Supplementary appendix - thelancet.com · Supplementary appendix. ... Southern Europe, Western Europe, and Africa. CD – Crohn’s disease; UC – ulcerative colitis; ... British

Supplementary appendixThis appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors.

Supplement to: 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 2017; published online Oct 16. http://dx.doi.org/10.1016/S0140-6736(17)32448-0.

1

Appendices

Appendix 1: Detailed MEDLINE and EMBASE search strategy for article selection (1 December 2010 to 31 December 2016).

MEDLINE EMBASE 1. Inflammatory Bowel Diseases/ 2. Colitis, Ulcerative/ 3. Crohn Disease/ 4. Epidemiology/ 5. epidemiolog*.tw. 6. (crohn* or (ulcerative adj5 colitis) or inflammatory bowel*).tw. 7. 1 or 2 or 3 or 6 8. incidence.mp. or *Incidence/ 9. prevalence.mp. or *Prevalence/ 10. 4 or 5 or 8 or 9 11. 7 and 10 12. limit 11 to (comment or editorial or letter) 13. 11 not 12

1. *enteritis/ 2. *Crohn disease/ 3. *ulcerative colitis/ 4. Epidemiology/ 5. epidemiolog*.tw. 6. (inflammatory bowel disease* or IBD or crohn or (ulcerative adj5 colitis)).tw. 7. 1 or 2 or 3 or 6 8. incidence.mp. or *Incidence/ 9. prevalence.mp. or *Prevalence/ 10. 4 or 5 or 8 or 9 11. 7 and 10 12. limit 11 to (embase and (editorial or letter)) 13. 11 not 12

2

Appendix 2: Incidence of inflammatory bowel disease since 1990 in North America, South America, Oceania, Eastern Asia, South-eastern Asia, Southern Asia,

Western Asia, Eastern Europe, Northern Europe, Southern Europe, Western Europe, and Africa. CD – Crohn’s disease; UC – ulcerative colitis; IBDU –

Inflammatory Bowel Disease Unclassified; CI – confidence interval.

First Author

(Publication Year) Country Area Age Group

Inclusion Study Period IBD Incidence CD Incidence UC Incidence

(UC+IBDU)

UC:CD Ratio

Annual Average Percent Change

CD

(95% CI)

UC

(95% CI)

North America (n=9)

Bernstein (2006)1 Canada Total (average of the 5 provinces) all ages 1998-2000 25·2 13·40 11·8 0·88

Nova Scotia (province) all ages 1998-2000 39·4 20·20 19·2 0·95

British Columbia (province) all ages 1998-2000 18·7 8·80 9·9 1·13

Alberta (province) all ages 1998-2000 27·5 16·50 11·0 0·67

Saskatchewan (province) all ages 1998-2000 23·9 13·50 10·4 0·77

Manitoba (province) all ages 1998-2000 30·8 15·40 15·4 1

Green (2006)2 Canada Manitoba (province) all ages 1990-2001 28·28 14·83 13·45 0·91 -0·4

(-2·4, 1·7)

-2·1

(-4·5, 0·5)

Benchimol (2014)3 Canada Ontario (province) all ages 1999-2008 21·6 10·10 10·4

(11·6)

1·03 1·7

(0·4, 2·9)a

1·8

(0·5, 3·2)a

Bitton (2014)4 Canada Québec (province) all ages 2001-2008 27·5 17·40 10·1 0·58 -1·2 -3·6

3

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

(-1·7, -0·7)a (-5·3, -1·8)a

Leddin (2014)5 Canada Nova Scotia (province) all ages 1996-2009 54·56 23·82* 23·14

(30·74)*

0·97 -3·0

(-4·1, -1·9)a

-1·2

(-2·4, -0·1)a

Loftus (2007)6 USA Olmsted County, Minnesota (state) all ages 1990-2000 16·7 7·90 8·8 1·11

Herrinton (2008)7 USA Northern California counties, California (state)

all ages 1996-2002 18·3 6·30 12 1·90

Shapiro (2016)8 USA Rhode Island (state) all ages 2008-2010 30·3 13·9 15·1 (16·4) 1·09

Shivashankar (2016)9

USA Olmsted County, Minnesota (state) all ages 2000-2010 22·9 10·7 12·2 1·14

South America (n=7)

Souza (2002)10 Brazil Ribeirão Preto (municipality) all ages 1990-1994 0·94**

all ages 1995-1999 1·44**

Victoria (2009)11 Brazil São Paulo (the city or state) ≥16 years 1991-1995 4·54 0·68 3·86 5·68

≥16 years 1996-2000 8·66 1·48 6·76 (7·18) 4·57

≥16 years 2001-2005 9·73 3·50 4·48 (6·23) 1·28

Parente (2015)12 Brazil Piauí (state) ≥18 years 1988-2012 0·32 0·13* 0·19* 1·46 11·1 14·9

4

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

(4·8, 17·8)a (10·4, 19·6)a

Appleyard (2004)13 Puerto Rico Southwest: Guayama, Ponce, San German, Yauco, Mayagüez (cities or municipalities)

