It is estimated that there are around 2.4 to 3.1 million adults affected with inflammatory bowel disease (either Crohn disease [CD] or ulcerative colitis) in the US.[10]Centers for Disease Control and Prevention. Inflammatory bowel disease (IBD): IBD facts and stats. Jun 2024 [internet publication].
https://www.cdc.gov/inflammatory-bowel-disease/php/facts-stats/index.html
The onset of CD typically occurs in the second to fourth decade of life, with a smaller peak from 50-60 years.[11]Feuerstein JD, Cheifetz AS. Crohn disease: epidemiology, diagnosis, and management. Mayo Clin Proc. 2017 Jul;92(7):1088-103.
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30313-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28601423?tool=bestpractice.com
[12]Torres J, Mehandru S, Colombel JF, et al. Crohn's disease. Lancet. 2017 Apr 29;389(10080):1741-55.
http://www.ncbi.nlm.nih.gov/pubmed/27914655?tool=bestpractice.com
[13]Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012 Jan;142(1):46-54;e42;quiz e30.
https://www.gastrojournal.org/article/S0016-5085(11)01378-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22001864?tool=bestpractice.com
CD is more common in the industrialized world, particularly in North America and Western Europe, but incidence is increasing in newly industrialized countries in Asia, South America, and the Middle East.[11]Feuerstein JD, Cheifetz AS. Crohn disease: epidemiology, diagnosis, and management. Mayo Clin Proc. 2017 Jul;92(7):1088-103.
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30313-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28601423?tool=bestpractice.com
[12]Torres J, Mehandru S, Colombel JF, et al. Crohn's disease. Lancet. 2017 Apr 29;389(10080):1741-55.
http://www.ncbi.nlm.nih.gov/pubmed/27914655?tool=bestpractice.com
[13]Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012 Jan;142(1):46-54;e42;quiz e30.
https://www.gastrojournal.org/article/S0016-5085(11)01378-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22001864?tool=bestpractice.com
[14]Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018 Dec 23;390(10114):2769-78.
http://www.ncbi.nlm.nih.gov/pubmed/29050646?tool=bestpractice.com
[15]Ng SC, Tang W, Ching JY, et al. Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study. Gastroenterology. 2013 Jul;145(1):158-65;e2.
https://www.gastrojournal.org/article/S0016-5085(13)00500-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/23583432?tool=bestpractice.com
[16]Selvaratnam S, Gullino S, Shim L, et al. Epidemiology of inflammatory bowel disease in South America: a systematic review. World J Gastroenterol. 2019 Dec 21;25(47):6866-75.
https://www.wjgnet.com/1007-9327/full/v25/i47/6866.htm
http://www.ncbi.nlm.nih.gov/pubmed/31885427?tool=bestpractice.com
One systematic review reported CD annual incidences of 20.2 per 100,000 person-years in North America, 12.7 per 100,000 person-years in Europe, and 5.0 per 100,000 person-years in Asia and the Middle East.[13]Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012 Jan;142(1):46-54;e42;quiz e30.
https://www.gastrojournal.org/article/S0016-5085(11)01378-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22001864?tool=bestpractice.com
One pooled analysis of population-based cohorts reported that females from the Western countries had a lower risk of CD during childhood, until the age range of 10-14 years.[17]Shah SC, Khalili H, Gower-Rousseau C, et al. Sex-based differences in incidence of inflammatory bowel diseases-pooled analysis of population-based studies from western countries. Gastroenterology. 2018 Oct;155(4):1079-89.e3.
https://www.gastrojournal.org/article/S0016-5085(18)34685-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29958857?tool=bestpractice.com
The risk of CD was higher thereafter and was statistically significant for women ages 25-29 years and >35 years.[17]Shah SC, Khalili H, Gower-Rousseau C, et al. Sex-based differences in incidence of inflammatory bowel diseases-pooled analysis of population-based studies from western countries. Gastroenterology. 2018 Oct;155(4):1079-89.e3.
