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Gut. Mar 2000; 46(3): 336–343.
PMCID: PMC1727835

Ulcerative colitis in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival

Abstract

BACKGROUND—There is significant geographic variation in the reported incidence of ulcerative colitis.
AIMS—To update the incidence and prevalence of ulcerative colitis in Olmsted County, Minnesota, examine temporal trends, and determine overall survival.
PATIENTS—All Olmsted County residents diagnosed with ulcerative colitis between 1940 and 1993 (incidence cases), and all residents with ulcerative colitis alive on 1 January 1991 (prevalence cases).
METHODS—Incidence and prevalence rates were adjusted using 1990 US census figures for whites. The effects of age, sex, and calendar year on incidence rates were evaluated using Poisson regression. Survival from diagnosis was compared with that expected for US north-central whites.
RESULTS—Between 1940 and 1993, 278 incidence cases were identified, for an adjusted incidence rate of 7.6 cases per 100 000 person years (95% confidence interval (CI), 6.7 to 8.5). On 1 January 1991, there were 218 residents with definite or probable ulcerative colitis, for an adjusted prevalence rate of 229 cases per 100 000 (95% CI, 198 to 260). Increased incidence rates were associated with later calendar years (p<0.002), younger age (p<0.0001), urban residence (p<0.0001), and male sex (p<0.003). Overall survival was similar to that expected (p>0.2).
CONCLUSIONS—The overall incidence rate of ulcerative colitis in Olmsted County increased until the 1970s, and remained stable thereafter. Incidence rates among men and urban residents were significantly higher. The prevalence rate in Rochester in 1991 was 19% higher than that in 1980. Overall survival was similar to that of the general population.


Keywords: ulcerative colitis; incidence; prevalence; survival; prognosis; epidemiology