≥15 years 1996-2000 3·68 1·18 2·50 2·12

Edwards (2008)14 Barbados Nationwide all ages 1990-1994 3·6 1·30 2·30 1·77 -5·3

(-25·3, 20·1)i

-2·6

(-21·5, 20·7)i

all ages 1995-1999 3·05 0·71 2·34 3·30 -5·3

(-25·3, 20·1)i

-2·6

(-21·5, 20·7)i

all ages 2000-2004 2·19 0·61 1·58 2·59 -5·3

(-25·3, 20·1)i

-2·6

(-21·5, 20·7)i

Buenavida (2011)15 Uruguay Nationwide ≥15 years 2007-2008 5 0·74 4·26 5·76

Linares (1999)16 Panama District of Colón all ages 1990-1993 1·79 0·00** 1·79**

Argentina General Pueyrredón Partido (partido: administrative subdivision)

all ages 1990-1993 2·00**

Oceania (n=7)

Gearry (2006)17 New Zealand Canterbury (region) all ages 2004-2005 24·1 16·5 7·6 0·46

5

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Su (2016)18 New Zealand Canterbury (region) all ages 2014 39·79 26 13·4 (13·79) 0·52

Wilson (2010)19 Australia Geelong (the city or municipality) all ages 2007-2008 46·7 29·3 17·4 0·59

Ng (2013)20 Australia Geelong (the city or municipality) all ages 2010-2011 23·67 14 7·33 (9·67) 0·52

Vegh (2014)21 Australia Melbourne (the city or metropolitan area)

≥15 years 2011 30·3 16·00 11·4 (14·3) 0·71

Ng (2016)22 Australia Geelong (the city or municipality) all ages 2011-2013 22·28 12·96 9·32 ·0·71

Studd (2016)23 Australia Barwon (region), Victoria (state) all ages 2010-2011 24·2 14·7 7·5 (9·5) 0·51

Eastern Asia (n=22)

Morita (1995)24 Japan Nationwide all ages 1991 2·46 0·51 1·95 3·82

Yao (2000)25 Japan Nationwide all ages 1986-1998 0·90

Leong (2004)26 China Shatin and Sai Kung districts in Hong Kong

all ages 1990-1992 0·84 0·41 0·78 1·90 10·2

(-8·8, 33·2)ii

3·5

(0·5, 6·5)a ii

Shatin and Sai Kung districts in Hong Kong

all ages 1993-1995 0·98 0·35 0·86 2·45 10·2

(-8·8, 33·2)ii

3·5

(0·5, 6·5)a ii


all ages 1996-1998 1·68 0·91 0·91 1·00 10·2

(-8·8, 33·2)ii

3·5

(0·5, 6·5)a ii

6

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)


all ages 1999-2001 2·13 1·00 1·15 1·15 10·2

(-8·8, 33·2)ii

3·5

(0·5, 6·5)a ii

Lok (2007)27 China Hong Kong (special administrative region)

all ages 1991-2006 0·19 4·4

(-0·7, 9·7)

Lok (2008)28 China Hong Kong (special administrative region)

all ages 1997-2006 0·59 1·8

(-10·0, 15·1)

Chow (2009)29 China Hong Kong (special administrative region)

≥15 years 2006 2·1

Ng (2013)20 China Hong Kong (special administrative region)

all ages 2011-2012 3·06 1·31 1·66 (1·75) 1·27

Ng (2016)22 China Hong Kong (special administrative region)

all ages 2011-2013 2·58 1·23 1·34 ·1·08

Zeng (2013)30 China Guangdong (province) all ages 2011-2012 3·14 1·09 2·05 1·88

Zhao (2013)31 China Wuhan (city) all ages 2010 1·96 0·51 1·45 2·84

Ng (2013)20 China Chengdu (city) all ages 2011-2012 0·58 0·14 0·43 (0·43) 3·07

Guangzhou (city) all ages 2011-2012 3·43 1·21 2·21 (2·21) 1·83

Xi’an (city) all ages 2011-2012 0·54 0·07 0·42 (0·47) 6·00

7

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Ng (2016)22 China Daqing (city) all ages 2011-2013 1·77 0·13 1·64 12·61

Guangzhou (city) all ages 2011-2013 3·30 1·31 1·99 1·51

Kunming (city) all ages 2011-2013 1·17 0·06 1·10 18·33

Xiangshan (county in the province of Zhejiang)

all ages 2011-2013 1·26 0·34 0·92) ·2·70

Ng (2013)20 China Macau (special administrative region)

all ages 2011-2012 2·20 0·6 1·00 (1·60) 1·67

Ng (2016)22 China Macau (special administrative region)

all ages 2011-2013 2·38 1·06 1·32 1·24

Yang (2014)32 China Daqing (city) all ages 2012-2013 2·01 0·15 1·86 12·40

Chuang (2013)33 Taiwan Nationwide all ages 1998-2010 0·99 0·19 0·8 4·21

Chen (2013)34 Taiwan Nationwide all ages 1998-2008 0·66 6·2

(3·3, 9·2)a

Wei (2013)35 Taiwan Nationwide all ages 1998-2008 1·18 0·24 0·94 3·92 4·0

(1·0, 7·1)a

4·8

(1·8, 8·0)a

Ng (2016)22 Taiwan Nationwide all ages 2011-2013 1·33 0·16 1·17 7·31

Kuo (2015)36 Taiwan Nationwide all ages 2000-2010 1·046 0·208 0·838 4·03

8

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Yang (2008)37 South Korea Songpa (a district in Seoul) all ages 1991-2005 2·04 0·53 1·51 2·85 13·8

