Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2024; 30(9): 1154-1163
Published online Mar 7, 2024. doi: 10.3748/wjg.v30.i9.1154
Recent trends in the epidemiology and clinical outcomes of inflammatory bowel disease in South Korea, 2010-2018
Seulji Kim, Hyun Jung Lee, Seung Woo Lee, Sanghyun Park, Seong-Joon Koh, Jong Pil Im, Byeong Gwan Kim, Kyung-Do Han, Joo Sung Kim
Seulji Kim, Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul 01812, South Korea
Hyun Jung Lee, Seong-Joon Koh, Jong Pil Im, Byeong Gwan Kim, Joo Sung Kim, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
Seung Woo Lee, Sanghyun Park, Kyung-Do Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Co-first authors: Seulji Kim and Hyun Jung Lee.
Co-corresponding authors: Joo Sung Kim and Kyung-Do Han.
Author contributions: Kim S, Lee HJ, Kim JS and Han KD designed the study; Lee SW and Park S collected the data; Kim S, Lee HJ and Han KD analyzed the data; Kim S, Lee HJ, and Kim JS were involved in the interpretation of the result of analyzed data; Kim S and Lee HJ wrote the original draft of the manuscript; all authors participated in the critical review of the results, reading and editing the manuscript, and approving the final manuscript. Kim S and Lee HJ equally contributed to this study as co-first authors. This study was conducted through collaboration based on teamwork, and Kim S and Lee HJ contributed equally throughout the research process to refine and enhance the quality of the study. Therefore, we believe it is appropriate to designate Kim S and Lee HJ as co-first authors. In addition, Kim JS and Han KD are experts in different fields of clinical gastroenterology and statistical analysis, respectively, and equally made an effort to contributed to making the research topic more in-depth and multifaceted. Therefore, designating Kim JS and Han KD as co-corresponding authors reflects our team’s collaboration and various research perspectives.
Supported by National Research Foundation of Korea, No. RS-2023-00227939.
Institutional review board statement: The study was reviewed and approved by the Seoul National University Hospital Institutional Review Board (Seoul, Korea).
Informed consent statement: All personal information was encrypted and all data were anonymous. Therefore, informed consent of all study subjects is waived.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joo Sung Kim, MD, PhD, Professor, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, No. 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea. jooskim@snu.ac.kr
Received: November 11, 2023
Peer-review started: November 11, 2023
First decision: December 15, 2023
Revised: December 23, 2023
Accepted: February 8, 2024
Article in press: February 8, 2024
Published online: March 7, 2024
Processing time: 115 Days and 16.9 Hours
Abstract
BACKGROUND

Inflammatory bowel disease (IBD) was previously regarded as a Western disease; however, its incidence is increasing in the East. The epidemiology of IBD in Asia differs significantly from the patterns in the West.

AIM

To comprehensively investigate the epidemiology of IBD in South Korea, including its incidence, prevalence, medication trends, and outcomes.

METHODS

We analyzed claims data from the Health Insurance Review and Assessment Service and Rare and Intractable Diseases (RIDs), operated by the National Health Insurance Service of South Korea. Patients with IBD were identified based on the International Classification of Diseases, Tenth Revision, and RID diagnostic codes for Crohn’s disease (CD) and ulcerative colitis (UC) from 2010 to 2018.

RESULTS

In total, 14498 and 31409 patients were newly diagnosed with CD and UC, respectively, between 2010 and 2018. The annual average incidence of CD was 3.11 cases per 105 person-years, and that of UC was 6.74 cases per 105 person-years. Since 2014, the incidence rate of CD has been stable, while that of UC has steadily increased, shifting the peak age group from 50-year-olds in 2010 to 20-year-olds in 2018. The CD and UC prevalence increased consistently over the study period; the use of 5-aminosalicylates and corticosteroids gradually decreased, while that of immunomodulators and biologics steadily increased in both CD and UC. The clinical outcomes of IBD, such as hospitalization and surgery, decreased during the study period.

CONCLUSION

The CD incidence has been stable since 2014, but that of UC has increased with a shift to a younger age at peak incidence between 2010 and 2018. IBD clinical outcomes improved over time, with increased use of immunomodulators and biologics.

Keywords: Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Incidence; Prevalence

Core Tip: Inflammatory bowel disease (IBD) was previously regarded as a Western disease; however, its incidence is increasing in the East, with a different epidemiological pattern. This nationwide cohort study analyzed claims data from South Korea between 2010 and 2018. The incidence of ulcerative colitis increased continuously, particularly among younger demographic groups, during this period, whereas the incidence of Crohn’s disease remained stable from 2014. Additionally, in this period, hospitalization and surgery rates for IBD decreased as the use of immunomodulators and biologics increased.