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Selected References

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  • Garland CF, Lilienfeld AM, Mendeloff AI, Markowitz JA, Terrell KB, Garland FC. Incidence rates of ulcerative colitis and Crohn's disease in fifteen areas of the United States. Gastroenterology. 1981 Dec;81(6):1115–1124. [PubMed]
  • Sonnenberg A, McCarty DJ, Jacobsen SJ. Geographic variation of inflammatory bowel disease within the United States. Gastroenterology. 1991 Jan;100(1):143–149. [PubMed]
  • Sonnenberg A, Wasserman IH. Epidemiology of inflammatory bowel disease among U.S. military veterans. Gastroenterology. 1991 Jul;101(1):122–130. [PubMed]
  • Shivananda S, Lennard-Jones J, Logan R, Fear N, Price A, Carpenter L, van Blankenstein M. Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Gut. 1996 Nov;39(5):690–697. [PMC free article] [PubMed]
  • Logan RF. Inflammatory bowel disease incidence: up, down or unchanged? Gut. 1998 Mar;42(3):309–311. [PMC free article] [PubMed]
  • Nordenvall B, Broström O, Berglund M, Monsen U, Nordenström J, Sörstad J, Hellers G. Incidence of ulcerative colitis in Stockholm County 1955-1979. Scand J Gastroenterol. 1985 Sep;20(7):783–790. [PubMed]
  • Langholz E, Munkholm P, Nielsen OH, Kreiner S, Binder V. Incidence and prevalence of ulcerative colitis in Copenhagen county from 1962 to 1987. Scand J Gastroenterol. 1991 Dec;26(12):1247–1256. [PubMed]
  • Ekbom A, Helmick C, Zack M, Adami HO. The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden. Gastroenterology. 1991 Feb;100(2):350–358. [PubMed]
  • Probert CS, Jayanthi V, Pinder D, Wicks AC, Mayberry JF. Epidemiological study of ulcerative proctocolitis in Indian migrants and the indigenous population of Leicestershire. Gut. 1992 May;33(5):687–693. [PMC free article] [PubMed]
  • Tysk C, Järnerot G. Ulcerative proctocolitis in Orebro, Sweden. A retrospective epidemiologic study, 1963-1987. Scand J Gastroenterol. 1992 Nov;27(11):945–950. [PubMed]
  • Srivastava ED, Mayberry JF, Morris TJ, Smith PM, Williams GT, Roberts GM, Newcombe RG, Rhodes J. Incidence of ulcerative colitis in Cardiff over 20 years: 1968-87. Gut. 1992 Feb;33(2):256–258. [PMC free article] [PubMed]
  • Gower-Rousseau C, Salomez JL, Dupas JL, Marti R, Nuttens MC, Votte A, Lemahieu M, Lemaire B, Colombel JF, Cortot A. Incidence of inflammatory bowel disease in northern France (1988-1990). Gut. 1994 Oct;35(10):1433–1438. [PMC free article] [PubMed]
  • Maté-Jimenez J, Muñoz S, Vicent D, Pajares JM. Incidence and prevalence of ulcerative colitis and Crohn's disease in urban and rural areas of Spain from 1981 to 1988. J Clin Gastroenterol. 1994 Jan;18(1):27–31. [PubMed]
  • Stewénius J, Adnerhill I, Ekelund G, Florén CH, Fork FT, Janzon L, Lindström C, Mars I, Nyman M, Rosengren JE. Ulcerative colitis and indeterminate colitis in the city of Malmö, Sweden. A 25-year incidence study. Scand J Gastroenterol. 1995 Jan;30(1):38–43. [PubMed]
  • Manousos ON, Giannadaki E, Mouzas IA, Tzardi M, Koutroubakis I, Skordilis P, Vassilakis S, Kouroumalis E, Vlachonikolis IG. Ulcerative colitis is as common in Crete as in northern Europe: a 5-year prospective study. Eur J Gastroenterol Hepatol. 1996 Sep;8(9):893–898. [PubMed]
  • Moum B, Vatn MH, Ekbom A, Aadland E, Fausa O, Lygren I, Sauar J, Schulz T, Stray N. Incidence of ulcerative colitis and indeterminate colitis in four counties of southeastern Norway, 1990-93. A prospective population-based study. The Inflammatory Bowel South-Eastern Norway (IBSEN) Study Group of Gastroenterologists. Scand J Gastroenterol. 1996 Apr;31(4):362–366. [PubMed]
  • Tragnone A, Corrao G, Miglio F, Caprilli R, Lanfranchi GA. Incidence of inflammatory bowel disease in Italy: a nationwide population-based study. Gruppo Italiano per lo Studio del Colon e del Retto (GISC) Int J Epidemiol. 1996 Oct;25(5):1044–1052. [PubMed]
  • Trallori G, Palli D, Saieva C, Bardazzi G, Bonanomi AG, d'Albasio G, Galli M, Vannozzi G, Milla M, Tarantino O, et al. A population-based study of inflammatory bowel disease in Florence over 15 years (1978-92). Scand J Gastroenterol. 1996 Sep;31(9):892–899. [PubMed]
  • Fonager K, Sørensen HT, Olsen J. Change in incidence of Crohn's disease and ulcerative colitis in Denmark. A study based on the National Registry of Patients, 1981-1992. Int J Epidemiol. 1997 Oct;26(5):1003–1008. [PubMed]
