PhD Scientific Days 2025

Poster Session II. - W: Conservative Medicine

Evolution of epidemiological stages of ulcerative colitis in Hungary – trends of age and gender specific incidence and prevalence from a population-based cohort between 1977–2018

Name of the presenter

Gönczi Lóránt

Institute/workplace of the presenter

Semmelweis University

Authors

Dr. Lóránt Gönczi¹, Akos Ilias¹, Peter L Lakatos^1,2

1: Semmelweis University
2: Mc Gill University, Montreal Canada

Text of the abstract

Background: The evolution of inflammatory bowel disease (IBD) occurs across four epidemiological stages: emergence, acceleration in incidence, compounding prevalence and prevalence equilibrium; as put forward by Kaplan. et al. (Nat Rev Gastroenterol Hepatol. 2021). Newly industrialized countries are in the acceleration in incidence stage, which is associated with rapidly rising incidence and low prevalence, while the western world is in the compounding prevalence stage: stable incidence and rapidly increasing prevalence.
The Veszprém IBD cohort is one of the very few well-established prospective, population based inception cohorts.
Aim: Our aim was to analyze total, age and gender specific incidence and prevalence rates of ulcerative colitis (UC) patients over the past four decades (1977-2018).
Methods: Data of 1,370 UC patients were analyzed. Patient inclusion was between January 1, 1977 and December 31, 2018. All patients in Veszprem county, a well-defined administrational area of Hungary, was included. The source of age- and gender-specific demographic data for statistical analysis was derived from the results of a national population census (source: Hungarian Central Statistical Office).
Results: Adjusted mean incidence rate of UC increased from 4.06 (CI95%: 2.47-6.66) /105 person-years in 1977-1991 to 13.31 (CI95%: 10.71-17.50) /105 in 1997-2001. The following years show a plateau/ slight decrease in incidence: 11.16 (CI95%: 8.18-15.23) /105 in 2007-2011 and 10.92 (CI95%: 7.98-14.96) /105 in 2012-2018.
The total prevalence of UC patients show a steady increase from 60.05 (CI95%: 52.07-68.42) /105 persons in 1991 to 317.62 (CI95%: 299.62-336.70) /105 in 2015. Age specific prevalence rates show similarly high prevalence rates among elderly patients (60-69y) compared to adult patients, meaning a saturation of age specific curves in the elderly. Age specific prevalence of UC among the 60-69 years old is as high as 506.42 (CI95%: 443.23-578.56) /105 persons in 2015.
Conclusion: Incidence rates of UC patients plateaued around the 2000s and show slight decrease afterwards. Prevalence rates of UC show a steady increase, thus Hungary is well into the 3rd epidemiological phase of compounding prevalence. As we already see a saturation of prevalence rates among elderly UC patients, a transition to the 4th stage of prevalence equilibrium may began.