Epidemiologic characteristics of patients with inflammatory bowel disease undergoing colonoscopy

Background: The aim was too describe the demographic characteristics of patients with inflammatory bowel disease (IBD) undergoing colonoscopy.

Methods: The Clinical Outcomes Research Initiative (CORI) maintains a database of endoscopic procedures in diverse clinical practices distributed throughout the US. The data from 2000-2007 were used to analyze the demographic characteristics of patients with Crohn's disease (CD) and ulcerative colitis (UC).

Results: During the period 2000-2007, 4631 patients with CD and 6619 patients with UC were compared to a control population of 826,207 patients without IBD. CD and UC patients were significantly (P < 0.0001) younger than controls: 41.7 ± 18.4, 47.3 ± 17.4, 59.2 ± 14.0 years, respectively. CD and UC were less common among nonwhite than white endoscopy patients: odds ratio (OR) = 0.64 (0.58-0.70) for CD and OR = 0.71 (0.66-0.77) for UC. Endoscopy for IBD was only slightly less common among female than male CD patients (0.94, 0.89-1.00), but significantly less common among female than male UC patients (0.72, 0.68-0.75). Compared with community/private practices, relatively more endoscopies were performed among IBD patients in academic institutions: OR = 1.68 (1.56-1.81) for CD and OR = 1.27 (1.19-1.36) for UC. The race-, sex-, and age-adjusted rates of CD and UC were both significantly higher in the northern than southern regions of the US, with a significant correlation of r = 0.89, degrees of freedom = 4, P = 0.017 between the geographic distributions of the two diagnoses.

Conclusions: The endoscopy patterns of IBD patients may be influenced in part by the epidemiology of these two diagnoses, as well as by underlying trends in the utilization of colonoscopy.