The incidence of all-age IBD is increasing worldwide, with studies in paediatric IBD (PIBD) showing a continued rise in the last few decades [1]. A recent significant publication by the French EPIMAD (population-based registry) group evaluated the incidence, prevalence and clinical presentation over a 30-year period from 1988 to 2017 [2]. Of the 22,879 incident IBD cases, 2013 were diagnosed before the age of 17 years (9% of all cases). IBD incidence rates rose significantly over the study period in all paediatric age groups [highest incidence of 10.6/100,000 (95%CI 10.1–11.1) in the 10- to 16-year group], with the overall paediatric population showing the highest annual percentage change between the earliest and the latest epoch [+4.6% (95%CI 3.9–5.2) compared to +1.5% (95%CI 1.2–1.8) for the entire IBD cohort].

The incidence and prevalence of IBD varies throughout the world, with the highest incidence seen in industrialised regions of North America and Europe [1]. Within Europe an East–West gradient has been demonstrated, with Western centres showing almost twice the incidence observed in Eastern centres [2].

The general trend in migration is from lower and middle income countries to higher income countries in Western Europe and North America.

Change is the engine that propels scientific progress, and within this dynamic, committees evolve. As members transition, embracing fresh perspectives, the spirit of innovation flourishes, shaping the path ahead. Amidst this journey, EpiCom is pleased to introduce Paul Henderson while bidding farewell to Julien Kirchgesner.

A total of 116 abstracts with an epidemiology theme were accepted for presentation at the ECCO Congress in 2024. This represented an increase over the previous year, with total submissions in this category up by 20%. It is clear that ECCO Members and IBD researchers see epidemiology as a vital part of our understanding of the overall picture of IBD aetiology, management and outcomes. Here we highlight just a few of the top abstracts that caught our eye.

At the upcoming ECCO’24 Congress in Stockholm, the Epidemiological Committee (EpiCom) will hold its 7^th Workshop on Wednesday, February 21.

In the dynamic landscape of healthcare, patients are now assuming a pivotal role beyond their traditional status as care recipients. They are emerging as active partners, capable of contributing invaluable insights to medical research. The theme of the 7^th EpiCom Workshop will be "The patient as an Epidemiologist", and the workshop will aim to shed light on the empowering potential of patient involvement, underscoring the significance of utilising appropriate tools to assess clinically relevant outcomes. Moreover, it will emphasise the pivotal role of digital tools in enabling patients to directly contribute to the research process.

Introduction

The incidence and prevalence of Inflammatory Bowel Disease (IBD) are progressively increasing worldwide, particularly in developing countries. Despite increasing awareness of IBD and improvements in biomarkers and diagnostic techniques, a significant diagnostic delay is still frequently observed. This is highly relevant as diagnostic delay prevents application of medical treatment during very early disease stages and the implementation of certain disease intervention strategies. Diagnostic delay is consequently still limiting our potential to alter the natural history of the disease, as has recently been shown by UK colleagues. In a systematic review and meta-analysis, it was demonstrated that individuals with Crohn’s Disease (CD) in the higher quartiles of diagnostic delay (median 24 months) were more likely to have stricturing or penetrating disease and were also more likely to undergo intestinal surgery, while in patients with Ulcerative Colitis (UC) such a delay was associated with increased probability of colectomy [1]. Hence, reducing diagnostic delay should be a priority if we are aiming to apply effective disease intervention strategies.

During the recent ECCO Congress in Copenhagen, EpiCom said goodbye to Valérie Pittet and Behrooz Z. Alizadeh while Kristine Allin and Iago Rodríguez-Lago were welcomed as new Committee Members. We thank Valérie and Behrooz for their dedication to ECCO and wish them huge success in their future academic activities.

A total of 74 epidemiological abstracts and 18 digital oral presentations were presented at ECCO'23 in Copenhagen. Five abstracts of particular interest are discussed below.

A novel population-based UK study by Cooney and colleagues (OP 28) examined the association of IBD and various mental health disorders such as depression, anxiety and self-harm in children and adolescents. A large primary care database was used to identify cases. Each case was propensity matched with four controls. Relative risk of all outcomes up to 10 years in the IBD cohort versus controls was estimated using adjusted Cox proportional hazards models controlling for age, sex, socioeconomic status, ethnicity and other conditions. A total of 3898 young patients with incident IBD were matched to 15,571 controls. IBD patients were significantly more likely to develop PTSD [adjusted hazard ratio (aHR) 2.47, 95% CI 1.23–4.94], eating disorders (aHR 1.85, 95% CI 1.05–3.26), self-harm (aHR 1.49, 95% CI 1.00–2.21), sleep disturbance (aHR 1.40, 95% CI 1.15–1.71), depression (aHR 1.34, 95% CI 1.16–1.56) and anxiety disorder (aHR 1.25, 95% CI 1.06–1.48). These findings highlight the need to screen for these conditions in young patients.

A total of 74 epidemiological abstracts and 18 digital oral presentations were presented at ECCO'23 in Copenhagen. Five abstracts of particular interest are discussed below.

A novel population-based UK study by Cooney and colleagues (OP 28) examined the association of IBD and various mental health disorders such as depression, anxiety and self-harm in children and adolescents. A large primary care database was used to identify cases. Each case was propensity matched with four controls. Relative risk of all outcomes up to 10 years in the IBD cohort versus controls was estimated using adjusted Cox proportional hazards models controlling for age, sex, socioeconomic status, ethnicity and other conditions. A total of 3898 young patients with incident IBD were matched to 15,571 controls. IBD patients were significantly more likely to develop PTSD [adjusted hazard ratio (aHR) 2.47, 95% CI 1.23–4.94], eating disorders (aHR 1.85, 95% CI 1.05–3.26), self-harm (aHR 1.49, 95% CI 1.00–2.21), sleep disturbance (aHR 1.40, 95% CI 1.15–1.71), depression (aHR 1.34, 95% CI 1.16–1.56) and anxiety disorder (aHR 1.25, 95% CI 1.06–1.48). These findings highlight the need to screen for these conditions in young patients.

Valerie Pittet  © ECCO

As you probably know ECCO Members have to step down and new members take their place - that means fresh ideas and various perspectives are heard, leading to renewed enthusiasm that will drive the EpiCom agenda for the future. The Epidemiological Committee  would like to welcome Ravi Misra as board member, while saying good bye to former Chair Naila Arebi.