Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2024; 30(9): 1154-1163
Published online Mar 7, 2024. doi: 10.3748/wjg.v30.i9.1154
Recent trends in the epidemiology and clinical outcomes of inflammatory bowel disease in South Korea, 2010-2018
Seulji Kim, Hyun Jung Lee, Seung Woo Lee, Sanghyun Park, Seong-Joon Koh, Jong Pil Im, Byeong Gwan Kim, Kyung-Do Han, Joo Sung Kim
Seulji Kim, Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul 01812, South Korea
Hyun Jung Lee, Seong-Joon Koh, Jong Pil Im, Byeong Gwan Kim, Joo Sung Kim, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
Seung Woo Lee, Sanghyun Park, Kyung-Do Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Co-first authors: Seulji Kim and Hyun Jung Lee.
Co-corresponding authors: Joo Sung Kim and Kyung-Do Han.
Author contributions: Kim S, Lee HJ, Kim JS and Han KD designed the study; Lee SW and Park S collected the data; Kim S, Lee HJ and Han KD analyzed the data; Kim S, Lee HJ, and Kim JS were involved in the interpretation of the result of analyzed data; Kim S and Lee HJ wrote the original draft of the manuscript; all authors participated in the critical review of the results, reading and editing the manuscript, and approving the final manuscript. Kim S and Lee HJ equally contributed to this study as co-first authors. This study was conducted through collaboration based on teamwork, and Kim S and Lee HJ contributed equally throughout the research process to refine and enhance the quality of the study. Therefore, we believe it is appropriate to designate Kim S and Lee HJ as co-first authors. In addition, Kim JS and Han KD are experts in different fields of clinical gastroenterology and statistical analysis, respectively, and equally made an effort to contributed to making the research topic more in-depth and multifaceted. Therefore, designating Kim JS and Han KD as co-corresponding authors reflects our team’s collaboration and various research perspectives.
Supported by National Research Foundation of Korea, No. RS-2023-00227939.
Institutional review board statement: The study was reviewed and approved by the Seoul National University Hospital Institutional Review Board (Seoul, Korea).
Informed consent statement: All personal information was encrypted and all data were anonymous. Therefore, informed consent of all study subjects is waived.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joo Sung Kim, MD, PhD, Professor, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, No. 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea. jooskim@snu.ac.kr
Received: November 11, 2023
Peer-review started: November 11, 2023
First decision: December 15, 2023
Revised: December 23, 2023
Accepted: February 8, 2024
Article in press: February 8, 2024
Published online: March 7, 2024
Processing time: 115 Days and 16.9 Hours
ARTICLE HIGHLIGHTS
Research background

Over time, inflammatory bowel disease (IBD) has become a global disease with changing epidemiological patterns. Traditionally, IBD has been considered a Western disease; however, its incidence has increased in newly industrialized countries, including Asia, since the turn of the twenty-first century.

Research motivation

Although the epidemiology of IBD differs between the Western and Eastern worlds, and understanding the epidemiology of IBD is crucial for better management of patients and healthcare resources, data on IBD epidemiology in Asia remain limited.

Research objectives

We aimed to evaluate the incidence and prevalence of IBD using a nationwide population-based cohort in South Korea. Additionally, we sought to investigate the temporal changes in the medications and clinical outcomes of IBD.

Research methods

This study used claims data from the National Health Insurance Service of South Korea. We identified IBD patients using the International Classification of Diseases, Tenth Revision, and Rare and Intractable Disease diagnostic codes for Crohn’s disease (CD) and ulcerative colitis (UC). The incidence, prevalence, medication use, and clinical outcomes of IBD were assessed from 2010 to 2018.

Research results

Over the study period, from 2010 to 2018, 14498 and 31409 patients were newly diagnosed with CD and UC, respectively. The incidence of CD has stabilized in South Korea, while that of UCD has steadily increased with a shifted peak age from the 50-s to the 20-s since 2014. The prevalence rates of both CD and UC increased consistently. Over the study period, the use of immunomodulators and biologics increased, but that of 5-aminosalicylates and steroids decreased in both CD and UC patients, which was accompanied by decreased IBD-related hospitalizations and surgeries.

Research conclusions

The nationwide study revealed the recent epidemiology of IBD in South Korea. The incidence of CD has been stable since 2014, but that of UC has increased with a shift to a younger age at peak incidence between 2010 and 2018. Additionally, the clinical outcomes of IBD improved over the study period, in parallel with the increased use of immunomodulators and biologics.

Research perspectives

Future studies are required to evaluate the long-term prognosis of IBD according to changes in IBD treatment medications, including indicators such as disease activity and quality of life.