.52a	P,R	2016	Hammer et al[19]	A
Iceland	< 16	1950-2010					P,R	2013	Agnarsson et al[29]	A
		1951-1960	1.2	0.2	1.1
		1961-1970	0.9	0.1	0.7
		1971-1980	0.9	0.1	0.7
		1981-1990	2.5a	1.2a	1.2a	0.1a
		1991-2000/2001-2010	5.6/5.0	2.5/2.3	2.5/2.3	0.3/0.3
Iceland	< 19	1990-1994		4.5	5		P	2000	Bjornsson et al[112]	A
Ireland	< 16	2000-2010	2.5-5.6a	2.3a	1.1a		R	2012	Hope et al[120]	A
Ireland	< 10	2000-2014	0.8-3.3a				P,R	2017	Coughlan et al[121]	A
The Netherlands	< 18	1999-2001	5.2	2.1	1.6	3.6	P	2004	van der Zaag-Loonen et al[124]	A
Germany/Southern	< 15	2004-2006	4.0a	2.4a	1.1a		P	2008	Ott et al[123]	B
Norway/Southeastern	< 16	1990-1994	4.2	2	2.1		P	2002	Bentsen et al[85]	B
Norway/Southeastern	< 14	1990-1993			1.3		P	1996	Moum et al[95]	B
Norway/Southeastern	< 16	1990-1993	4.7	2.7	2		P	2004	Stordal et al[93]	B
Norway/Southeastern	< 18	2005-2007	10.9b	6.8b	3.6b	0.6	P	2009	Perminow et al[92]	B
Norway/Southeastern	< 16	1993-2004	5.6-5.7a	2.0-3.6a	3.7-2.1a		P,R	2006	Perminow et al[60]	B
Norway/Western	< 16	1984-1985	6.8	2.5	4.3	0	P	1989	Olafsdottir et al[97]	B
Norway/Western	< 14	1984-1985		2.5			P	1988	Haug et al[163]	B
Norway/Souteastern	< 14	1990	3	1.2	0.6		P	1995	Moum et al[94]	B
Norway/Southeastern	< 14	1990-1993		0.94			P	1996	Moum et al[96]	B
Sweden/Northern Stockholm	< 17	1990-1998	6.9a	3.8a	2.1a	1.1a	R	1999	Askling et al[99]	B
Sweden/Northern Stockholm	< 15	1990-2001	7.4a	4.9a	2.2a	0.2a	P	2003	Hildebrand et al[59]	B
Sweden/Soutwestern	< 16	1983-1987	5.3	2.7	2.6	0.7	P	1994	Hildebrand et al[164]	B
Sweden/Stockholm	< 15	2002-2007	12.8a,b	9.2a,b	2.8a,b		P	2013	Malmborg et al[38]	B
Sweden	< 15	1984-1995	4.6-7.0a	1.2-1.3a	1.4-3.2a	1.1a	P	2000	Lindberg et al[68]	A
Sweden	< 14	1963-1967		1.4 - 0.7a			R	1991	Lindberg et al[98]	A
		1983-1987		0.7
Sweden/the Uppsala region	< 17	2005-2009	18.9		8.9		P	2013	Sjoberg et al[100]	B
Sweden/the Uppsala region	< 17	2005-2009		10			P	2014	Sjoberg et al[101]	B
Sweden/the Uppsala region	< 19	1965-1983					R	1991	Ekbom et al[56]	B
		1965-1970		5.9-5.0a	5.2-4.8a
		1975-1983		4.8-3.2	3.9-2.7
Sweden/Orebro	< 19	1963-1987			6		R	1992	Tysk et al[165]	B
Sweden/Stockholm County	< 14	1955-1983		4.1			R	1997	Lapidus et al[35]	B
Sweden	< 15	1984-1985	4.8	1.7	1.7		P	1991	Hildebrand et al[166]	A
UK/ Scotland	< 16	2003-2008	7.8a	4.8a	2.1a	1.0a	P,R	2012	Henderson et al[2]	A
		1990-1995	4.5	2.9	1.6
UK/Wesex Southern England	< 16	2002-2012/2013-2017						2014, 2018	Ashton et al Ashton et al[116,117]	B
		2002-2006	6.4a,b	3.8a,b	2.0a,b		P
		2008-2012	9.4	5.9	2.6
UK/Scotland	< 16	1981-1995	3.4	2.3a	1.2a		R	2004	Armitage et al[114]	A
UK/Wales	< 16	1996-2003	5.4	3.6	1.5		P	2006	Ahmed et al[30]	B