(8·7, 19·0)a

9·5

(2·7, 16·7)a

Kim (2015)38 South Korea Nationwide all ages 2006-2012 7·8 3·2 4·6 1·44 -2·4

(-4·7, 0·0)

-2·2

(-4·6, 0·2)

South-eastern Asia (n=11)

Ng (2016)22 Brunei Nationwide all ages 2011-2013 0·62 0·41 0·21 0·51

Ng (2013)20 Indonesia Central Jakarta (1 of 5 cities that forms Jakarta)

all ages 2011-2012 0·88 0·33 0·55 (0·55) 1·67

Ng (2016)22 Indonesia Central Jakarta (1 of 5 cities that forms Jakarta)

all ages 2011-2013 0·74 0·25 0·50 2·00

Ng (2013)20 Malaysia Kinta Valley (district) all ages 2011-2012 0·94 0·24 0·59 (0·71) 2·46

Hilmi (2015)39 Malaysia Kinta Valley (district) all ages 1990-2013 0·67 0·18 0·49 2·72 12·0

(-31·9, 84·0)

8·5

(1·8, 15·7)a

Ng (2016)22 Malaysia Kinta Valley (district) all ages 2011-2013 0·82 0·14 0·68 4·85

Ng (2016)22 Philippines Manila (city) all ages 2011-2013 0·31 0·16 0·15 0·93

Ng (2013)20 Singapore Nationwide all ages 2011-2012 1·06 0·40 0·61 (0·66) 1·53

9

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Ng (2016)22 Singapore Nationwide all ages 2011-2013 1·01 0·40 0·61 1·52

Ng (2013)20 Thailand Bangkok (city) all ages 2011-2012 0·63 0·35 0·28 (0·28) 0·80

Chiangmai (the city or province) all ages 2011-2012 0·67 0·3 0·36 (0·36) 1·20

Ng (2016)22 Thailand Bangkok (city) all ages 2011-2013 0·55 0·31 0·25 0·80

Chiangmai (the city or province) all ages 2011-2013 0·48 0·25 0·23 ·0·92

Southern Asia (n=7)

Ng (2013)20 Sri Lanka Gampaha (the town or district) all ages 2011-2012 1·59 0·59 0·95 (1·00) 1·61

Ng (2016)22 Sri Lanka Gampaha (the town or district) all ages 2011-2013 1·69 0·52 1·17 2·25

Kasturiratne (2014)40

Sri Lanka Gampaha (the town or district) all ages 2011-2012 1·59 0·59 0·95 (1·00) 1·61

Niriella (2010)41 Sri Lanka Colombo and Gampaha (towns or districts)

all ages 2007-2008 0·78 0·09 0·69 7·67

Ng (2016)22 India Hyderabad (city) all ages 2011-2013 9·31 3·91 5·4 1·38

Sood (2003)42 India Punjab (province) all ages 1999-2000 6·02

Zahedi (2014)43 Iran Kerman (the city or province) all ages 2011-2012 5·78 0·80 4·98 6·23

Western Asia (n=9)

10

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Vegh (2014)21 Israel Southern Israel: Beer Sheva and Northern Negev (Beer Sheva, or Beersheba, is a city; Negev is a region)

≥15 years 2011 11·4 4·90 6·5 1·33

Burisch (2014)44 Israel Southern Israel: Beer Sheva and Northern Negev (Beer Sheva, or Beersheba, is a city; Negev is a region)

≥15 years 2010 12·8 8·40 4·4 0·52

Abdul-Baki (2007)45

Lebanon Beirut (city) all ages 2000-2004 5·5 1·4 4·1 2·93

Tezel (2003)46 Turkey Trakya (region: the 3 provinces of Edirne, Tekirdag, Kirklareli)

≥15 years 1998-2001 0·77

Tozun (2009)47 Turkey Nationwide all ages 2000-2003 6·6 2·20 4·4 2·00

Al-Ghamdi (2004)48 Saudi Arabia Riyadh (city) all ages 1983-2002 0·94 0·94 0·00

Burisch (2014)44 Cyprus Nicosia (the city or municipality) ≥15 years 2010 9·3 6·30 3 0·48

Vegh (2014)21 Cyprus

Nicosia (the city or municipality) ≥15 years 2011 8·3 5·00 3·3 0·66

Al-Shamali (2003)49 Kuwait Nationwide all ages 1990-1999 2·97** -1·7

(-8·9, 6·1)

11

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Eastern Europe (n=13)

Gheorghe (1997)50 Romania Bucharest (city) all ages 1990-1997 0·42

Gheorghe (2004)51 Romania Nationwide all ages 2002-2003 1·47 0·50 0·97 1·94

Burisch (2014)44 Romania Timis (county) ≥15 years 2010 4·2 1·70 2·5 1·47

Vegh (2014)21 Romania Timis (county) ≥15 years 2011 6·5 2·80 3·7 1·32

Lakatos (2003)52 Hungary Veszprém (province) all ages 1992-1996 7·88

Hungary Veszprém (province) all ages 1997-2001 6·5 11·10

Lakatos (2011)53 Hungary Veszprém (province) all ages 2002-2006 21·4 8·90 11·9 (12·4) 1·34 9·9

