S2040 Temporal Trends in the Incidence and Prevalence of Very Early and Early Onset Inflammatory Bowel Disease in the United States Over the Past 3 Decades

Introduction: Inflammatory bowel disease (IBD) imposes a significant global health burden due to the associated morbidity, diminished quality of life and mortality. Very early onset and early onset IBD is an emerging entity of IBD which refers to disease onset in those younger than 10 years old. Therefore, it is of paramount importance to evaluate the temporal trends in the incidence and prevalence of very early and early onset of IBD in the United States to enable risk stratification and implementation of health policy measures. Methods: Data from the Global Burden of Disease Database was retrieved to evaluate the temporal trends in the incidence and prevalence rates of very early and early onset IBD (<10 years old) in the US for the period 1990-2021. The Annual Percent Change (APC) and the Average Annual Percent Change (AAPC) were calculated using Joinpoint analysis software. Stratification by gender was performed to evaluate for any gender differences. Results: Over the period 1990-2021, an estimated total of 3,129 cases of very early and early onset IBD were reported in the US with a male predominance of 51.9%. A statistically significant decline in the incidence rate was observed across the United States with an AAPC of -0.21 (95% CI -0.25 to -0.17, P < 0.001). Stratification by gender revealed a statistically significant decline in the incidence rates in both males (AAPC -0.27, 95% CI -0.31 to -0.23, P < 0.001) and females (AAPC -0.18, 95% CI -0.22 to -0.15, P < 0.001). Prevalence wise, the estimated total cumulative prevalence was 6,635 cases with a male predominance of 51.7%. A statistically significant decline in the prevalence rate was observed across the US for the period 1990-2021 with an AAPC of -0.25 (95% CI -0.29 to -0.21, P < 0.001). Stratification by gender revealed a statistically significant decrease in the prevalence rates in both, males (AAPC -0.28, 95% CI -0.32 to -0.24, P < 0.001) and females (AAPC -0.20, 95% CI -0.23 to -0.17, P < 0.001). Conclusion: Over the span of 3 decades, the United States experienced a statistically significant decline in the incidence and prevalence rates of very early and early onset IBD. Further evaluation of the factors leading to this decline is warranted in addition to comparison the trends to other nations.