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EPIDEMIOLOGY


The gender distribution also mirrored the results from the other provinces, with a female: male ratio of 1.30 for the 15 to 64 age group for IBD.


The Ontario Crohn’s and Colitis Cohort


In 2009, a case definition was validated in Ontario to identify children diagnosed with IBD within Ontario’s health databases. This resulted in the Ontario Crohn’s and Colitis Cohort (OCCC) - housed and updated annually by the Institute for Clinical Evaluative Sciences. The OCCC tracks childhood-onset IBD in Ontario from 1991onward. This resulted in the landmark pediatric study showed rising incidence of IBD in children.35


At present, the OCCC is being


expanded to include patients with adult-onset IBD, creating one of the largest surveillance programs for IBD in the world. This research is ongoing, and will contribute to future iterations of this Impact of IBD report. It is important to continue research using population-based health administrative and clinical databases across all provinces, in order to have a more robust estimate of IBD epidemiology and impact.


Estimated Current Prevalence


The current prevalence of IBD in Canada can be estimated using either or both sets of prevalence results. The survey was more likely to over-estimate the total number of people with IBD because of imprecise understanding of medical questions in the general public, but it included all regions of Canada. The database study was more likely to be accurate for the provinces that contributed data, but it was missing some provinces.


To estimate the current number of Canadians with IBD, the database studies were extended to all remaining provinces and territories using the Canadian average (excluding BC). Over time, there was an increase in the population of Canada, which would increase the number of people with IBD. More importantly, every year there are new cases diagnosed (see Section 3.3). The new cases have to be added to the existing group of people with IBD to calculate a current estimate. On the other hand, there are also losses due to migration and death, and these cases need to be subtracted.*


In 2012, there are predicted to be 129,000 Canadians with CD and 104,000 Canadians with UC, for a total of 233,000 people (0.67% of the population). The results are depicted for each province in Figure 3.


(Note: total incidence for IBD was 29 new cases per year per 100,000 but ‘net’ incidence – new cases minus deaths and migration – was 17).


*


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 32


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