(-2·3, 23·6)

-6·2

(-20·2, 10·2)

Burisch (2014)44 Hungary Veszprém (province) ≥15 years 2010 24 12·00 10·7 (12) 0·89

Vegh (2014)21 Hungary Veszprém (province) ≥15 years 2011 26·5 14·60 11·9 0·82

Vegh (2014)21 Czech Prague (city) ≥18 years 2011 11·6 5·50 5 (6·1) 0·91

Burisch (2014)44 Czech Prague (city) ≥18 years 2010 12·7 5·60 5·8 (7·1) 1·04

South Bohemia (administrative region)

≥18 years 2010 7·8 3·90 3·9 1·00

Burisch (2014)44 Moldova Chisinau (city) ≥15 years 2010 3·9 0·40 3·5 8·75

12

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Vegh (2014)21 Moldova Chisinau (city) ≥15 years 2011 4·7 0·80 3·9 4·88

Burisch (2014)44 Russia Moscow (city) ≥15 years 2010 5·3 0·90 4·2 (4·4) 4·67

Northern Europe (n=44)

Moum (1995)54 Norway Southeast (the counties of Oslo, Østfold, Telemark, and Aust-Agder)

all ages 1990 15·7 5·10 10·6 2·08


all ages 1990-1993 13·6


all ages 1990-1993 5·80

Bengtson (2009)57 Norway Southeast (the counties of Oslo, Østfold, Telemark, and Aust-Agder)

all ages 1990-1993 18·8 6·00 12·8 2·13

Jacobsen BA (2006)58

Denmark North Jutland (region) all ages 1988-2002 18·89 6·73 12·16 1·81 3·3

(-8·4, 16·6)

Norgard (2014)59 Denmark Nationwide all ages 1995-2011 19·31*

Norgard (2014)59 Denmark Nationwide all ages 1995-2012 8·20*

13

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Burisch (2014)44 Denmark Aarhus (city) ≥15 years 2010 18·8 8·20 10·6 1·29

Burisch (2014)44 Denmark Amager (island) ≥15 years 2010 16·3 4·80 7·4 (11·5) 1·54

Burisch (2014)44 Denmark Funen (island) ≥15 years 2010 33·4 11·40 20·1 (21·5) 1·76

Burisch (2014)44 Denmark Herlev (suburb of Copenhagen) ≥15 years 2010 24·4 7·00 8·3 (17·5) 1·19

Burisch (2014)44 Denmark Herning (city) ≥15 years 2010 22·5 7·10 13 (15·3) 1·83

Burisch (2014)44 Denmark Viborg (city) ≥15 years 2010 26·7 9·60 15·7 (17·1) 1·64

Vegh (2014)21 Denmark Amager (island) ≥15 years 2011 21·4 5·20 9·6 (16·2) 1·85

Vegh (2014)21 Denmark Herlev (suburb of Copenhagen) ≥15 years 2011 21·5 3·80 11·5 (17·7) 3·03

Thompson (1998)60 UK England and Wales (countries) all ages 1991-1992 10·60

Carr (1999)61 UK Leicester (city) ≥16 years 1991-1994 9·1

Rubin (2000)62 UK Stockton-on-Tees (borough) all ages 1990-1994 22·2 8·30 13·9 1·67

Yapp TR (2000)63 UK Cardiff all ages 1991-1995 5·60

Garcia (2005)64 UK Nationwide 20-84 1995-1997 10 8·00 2 0·25

Gunesh (2008)65 UK Cardiff (city) all ages 1991-1995 6·00 1·1

(-0·8, 3·1)iii

14

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

UK Cardiff (city) all ages 1996-2000 6·60 1·1

(-0·8, 3·1)iii

UK Cardiff (city) all ages 2001-2005 7·00 1·1

(-0·8, 3·1)iii

Burisch (2014)44 UK Brent and Harrow (boroughs) ≥15 years 2010 19·3 2·40 15·6 (16·9) 6·50

Burisch (2014)44 UK Hull and East Yorkshire Yorkshire (city and riding)

≥15 years 2010 18·6 8·90 8·3 (9·7) 0·93

Burisch (2014)44 Ireland Dublin (city) ≥15 years 2010 12·9 4·30 4·2 (8·6) 0·98

Björnsson (2000)66 Iceland Nationwide all ages 1990-1994 22 5·50 16·5 3·00

Björnsson (2015)67 Iceland Nationwide all ages 1995-2009 27·08 6·4 20·4

(20·68)

3·19 -0·1

(-10·3, 11·3)

1·4

(-1·7, 4·6)

Burisch (2014)44 Iceland Nationwide ≥15 years 2010 28·5 5·60 17·8 (22·9) 3·18

Salupere (2001)68 Estonia Tartu (county) all ages 1993-1998 3·1 1·40 1·7 1·21

Burisch (2014)44 Estonia Tartu (county) ≥15 years 2010 11·1 5·40 5·7 1·06

Lapidus (2006)69 Sweden Stockholm (city) 16-90 1990-2001 8·30 2·2

(-2·2, 6·7)

15

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Ronnblom (2010)70 Sweden Uppsala (the city or county) all ages 2005-2007 17·5