  • Björnsson S, Johannsson JH, Oddsson E. Inflammatory bowel disease in Iceland, 1980-89. A retrospective nationwide epidemiologic study. Scand J Gastroenterol. 1998 Jan;33(1):71–77. [PubMed]
  • Russel MG, Dorant E, Volovics A, Brummer RJ, Pop P, Muris JW, Bos LP, Limonard CB, Stockbrügger RW. High incidence of inflammatory bowel disease in The Netherlands: results of a prospective study. The South Limburg IBD Study Group. Dis Colon Rectum. 1998 Jan;41(1):33–40. [PubMed]
  • Ekbom A, Helmick CG, Zack M, Holmberg L, Adami HO. Survival and causes of death in patients with inflammatory bowel disease: a population-based study. Gastroenterology. 1992 Sep;103(3):954–960. [PubMed]
  • Langholz E, Munkholm P, Davidsen M, Binder V. Colorectal cancer risk and mortality in patients with ulcerative colitis. Gastroenterology. 1992 Nov;103(5):1444–1451. [PubMed]
  • Persson PG, Bernell O, Leijonmarck CE, Farahmand BY, Hellers G, Ahlbom A. Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study. Gastroenterology. 1996 May;110(5):1339–1345. [PubMed]
  • Palli D, Trallori G, Saieva C, Tarantino O, Edili E, D'Albasio G, Pacini F, Masala G. General and cancer specific mortality of a population based cohort of patients with inflammatory bowel disease: the Florence Study. Gut. 1998 Feb;42(2):175–179. [PMC free article] [PubMed]
  • Calkins BM, Lilienfeld AM, Garland CF, Mendeloff AI. Trends in incidence rates of ulcerative colitis and Crohn's disease. Dig Dis Sci. 1984 Oct;29(10):913–920. [PubMed]
  • Sedlack RE, Nobrega FT, Kurland LT, Sauer WG. Inflammatory colon disease in Rochester, Minnesota, 1935-1964. Gastroenterology. 1972 May;62(5):935–941. [PubMed]
  • Stonnington CM, Phillips SF, Melton LJ, 3rd, Zinsmeister AR. Chronic ulcerative colitis: incidence and prevalence in a community. Gut. 1987 Apr;28(4):402–409. [PMC free article] [PubMed]
  • Stonnington CM, Phillips SF, Zinsmeister AR, Melton LJ., 3rd Prognosis of chronic ulcerative colitis in a community. Gut. 1987 Oct;28(10):1261–1266. [PMC free article] [PubMed]
  • Pinchbeck BR, Kirdeikis J, Thomson AB. Inflammatory bowel disease in northern Alberta. An epidemiologic study. J Clin Gastroenterol. 1988 Oct;10(5):505–515. [PubMed]
  • Hiatt RA, Kaufman L. Epidemiology of inflammatory bowel disease in a defined northern California population. West J Med. 1988 Nov;149(5):541–546. [PMC free article] [PubMed]
  • Stowe SP, Redmond SR, Stormont JM, Shah AN, Chessin LN, Segal HL, Chey WY. An epidemiologic study of inflammatory bowel disease in Rochester, New York. Hospital incidence. Gastroenterology. 1990 Jan;98(1):104–110. [PubMed]
  • Kurland LT, Molgaard CA. The patient record in epidemiology. Sci Am. 1981 Oct;245(4):54–63. [PubMed]
  • Melton LJ., 3rd History of the Rochester Epidemiology Project. Mayo Clin Proc. 1996 Mar;71(3):266–274. [PubMed]
  • Sedlack RE, Whisnant J, Elveback LR, Kurland LT. Incidence of Crohn's disease in Olmsted County, Minnesota, 1935-1975. Am J Epidemiol. 1980 Dec;112(6):759–763. [PubMed]
  • Gollop JH, Phillips SF, Melton LJ, 3rd, Zinsmeister AR. Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943-1982. Gut. 1988 Jan;29(1):49–56. [PMC free article] [PubMed]
  • Loftus EV, Jr, Silverstein MD, Sandborn WJ, Tremaine WJ, Harmsen WS, Zinsmeister AR. Crohn's disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. Gastroenterology. 1998 Jun;114(6):1161–1168. [PubMed]
  • Tysk C, Järnerot G. Has smoking changed the epidemiology of ulcerative colitis? Scand J Gastroenterol. 1992 Jun;27(6):508–512. [PubMed]
  • Bernstein CN, Blanchard JF, Rawsthorne P, Wajda A. Epidemiology of Crohn's disease and ulcerative colitis in a central Canadian province: a population-based study. Am J Epidemiol. 1999 May 15;149(10):916–924. [PubMed]

Figures and Tables

Figure 1
Crude incidence of ulcerative colitis in Olmsted County, 1940-93, by age at diagnosis and sex.
Figure 2
Adjusted incidence of ulcerative colitis in Olmsted County, 1940-93, by year of diagnosis and sex. Sex specific rates are age adjusted to the US white population, 1990; the total rate is age and sex adjusted to the US white population, 1990.  ...
Figure 3
Adjusted incidence of ulcerative colitis in Olmsted County, 1944-93, by year of diagnosis, sex, and rural versus urban residence. Rates are age adjusted to the US white population, 1990. 
Figure 4
Overall survival of ulcerative colitis inception cohort in Olmsted County, 1940-93 and expected survival of age and sex matched Minnesota whites in 1990 (p>0.2, log rank test).

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