A Review of Pediatric to Adult Transition of Care in Inflammatory Bowel Disease

Canada is reported to have one of the highest rates of both incidence and prevalence of inflammatory bowel disease (IBD). Benchimol et al. conducted a population-based cohort study from 1999-2008 using health administrative data from Ontario, Canada, and reported that the prevalence of IBD in Canada in 2008 was 534.3 per 100,000 people (68,017 affected individuals among 12,738,350 Ontario residents). Between 1999 and 2008, the incidence of IBD increased annually in children under the age of 10 (9.7% per year, p<0.0001) and in those aged 10-19 (3.8% per year, p<0.0001). Coward et al. published a similar population based health administrative data study using data from eight provinces in Canada. In this study the national incidence of IBD was estimated to be 29.9 per 100,000 (95% PI 28.3-31.5) in 2023.ll The incidence of IBD in pediatric patients was found to be increasing (average annual percentage change (AAPC) 1.27%; 95% CI 0.82-1.67). The prevalence of IBD was 843 per 100,000 (95% PI 716-735) in 2023 with forecasted increases (AAPC 2.43%;95% CI 2.32-2.54). In pediatric patients the prevalence in 2023 was 82 (95% PI 77-88) and the forecasted AAPC was 1.91 (1.46-2.31). According to the 2023 Impact of IBD in Canada Report by Crohn’s and Colitis Canada, an estimated 322,600 Canadians are living with IBD, with 11,000 new diagnoses expected in 2023. The global incidence and prevalence of IBD has been rising. In 2011, Benchimol et al. published a systematic review detailing international trends in IBD. The review demonstrated a 60% increase in Crohn’s disease (CD) and a 20% increase in ulcerative colitis (UC) across both developing and developed countries. Benchimol et al. also published the results of a health administrative data analysis evaluating children with a diagnosis of IBD between 1999-2010 across five Canadian provinces, which together account for 79.2% of the Canadian population. They reported that incidence of IBD in children aged five and under increased during the study period (annual percentage increase [APC] +7.19%; 95% CI, +2.82% to +11.56%). The prevalence of IBD also increased significantly during the study period (APC+4.56%; 95% CI, +3.71% to +5.42%).