Sjoberg (2013)71 Sweden Uppsala (the city or county) all ages 2005-2009 20

Sjoberg (2014)72 Sweden Uppsala (the city or county) all ages 2005-2009 9·90 13·8

(2·4, 26·4)a

5·3

(-1·5, 12·6)

Burisch (2014)44 Sweden Linköping (city) ≥15 years 2010 40·0 10·10 16·5 (30) 1·63

Örebro (the city or county) ≥15 years 2010 28·3 8·30 16·1 (20) 1·94

Manninen (2010)73 Finland Tampere (city) ≥15 years 1999 29·2 9·4 19·6 (19·9) 2·09

Jussila (2012)74 Finland Nationwide all ages 2000-2007 34 9·20 24·8 2·70

Burisch (2014)44 Finland Pirkanmaa (region) ≥15 years 2010 27·7 5·00 18·0 (22·7) 3·60

Kiudelis (2012)75 Lithuania Kaunas (city and district) ≥15 years 2007-2009 8·14 1·21 6·56 (6·94) 5·42

Burisch (2014)44 Lithuania Kaunas (city and district) ≥15 years 2010 9·1 2·60 6·5 2·50

Vegh (2014)21 Lithuania Kaunas (city and district) ≥15 years 2011 12·2 1·40 10·8 7·71

Burisch (2014)44 Faroe Islands Nationwide ≥15 years 2010 83·1 11·1 31·8 (72) 2·86

Vegh (2014)21 Faroe Islands Nationwide ≥15 years 2011 68·4 10·50 57·9 5·51

Hammer (2016)76 Faroe Islands Nationwide all ages 1990-1999 6 26 4·3 2·3 2·0

16

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

(-9·5, 15·5)iv (-15·8, 23·6)iv

Faroe Islands Nationwide all ages 2000-2009 10 26 13 2·3

(-9·5, 15·5)iv

2·0

(-15·8, 23·6)iv

Faroe Islands Nationwide all ages 2010-2014 75 10 44 (65) 4·4 2·3

(-9·5, 15·5)iv

2·0

(-15·8, 23·6)iv

Burisch (2014)44 Greenland Nationwide ≥15 years 2010 19·6 0 19·6 2·09

Southern Europe (n=33)

Ranzi (1996)77 Italy Lombardia (administrative region) all ages 1990-1993 10·4 3·40 7 2·06

Cottone (2006)78 Italy Casteltermini (town) all ages 1997-2002 15·4

Tursi (2013)79 Italy Apulia (region) all ages 2009-2012 12 5·00 6 (7) 1·20

Vegh (2014)21 Italy Northern Italy (5 regions: Padua, Florence, Cremona, Forli, and Reggio Emilia)

≥15 years 2011 10·5 3·30 6·2 (7·2) 1·88

Burisch (2014)44 Italy Northern Italy (5 regions: Padua, Florence, Cremona, Forli, and Reggio Emilia)

≥15 years 2010 11·6 4·30 6·4 (7·3) 1·49

Manousos (1996a)80 Greece Heraklion (the city or regional unit) all ages 1990-1994 3·00

17

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Manousos (1996b)81 Greece Heraklion (the city or regional unit) all ages 1990-1994 8·9

Ladas (2005)82 Greece Trikala (the city or regional unit) ≥10 years 1990-1994 10·2

Burisch (2014)44 Greece Ioannina (city) ≥15 years 2010 10·2 3·50 6 (6·7) 1·71

Vegh (2014)21 Greece Ioannina (city) ≥15 years 2011 7·2 3·60 3·6 1·00

Brullet (1998)83 Spain Total l (average of the 4 regions) all ages 1991-1993 13·5 5·50 8 1·45

Sabadell (city) all ages 1991-1993 15 5·20 9·8 1·88

Vigo (the city or municipality) all ages 1991-1993 12·7 5·00 7·7 1·54

Mallorca (island) all ages 1991-1993 13·6 5·80 7·8 1·34

Motril (the town or municipality) all ages 1991-1993 10·8 6·50 4·3 0·66

Lopez (1999)84 Spain Aragón (autonomous community) all ages 1992-1995 7·28 2·86 4·42 1·55

Monferrer (1999)85 Spain Castellon (province) all ages 1992-1996 8·7 1·90 6·8 3·58

Pozzati (2002)86 Spain Merida (city) 15-64 1996-2000 7·23 2·15 5·08 2·36

Garrido (2004)87 Spain Northern Huelva (province) all ages 1996-2003 11·8 6·60 5·2 0·79

Rodrigo (2004)88 Spain Oviedo (the city or municipality) all ages 2000-2002 16·6 7·50 9·1 1·21

Martinez (2005)89 Spain La Safor (comarca: an administrative subdivision)

all ages 1994-2003 7·8

18

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Rivera (2007)90 Spain Costa del Sol (coastline region of the province of Malaga)

all ages 2000-2001 7·26

Arin (2008)91 Spain Navarra (autonomous community) all ages 2001-2003 15·42 5·85 9·57 1·64

Anton (2010)92 Spain Caceres (the city or province) ≥15 years 2000-2009 17·17 5·70 11·47 2·01 -3·8

(-18·7, 13·8)

2·4

(-10·0, 16·4)

Lucendo (2014)93 Spain Ciudad Real (province) ≥16 years 2000-2012 14·69 8·92 5·6 (5·77) 0·63 7·2

