Inflammatory Bowel Disease Prevalence: Surveillance data from the U.S. National Health and Nutrition Examination Survey

Michael H Weisman; Oleg Stens; Hyun Seok Kim; Jason K Hou; Frederick W Miller; Charles F Dillon

doi:10.1016/j.pmedr.2023.102173

Inflammatory Bowel Disease Prevalence: Surveillance data from the U.S. National Health and Nutrition Examination Survey

Prev Med Rep. 2023 Mar 9:33:102173. doi: 10.1016/j.pmedr.2023.102173. eCollection 2023 Jun.

Authors

Michael H Weisman¹, Oleg Stens², Hyun Seok Kim³, Jason K Hou³, Frederick W Miller⁴, Charles F Dillon⁴

Affiliations

¹ Stanford University School of Medicine, Palo Alto, California, and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
² Department of Medicine, UCSD School of Medicine, San Diego, California.
³ Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
⁴ National Institute of Environmental Health Sciences, NIH. Bethesda, Maryland, USA.

Abstract

Determining the overall US prevalence of Inflammatory Bowel Disease (IBD) is essential to national level prevention programs and population risk assessment; however currently US IBD prevalence remains uncertain. We used US National Health and Nutrition Examination Survey (NHANES) data to estimate the population-based prevalence of a self-reported history of medically diagnosed IBD, comparing to prior reports. Lifetime IBD prevalence for adults aged 20 + years was estimated in the independently conducted NHANES II (1976-80) and NHANES 2009-10 surveys. Participants were considered to have IBD if they reported being told by a physician they had Crohn's Disease (CD) or ulcerative colitis (UC). Clinically relevant NHANES data were analyzed to assess the self-reports. Survey design variables and sample weights were used to account for the complex survey design. The NHANES 2009-10 US IBD diagnosed prevalence was 1.2% (95% CI 0.8,1.6%), or an estimated 2.3 million persons. UC prevalence was 1.0% (95% CI 0.5,1.4%; 1.9 million persons) and CD prevalence was 0.3% (95% CI 0.1,0.4%; 578,000 persons). NHANES II UC prevalence was 1.0 (95% CI 0.8,1.2%), similar to 2009-10. UC prevalence was higher for ages ≥ 50 years in both surveys. NHANES 2009-10 data showed no UC sex differences, but women had higher UC prevalence in NHANES II. Remarkably, UC prevalence was similar between the two NHANES surveys fielded 30 years apart. The NHANES data are consistent with IBD prevalences reported in previous US nationally representative surveys, indicating that diagnosed IBD may affect approximately 1% of the US adult population.

Keywords: Crohn’s Disease; Inflammatory Bowel Disease; NHANES; Prevalence; Public Health Surveillance; Ulcerative Colitis; United States.