UK/Wales	< 16	1995-1997	2.6	1.4	0.8	0.5	P	2000	Hassan et al[118]	B
UK/Wales	< 16	1981-1995		2.5a	1.3a		R	2001	Armitage et al[53]	B
UK/Northeastern Scotland	< 16	1980-1999
		1980-1989		2.2	0.7		R	2002	Watson et al[115]	B
		1990-1999		4.4	1.5
UK/Scotland	< 16	1968-1983		0.7-2.3a	1.9-1.6a		R	1989	Barton et al[61]	A
UK/Cardiff	< 16	1996-2005		2.7			R	2007	Gunesh et al[119]	B
UK/Leicestershire	< 10	1972-1989			0.3a,d		R	1992	Probert et al[27]	B
UK/Wales South Glamorgan	< 16	1983-1993		2.2a	0.7a		R	1996	Cosgrove et al[57]	B
		1983-1988		1.3	0.7
		1989-1993		3.1	0.7
UK/British Isles and Ireland	< 16	1998-1999	5.3a,d	3.1a,d	1.4a,d	0.6d	P	2001	Sawczenko et al[16]	A
UK/Scotland	< 19	1990-1992		2.9a			R	1999	Armitage et al[113]	A
UK/East London	< 20	1997-2001		2.3-7.3a,d	2.4-8.1a,d		R	2004	Tsironi et al[17]
Northern America
Canada/Manitoba	< 17	1978-2007	6.9a	1.2-4.7a	0.5-1.6a		P	2014	El-Matary et[79]	B
Canada/Metropolitan Toronto	< 17	1991-1996		3.7	2.7		R	2004	Griffiths[82]	B
Canada/ 5 Provinces	< 16	1999-2010	9.7a	6.5a	2.4a		R	2017	Benchimol et al[31]	A
Alberta			9.7	5.9	2.7
Manitoba			7.2	4.2	2.8
Nova Scotia			15.2	9.3	4.2
Ontario			9.3	5.5	3.2
Quebec			10.3	8.8	1
Canada/Suothwestern Ontario	< 17	1997-2006	13.3a	4.9a	8.1a	0.3a	R	2009	Grieci et al[81]	B
		1997-2001	14.3	3.5	10.6	0.2
		2002-2006	12.4	6	6	0.4
Canada/Ontario	< 18	1994-2005					P	2009	Benchimol et al[54]	B
		1994	9.5a	6.2a	4.4a
		2005	11.4	7	4.8
Canada/Ontario	< 19	1999-2008					P	2014	Benchimol et al[84]	B
	0-9		2.9a	1.3a	1.3a	0.3
	10-19		21.5	12.8	7.6	1.1
Canada/British Columbia	< 16	1985-2005	5.2d	3.7d	1.0d	0.5d	R	2007	Pinsk et al[18]	B
			15.2	6.4	6.7	2.1
Canada/Ontario	< 18	1994-2009	9.4-13.2a	5.2-7.9a	3.9-4.1a		R	2014	Benchimol et al[84]	B
Canada/Eastern	< 20	1996-2009		14-11a2c	4-6a2c	0-1.5a2c	P	2014	Leddin et al[83]	B
Canada/Quebec	< 19	2001-2008					R	2014	Bitton et al[78]	B
	0-9			2.0a	1.0a
	10-19			20	4
Canada/ 5 Provinces	< 19	1998-2000					P	2006	Bernstein et al[39]	A
Alberta				9.4a	4.1a
British Columbia				5.4	3.2
Manitoba				6.9	4.5
Nova Scotia				12	5.7
Saskatchewan				7.9	4.2
Canada/Qubec	< 19	1993-2002		13.9			P	2009	Lowe et al[80]	B
U.S.A./Northern Carolina	< 17	1996-2006		2.2-4.3a,d	1.8-4.9a,d	0.5d	R	2010	Abramson et al[20]	B
U.S.A/Wisconsin	< 18	2000-2001	7.05d	4.6d	2.1d		P	2003	Kugathasan et al[21]	B
U.S.A/Wisconsin	< 18	2000-2007	9.5a,d	6.6a,d	2.4a,d	0.5a,d	P,R	2013	Adamiak et al[22]	B
U.S.A/Georgia	< 19	1986-1995		8.8a,d	5.3a,d		R	1998	Ogunbi et al[23]	B
U.S.A/Texas	< 17	1991-2002					R	2010	Malaty et al[52]	B
		1991-1996	1.1a	0.7a	0.3a	0.1a
		1997-2002	2.4	1.3	0.5	0.7