(2·8, 11·8)a

3·8

(-0·2, 7·9)

Burisch (2014)44 Spain Vigo (the city or municipality) ≥15 years 2010 21·4 10·80 9·4 (10·6) 0·87

Vegh (2014)21 Spain Vigo (the city or municipality) ≥15 years 2011 19·6 6·90 9·9 (12·7) 1·43

Jovanovicz Z (1999)94

Croatia Rijeka (metropolitan area) and Istria (region)

all ages 1990-1994 2·92** 7·8

(-1·4, 17·9)

Sincic (2006)95 Croatia Primorsko-goranska County (county)

all ages 2000-2004 11·1 6·50 4·6 0·71

Klarin (2013)96 Croatia Zadar (the city or county) all ages 2000-2010 16·6 8·40 8·2 0·98 13·5

(5·6, 21·9)a

4·6

(-3·2, 13·1)

Burisch (2014)44 Croatia Zagreb (city) ≥15 years 2010 6·6 3·30 3·3 1·00

Pezerovi (2014)97 Croatia Vukovarsko-Srijemska (county) ≥18 years 1991-2010 4·45 0·95 3·5 3·68 4·5 12·3

19

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

(-0·3, 9·5) (8·9, 15·8)a

Cachia (2008)98 Malta Nationwide all ages 1993-2005 9·17 1·29 7·88 6·11 0·8

(-6·5, 8·7)

4·6

(-0·8, 10·3)

Pavlovic-Calic (2008)99

Bosnia and Herzegovina

Tuzla (the city or canton) all ages 1995-2006 2·30 34·4

(22·1, 47·9)a

Salkic (2010)100 Bosnia and Herzegovina

Tuzla (the city or canton) all ages 1995-2006 3·43 24·8

(11·0, 40·3)a

Burisch (2014)44 Portugal Porto (city) ≥15 years 2010 10·8 7·00 3·8 0·54

Vegh (2014)21 Portugal Porto (city) ≥15 years 2011 11·8 5·70 6·1 1·07

Western Europe (n=18)

Van Gossum (1996)101

Belgium Brussels (the city or region) all ages 1992-1993 6·7 3·7 3 0·81

Latour (1996)102 Belgium Liege (the city or municipality) all ages 1993-1994 9 5·5 3·5 0·64

Latour (1998)103

Belgium Liege (the city or municipality) all ages 1993-1996 8·1 4·5 3·6 0·80

Flamenbaum (1997)104

France Puy-de-Dome (department: a county)

all ages 1993-1994 7·6 5·7 1·9 0·33

20

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Pagenault (1997)105 France Brittany (administrative region) all ages 1994-1995 5·7 2·8 2·9 1·04

Molinie (2004)106 France Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 1991-1999 9·9 6·4 3·5 0·54 1·2 (-4·6, 7·4) -2·5

(-3·5, -1·6)a

Edouard (2005)107 France West Indies (Guadeloupe and Martinique islands)

all ages 1997-1999 4·08 1·85 2·23 1·21

Nerich (2006)108 France Nationwide (Mainland France) all ages 2000-2002 15·4 8·2 7·2 0·88

Abakar-Mahamat (2007)109

France Corsica (island) all ages 2002-2003 13·55 4·05 9·5 2·35

Chouraki (2011)110 France Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 1991-1993 6·7 4·5 0·9

(-0·3, 2·2)v

-1·3

(-2·8, 0·3)v

Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 1997-1999 7·1 4·0 0·9

(-0·3, 2·2)v

-1·3

(-2·8, 0·3)v

Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 2006-2007 10·1 6·7 3·4 0·51 0·9

(-0·3, 2·2)v

-1·3

(-2·8, 0·3)v

Gower-Rousseau (2013)111

France Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 2006-2008 12 7·60 4·4 0·58

21

First Author



(UC+IBDU)

UC:CD Ratio


CD

(95% CI)

UC

(95% CI)

Genin (2013)112 France Northern France (4 departments: Nord, Pas-de-Calais, Somme, Seine-Maritime)

all ages 1990-2006 6·50

Timmer (1999)113 Germany Mulheim and Essen (cities) ≥15 years 1991-1995 3

Timmer (1999)114 Germany Mulheim and Essen (cities) ≥15 years 1991-1995 5·2

Ott (2008)115 Germany Oberpfalz (district in Bavaria) all ages 2004-2006 10·5 6·6 3·9 0·59

Petritsch (2013)116 Austria Styria (state) all ages 1997-2007 11·3 6·20 5·1 0·82 2·7

(0·6, 4·8)a

2·7

(0·0, 5·5)

Romberg-Camps (2008)117

Netherlands South Limburg (south region of Limburg province)

all ages 1991-2002 13·93 6·21 7·72 1·24 -1·5

(-4·6, 1·6)

-5·4

(-8·1, -2·6)a

de Groof (2016)118 Netherlands Central Netherlands near Almere and Amsterdam (cities)

≥18 years 2004-2012 29·9 10·5 17·2 (19·4) 1·64

Africa (n=1)

Hammada (2011)119 Algeria Constantine (city) ≥15 years 2003-2007 9·16 5·87 3·29 0·56

≥15 years 2003 2·76

≥15 years 2007 5·12

22

* Value calculated from data presented in the paper when incidence rates not reported in the manuscript, incidence reported separately for males and females or for Crohn’s disease and ulcerative colitis ** Incidence calculated after 1989 when the study period started before 1990 a Statistically significant (p < 0.05) for time-trend analysis i The time period calculated for the AAPC was 1990 to 2004 ii The time period calculated for the AAPC was 1990 to 2001 iii The time period calculated for the AAPC was 1991 to 2005 iv The time period calculated for the AAPC was 1990 to 2014 v The time period calculated for the AAPC was 1991 to 2007

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Appendix 3: Prevalence of inflammatory bowel disease since 1990 in North America, South America, Oceania, Eastern Asia, South-eastern Asia, Southern Asia,

Western Asia, Northern Europe, Southern Europe, Western Europe, and Africa.