https://www.gastrojournal.org/article/S0016-5085(18)34685-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29958857?tool=bestpractice.com
In contrast, 36% to 64% higher incidence of CD was reported in males, compared with females, across most age groups (early adolescence to 50 years) in people from the Asia-Pacific region (P <0.001).[18]Shah SC, Khalili H, Chen CY, et al. Sex-based differences in the incidence of inflammatory bowel diseases-pooled analysis of population-based studies from the Asia-Pacific region. Aliment Pharmacol Ther. 2019 Apr;49(7):904-11.
http://www.ncbi.nlm.nih.gov/pubmed/30773656?tool=bestpractice.com
CD appears to be more common in white people, and in individuals of Ashkenazi Jewish origin.[11]Feuerstein JD, Cheifetz AS. Crohn disease: epidemiology, diagnosis, and management. Mayo Clin Proc. 2017 Jul;92(7):1088-103.
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30313-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28601423?tool=bestpractice.com
[19]Aniwan S, Harmsen WS, Tremaine WJ, et al. Incidence of inflammatory bowel disease by race and ethnicity in a population-based inception cohort from 1970 through 2010. Therap Adv Gastroenterol. 2019 Feb 6;12:1756284819827692.
https://journals.sagepub.com/doi/10.1177/1756284819827692
http://www.ncbi.nlm.nih.gov/pubmed/30792818?tool=bestpractice.com
[20]Betteridge JD, Armbruster SP, Maydonovitch C, et al. Inflammatory bowel disease prevalence by age, gender, race, and geographic location in the US military health care population. Inflamm Bowel Dis. 2013 Jun;19(7):1421-7.
http://www.ncbi.nlm.nih.gov/pubmed/23518811?tool=bestpractice.com
Around 10% to 25% of affected patients have a first-degree relative with CD.[21]Peeters M, Nevens H, Baert F, et al. Familial aggregation in Crohn's disease: increased age-adjusted risk and concordance in clinical characteristics. Gastroenterology. 1996 Sep;111(3):597-603.
http://www.ncbi.nlm.nih.gov/pubmed/8780562?tool=bestpractice.com
[22]Joossens M, Simoens M, Vermeire S, et al. Contribution of genetic and environmental factors in the pathogenesis of Crohn's disease in a large family with multiple cases. Inflamm Bowel Dis. 2007 May;13(5):580-4.
http://www.ncbi.nlm.nih.gov/pubmed/17206668?tool=bestpractice.com
A higher prevalence among smokers has been reported.[23]Cosnes J, Beaugerie L, Carbonnel F, et al. Smoking cessation and the course of Crohn's disease: an intervention study. Gastroenterology. 2001 Apr;120(5):1093-9.
http://www.ncbi.nlm.nih.gov/pubmed/11266373?tool=bestpractice.com
[24]Silverstein MD, Lashner BA, Hanauer SB, et al. Cigarette smoking in Crohn's disease. Am J Gastroenterol. 1989 Jan;84(1):31-3.
http://www.ncbi.nlm.nih.gov/pubmed/2912028?tool=bestpractice.com
[25]Mahid SS, Minor KS, Soto RE, et al. Smoking and inflammatory bowel disease: a meta-analysis. Mayo Clin Proc. 2006 Nov;81(11):1462-71.
http://www.ncbi.nlm.nih.gov/pubmed/17120402?tool=bestpractice.com
[26]Parkes GC, Whelan K, Lindsay JO. Smoking in inflammatory bowel disease: impact on disease course and insights into the aetiology of its effect. J Crohns Colitis. 2014 Aug;8(8):717-25.
http://www.ncbi.nlm.nih.gov/pubmed/24636140?tool=bestpractice.com
One systematic review confirmed high prevalence values for CD in Europe (322 per 100,000 in Germany) and North America (319 per 100,000 in Canada).[14]Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018 Dec 23;390(10114):2769-78.
http://www.ncbi.nlm.nih.gov/pubmed/29050646?tool=bestpractice.com
However, incidence of CD appears to be stable or decreasing in these areas.[14]Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018 Dec 23;390(10114):2769-78.
http://www.ncbi.nlm.nih.gov/pubmed/29050646?tool=bestpractice.com