U.S.A/Olmstedt Minesota	< 19	1940-2000		3.4a	2.4a		R	2007	Loftus et al[58]	B
		1990-2000		4.8	3.2
U.S.A/Olmstedt Minesota	< 14	1943-1982		0.75a			R	1988	Gollop et al[167]	B
U.S.A/Olmstedt Minesota	< 19	1940-1993		2.5a			R	1998	Loftus et al[36]	B
U.S.A/Northern California	< 18	1996-2002		3	2.9		R	2008	Herrinton et al[76]	B
U.S.A/Olmstedt Minesota	< 19	1940-1993			1.8		R	2000	Loftus et al[168]	B
U.S.A/Rhode Island	< 19	2008-2010					P	2016	Shapiro et al[77]	B
	0-9			4.5a	1.1a	0.0a
	10-19			20.6	8.6	0.7
Latin America
Argentina/Provinces	< 18	2012-2013
Argentina			0.4				P	2017	Vincentin et al[87]	A
Buenos Aires			0.3
CABA			2.4
Chaco			0.3
Cordoba			0.3
Corrientes			0.6
Entre Rios			0.8
Mendoza			0.2
Misiones			0.9
San Juan			1
Tucana			0.2
Africa
Libya/Eastern/Benghazi	< 15	1997-2006					R	2009	Ahmaida et al[146]	B
		1997	0.0a
		2000	0.2
		2006	0.9
Asia /Middle East
Saudi Arabia	< 14	2003-2012	0.5	0.3	0.2		R	2014	El Mouzan et al[149]	A
Saudi Arabia/Riyadh	< 18	1993-2002	0.5				R	2006	El Mouzan et al[150]	B
Kuwait	< 15	1998-2008	2.2	1.5	0.6	0.03	R	2011	Al-Quabandi[151]	A
Israel/Tel Aviv	< 19	1970-1980			1		P	1989	Grossman et al[148]	B
Israel/Southeastern	< 19	1968-1992		3.6			R	1994	Odes et al[147]	B
the Kingdom of Bahrain	< 19	1990-2015		3.7a			P,R	2017	Zayyani et al[152]	A
		1990-1995		1.8
		2010-2015		7.6
Taiwan	< 18	1979-2000					R	2004	Tsai et al[154]	A
		1979-1995		0.9a	0.9a
		1996-2000		2.6	1
Singapore	< 18	1996-2009					R	2013	Chu et al[155]	A
		2000	2.2a
		2008	11.4
Taiwan	< 19	2000-2010					R	2015	Chia Jung Kuo et al[169]	A
	0-9			0.1a	0.1a
	10-19			0.2	0.2
Korea/South	< 19	2011-2014						2017	Jung et al[157]	B
	10-14			1.62	2.02		P
	15-19			8.22	4.82
China/Shangahai	< 18	2000-2010	5.5a	2.9a	2.5a		R	2013	Wang et al[153]	B
Korea/Seoul	< 19	1986-1997					R	2000	Yang et al[156]	B
	0-9	1986-1995/1995-1997			0-0.2
Australasia	10-19	1986 -1995/1995-1997			0.2-0.9
Australia/Randwick	< 16	1987-2011	33.1-4.3d				R	2014	Naidoo et al[24]	B
Australia/Victoria	< 16	1971-2001		0.1-2.0a			R	2003	Phavichitr et al[158]	B
Australia/Victoria	< 16	1983-1998		2.0a			R	2009	Ponsonby et al[37]	B
Australia/Victoria	< 16	1950-2009			0.4-1.6a		R	2013	Schildkraut et al[159]	B
New Zealand	< 16	2015	5.2	3.5	1	0.7	P	2017	Lopez et al[160]	A
New Zealand/Canterburry	< 16	1996-2015	7.2a				P	2018	Lopez et al[161]	B
New Zealand	< 15	2002-2003	2.9d	1.9d	0.5d		P	2008	Yap et al[26]	A
Sousthern Europe
Italy/Florence	< 15	1978-1992		1.9-3.4a	3.8-9.6a		R	1996	Trallori et al[136]	B
Italy/Lazio	< 19	2008-2009					R	2014	Domenicantonio et al[135]	B
	0-9			2.5	2
	10-19			8.72	7.52
Italy	< 18	1996-2003	0.9-1.4a				P	2008	Castro et al[63]	A