First Author

(Publication Year) Country Area

Age Group Inclusion

Study Period§

IBD Prevalence CD Prevalence

UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

North America (n=14)

Loftus (1998)1 USA Olmsted County, Minnesota (state) all ages 1991 133

Loftus (2000)2 USA Olmsted County, Minnesota (state) all ages 1991 229

Loftus (2007)3 USA Olmsted County, Minnesota (state) all ages 2001 388 174 214 1·23

Herrinton (2007)4▲ USA Nationwide all ages 1999-2001 320 129 191 1·48

Kappelman (2007)5▲ USA Nationwide including Puerto Rico and Virgin Islands all ages 2003-2004 439 201 238 1·18

Herrinton (2008)6 USA Northern California counties, California (state) all ages 2002 252·1 96·3 155·8 1·62

Kappelman (2013)7 USA Nationwide including Puerto Rico and Virgin Islands 0-64 years 2008-2009 483·7 235·6 248·1 1·05

Northeast states including Puerto Rico and Virgin Islands 0-64 years 2008-2009 526·5 247·2 279·3 1·13

South states 0-64 years 2008-2009 445·3 219·2 226·1 1·03

Midwest states 0-64 years 2008-2009 539 264 275 1·04

West states 0-64 years 2008-2009 483·2 219·3 263·9 1·20

Shivashankar (2016)8 USA Olmsted County, Minnesota (state) all ages 2011 533 246·7 286·3 1·16

Bernstein (1999)9 Canada Manitoba (province) all ages 1994 368·2 198·5 169·7 0·85

Bernstein (2006)10 Canada Total (average of the 5 provinces) all ages 1998-2000 472·9 279·2 193·7 0·69

33

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

British Columbia (province) all ages 1998-2000 395·8 233·7 162·1 0·69

Alberta (province) all ages 1998-2000 345·7 160·7 185 1·15

Saskatchewan (province) all ages 1998-2000 498·1 263·8 234·3 0·89

Manitoba (province) all ages 1998-2000 520 271·4 248·6 0·92

Nova Scotia (province) all ages 1998-2000 566·4 318·5 247·9 0·78

Green (2006)11 Canada Manitoba (province) all ages 1990-2001 420·1 222·2 197·9 0·89

Lowe (2009)12 Canada Québec (province) all ages 1993-2002 189·7

Benchimol (2014)13 Canada Ontario (province) all ages 2008 535·7 255·2 259·7 (280·5) 1·02

Bitton (2014)14 Canada Québec (province) all ages 2001-2008 384·9 225·6 139·8 (159·3)* 0·62

South America (n=5)

Appleyard (2004)15 Puerto Rico Southwest: Guayama, Ponce, San German, Yauco, and Mayagüez (cities and municipalities)

≥15 years 1996-2000 53·9 41·4 12·5 0·30

Vendrell (2013)16 Puerto Rico San Juan (city) all ages 2005 38·22 14·9 23·32 1·57

Edwards (2008)17 Barbados Nationwide all ages 2004 61 16·7 44·3 2·65

Victoria (2009)18 Brazil São Paulo (the city or state) ≥16 years 1991-1995 5·6 0·9 4·7 5·22

≥16 years 1996-2000 13·94 2·32 11·62 5·01

≥16 years 2001-2005 22·6 5·65 16·95 3·00

Parente (2015)19 Brazil Piauí (state) ≥18 years 1988-2012 12·8 5·08 7·72 1·52

34

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

Oceania (n=2)

Gearry (2006)20 New Zealand Canterbury (region) all ages 2004 300·2 155·2 145 0·93

Studd (2016)21 Australia Barwon (region), Victoria (state) all ages 2010-2011 401·8 197·3 196 (204·5) 0·99

Eastern Asia (n=10)

Sung (1994)22 China Hong Kong (special administrative region) all ages 1992 1·25

Lok (2007)23 China Hong Kong (special administrative region) all ages 1991-2006 1·5

Lok (2008)24 China Hong Kong (special administrative region) all ages 2006 7

Wei (2013)25 Taiwan Nationwide all ages 2008 9·4 1·78 7·62 4·28

Chuang (2013)26 Taiwan Nationwide all ages 1998-2010 5·64 1·05 4·59 4·37

Morita (1995)27 Japan Nationwide all ages 1991 23·97 5·85 18·12 3·10

Yao (2000)28 Japan Nationwide all ages 1986-1998 7·6

Asakura (2009)29 Japan Nationwide all ages 2003-2005 75·9 18·6 57·3 3·08

Yang (2000)30 Korea Songpa (a district in Seoul) all ages 1997 7·57

Yang (2008)31 Korea Songpa (a district in Seoul) all ages 2005 42·11 11·24 30·87 2·75

