Browsing by Author "Yang, H."

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    Incidence and Phenotype of Inflammatory Bowel Disease From 13 Countries in Asia-Pacific: Results From the Asia-Pacific Crohn's and Colitis Epidemiologic Study 2011-2013
    (American Gastroenterological Association(AGA) Institute, Published by Elsevier Inc., 2016) Ng, S.C.; Kaplan, G.; Banerjee, R.; Wei, Shu-Chen; Tang, Whitney; Zeng, Z.; Chen, Min-hu; Yang, H.; de Silva, H.J.; Niriella, M.A.; Ong, D.E.; Ling, Khoon-Lin; Hilmi, I; Pisespongsa, P.; Aniwan, S.; Limsrivilai, J.; Abdullah, M.; Chong, V.H.; Cao, Q.; Miao, Y.; Ong-Go, A.K.; Bell, S.; Niewiadomski, O.; Kamm, M.A.; Ng, K.K.; Yu, H.H.; Wang, Yu-Fang; Ouyang, Q.; Goh, K.L.; Lin, Hung-Hsin; Lin, Wei-Chen; Wu, K.; Simadibrata, M.; Chan, F.K.; Sung, J.
    Background: The Asia-Pacific Crohn's and Colitis Epidemiology Study, initiated in 2011, aimed to determine the incidence and phenotype of inflammatory bowel disease (IBD) in Asia-Pacific. We herein present incidence and phenotype data from 2011 through 2013 for 12 countries or areas in Asia (Brunei, China, Hong Kong, India, Indonesia, Macau, Malaysia, Philippines, Singapore, Sri Lanka, Taiwan, Thailand) and Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas using a web-based database. New cases were diagnosed based on standard criteria and ascertained from multiple sources. Endoscopy, pathology, and pharmacy records were searched for completeness of case capture. Age-standardized incidence was calculated with 95% confidence interval (CI). Crude incidence in different regions within Asia was pooled together using a random effect model. Results: We identified 1,572 new IBD patients (2011-2012, n=419; 2012-2013, n=1,153; 131 from Australia) including 1,057 (67%) ulcerative colitis (UC) and 515 (33%) Crohn's disease (CD). The mean annual incidence for IBD per 100,000 was 1.68 (95% CI, 1.59-1.77) in Asia and 22.28 (95% CI, 18.48-26.71) in Australia. The three countries within Asia with the highest incidence per 100,000 was India (9.31; 95% CI, 8.38-10.31), China (Guangzhou) (3.30; 95% CI, 2.68-4.06) and Hong Kong (2.58; 95% CI, 2.20-3.03). Within five regions of China, IBD incidence varied from 0.49 to 3.30 per 100,000. Pooled incidence of UC and CD within East Asia (China, Macau, Hong Kong, Taiwan) was 1.12 (95% CI, 0.77-1.48) and 0.33 (95% CI, 0.17-0.49), respectively. Pooled incidence of UC and CD within South East Asia (Brunei, Malaysia, Singapore, Indonesia, Thailand, Philippines) was 0.38 (0.21-0.55) and 0.30 (95% CI, 0.22-0.38), respectively. Ratio of UC:CD was 2.21 in Asia and 0.64 in Australia. Median time from symptom onset to diagnosis was 3 months [interquartile range (IQR), 2-10] for UC and 7 months (IQR 2-19) for CD. Stricturing, penetrating and perianal CD at diagnosis was common (21%, 10% and 17%, respectively) in Asia. Conclusion: Robust large-scale comparative epidemiologic IBD data from newly industrialized countries are emerging. Incidence of IBD varies throughout Asia with a higher incidence in East than South-East Asia. Complicated CD at diagnosis remains prevalent in Asia. Emergence of IBD in Asia will result in the need for specific health-care resources.
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    Population density and risk of inflammatory bowel disease: a prospective population-based study in 13 countries or regions in Asia-Pacific.
    (Wolters Kluwer Health, 2019) Ng, S.C.; Kaplan, G.G.; Tang, W.; Banerjee, R.; Adigopula, B.; Underwood, F.E.; Tanyingoh, D.; Wei, S.C.; Lin, W.C.; Lin, H.H.; Li, J.; Bell, S.; Niewiadomski, O.; Kamm, M.A.; Zeng, Z.; Chen, M.; Hu, P.; Ong, D.; Ooi, C.J.; Ling, K. L.; Miao, Y.; Miao, J.; de Silva, H.J.; Niriella, M.A.; Aniwan, S.; Limsrivilai, J.; Pisespongsa, P.; Wu, K.; Yang, H.; Ng, K.K.; Yu, H. H.; Wang, Y.; Ouyang, Q.; Abdullah, M.; Simadibrata, M.; Gunawan, J.; Hilmi, I.; Goh, K. L.; Cao, Q.; Sheng, H.; Ong-Go, A.; Chong, V. H.; Ching, J. Y. L.; Wu, J. C. Y.; Chan, F.K.L.; Sung, J.J.Y.
    INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.