Italy/Lombardia	< 14	1990-1993		1.2	1.2			1996	Ranzi et al[134]	B
Spain	< 18	1996-2009	1.0-2.8a,b	0.5-1.7a,b	0.4-0.9a,b		R	2013	Martin de Carpi et al[42]	A
Spain/the Vigo area	< 15	2010	18.3	10.3	8.7	1.2	P	2015	Fernandéz et al[50]	B
Spain/Navarra	< 14	2001-2003	2.6	1.7	0.9	0.6	P	2008	Letamendia et al[137]	B
Spain	< 18	1985-1995	0.2a1				R	2014	Martin de Carpi et al[51]	A
Spain/Asturias	< 14	1993-2000	0.3	0.2	0.1		P,R	2004	Fernandez Gonzalez[170]	B
Spain/Northern	< 14	2000-2002		5.8	1.6		P	2004	Rodrigo et al[44]	B
Spain/Aragon	< 14	1992-1995		0.4a	0.3a		P	1999	Lopez Miguel et al[171]	B
Malta	< 15	1993-2005		1.3a	7.9a		R	2008	Cachia et al[138]	A
Central and Eastern Europe
Croatia/Primorsko-Goranska	< 18	2000-2004		8.7	0.9		P	2006	Sincic et al[47]	B
Czech Republic/Moravia	< 16	1998-2001	2.2a	2.7a	1.8a	0.3a	R	2004	Kolek et al[140]	B
Czech Republic	< 15	1990-2001		0.3-.1.3a			P,R	2006	Pozler et al[139]	A
Czech Republic/West Bohemia	< 19	2000-2015	10.0a	6.2a	2.8a	1.0a	P	2017	Schwarz et al[45]	B
	< 15		7.3	4.6	2	0.7	P
Hungary	< 16	2007-2009	7.5	4.7	2.3	0.5	P	2013	Muller et al[141]	A
Hungary/Veszprem	< 19	1977-2011		0.0-7.2a	0.7-5.2a		P,R	2014	Lovasz et al[46]	B
Slovenia/Northestern	< 18	2002-2010	7.6	4.6	2.8		R	2014	Urlep et al[49]	B
		2002-2004	5.7	3.9	1.8
		2008-2010	8.9	5	3.4
Slovenia	< 18	2002-2010	7.6a,b	4.5a,b	2.9a,b	0.2a,b	R	2015	Urlep et al[48]	A
		2002-2004	5.8	3.6	2.2
		2005-2007	8.6	5.1	3.2
		2008-2010	8.4	4.9	3.2
Slovenia/Western	< 17	1994-2005	4.0a	2.4a	1.1a	0.5a	R	2009	Orel et al[143]	B
		1994-1999	3	2	0.8	0.3
		2000-2005	5.1	2.9	1.6	0.69
Yugoslavia/Zagreb Croatia	< 14	1980-1989		1.76			P,R	1991	Vucelic et al[145]	B
Yugoslavia/Zagreb Croatia	< 14	1980-1989			3.1		P,R	1991	Vucelic et al[144]	B
Poland	< 18	2002-2004	2.7	0.6	1.3	0.8	P	2009	Karolewska-Bochenek et al[67]	A
Hungary/Western	< 18	1977-2008		7.5a	5.5a		P	2011	Lakatos et al[142]	B

¹An approximate incidence rate at the beginning of the 25-year period based on the estimative population between the demographic census of 1981 and 1991;

²The incidence rates were extrapolated from Figures. Incidence: Incidence rates per 100000 person-years; P: Prospective; R: Retrospective; P,R: Prospective/retrospective; a: Statistical significant for time trend analysis (P < 0.05); b: Study incorporated previously published cohort for comparison from the same geographical area the rest of pediatric population; c: The only one study under the age of 20 years d: Studies on race, ethnicity and migration compared to the rest of pediatric population. IBD: Inflammatory bowel disease; CD: Crohn’s disease; UC: Ulcerative colitis; IBD-U: Inflammatory bowel disease-unclassified.