South-eastern Asia (n=1)

Hilmi (2015)34 Malaysia Kinta Valley (district) all ages 2013 9·24 2·17 6·67 (7·08) 3·07

Southern Asia (n=2)

35

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

Sood (2003)32 India Punjab (province) all ages 2000 44·3

Niriella (2010)33 Sri Lanka Colombo and Gampaha (towns or districts) all ages 2007-2008 6·5 1·2 5·3 4·42

Western Asia (n=4)

Odes (1994)35 Israel Southern Israel: Beer Sheva and Northern Negev (Beer Sheva, or Beersheba, is a city; Negev is a region)

all ages 1992 50·6

Tezel (2003)36 Turkey Trakya (region: the 3 provinces of Edirne, Tekirdag, Kirklareli)

≥15 years 2002 4·9

Abdul-Baki (2007)37 Lebanon Beirut (city) all ages 2000-2004 159·3 53·1 106·2 2·00

Siddique (2014)38 Kuwait Nationwide all ages 2005-2006 18·2

Northern Europe (n=11)

Probert (1993)39 UK Leicestershire (county) 15-80 1990 166·6 75·8 90·8 1·20

–South Asian 15-80 1990 169·2 33·2 136 4·10

–Hindu 15-80 1990 183·4 31·9 151·5 4·75

–Sikh 15-80 1990 169·2 30·8 138·4 4·49

–Muslim 15-80 1990 161·4 53·8 107·6 2·00

Lewis (2002)40 UK Nationwide all ages 1996 291 114·0 177·0 1·55

Rubin (2000)41 UK Stockton-on-Tees (borough) all ages 1994 388·2 144·8 243·4 1·68

Stone (2003)42 UK Central England (Trent region) all ages 2002 373 130 243 1·87

36

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

Lindgren (1996)43 Sweden Göteborg (city) ≥16 years 1990 94

Lapidus (2006)44 Sweden Stockholm (city) 16-90 2001 213

Busch (2014)45 Sweden Nationwide all ages 2010 540 190 350 1·84

Jacobsen (2006)46 Denmark North Jutland (region) all ages 2002 445 151 294 1·95

Bengtson (2009)47 Norway Southeast (the counties of Oslo, Østfold, Telemark, and Aust-Agder)

all ages 1990-1993 767 262 505 1·93

Manninen (2010)48 Finland Tampere (city) ≥15 years 1999 442 124 318 2·56

Jussila (2013)49 Finland Nationwide all ages 1993 215 38 177 4·66

Helsinki (city) all ages 1993 195 42 153 3·64

Turku (city) all ages 1993 189 33 156 4·73

Kuopio (city) all ages 1993 202 24 178 7·42

Tampere (city) all ages 1993 241 47 194 4·13

Oulu (city) all ages 1993 257 38 219 5·76

Southern Europe (n=8)

Trallori (1996)50 Italy Florence (metropolitan area) ≥15 years 1992 161 40 121 3·03

Sardu (2012)51 Italy Sardinia (island) 15-89 2009 139 15 124 8·27

Tursi (2013)52 Italy Apulia (region) all ages 2012 47 14 29 (33) 2·07

Saro Gismera C (2000)53 Spain Gijon (health district in the province of Asturias) ≥14 years 1997 238·26 116·47 121·79 1·05

37

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

Saro Gismera C (2003)54 Spain Asturias (province) ≥14 years 1997 197·41 87·45 109·96 1·26

Lucendo (2014)55 Spain Ciudad Real (province) ≥16 years 2012 239·76 137·17 99·84 (102·59) 0·73

Klarin (2013)56 Croatia Zadar (the city or county) all ages 2010 244·9 111 133·9 1·21

Pezerovi (2014)57 Croatia Vukovarsko-Srijemska (county) ≥18 years 2001 19 4·5 14·5 3·22

Western Europe (n=6)

Juillerat (2008)58 Switzerland Vaud (canton) ≥20 years 2003-2004 205·7 100·7 105 1·04

Pavlovic-Calic (2008)59 Bosnia and Herzegovina

Tuzla (the city or canton) all ages 2006 28·2

Salkic (2010)60 Bosnia and Herzegovina

Tuzla (the city or canton) all ages 2006 43·1

Azevedo (2010)61 Portugal Nationwide all ages 2003-2007 115 58 57 0·98

Hein (2014)62 Germany Hesse (state) all ages 2010 744 322 412 (422) 1·28

de Groof (2016)63 Netherlands Central Netherlands near Almere and Amsterdam (cities) ≥18 years 2004-2012 432·1 171·8 225·6 (260·3) 1·31

Eastern Europe (n=5)

Prikazska (1996)64 Slovakia Nationwide all ages 1994 6·75

Gheorghe (2004)65 Romania Nationwide all ages 2002-2003 3·93 1·51 2·42 1·60

Lakatos (2003)66 Hungary Veszprém (province) all ages 1991-2001 136 35 101 2·89

Lakatos (2011)67 Hungary Veszprém (province) all ages 2006 338·2 115·3 211·1 (222·9) 1·83

38

First Author


Age Group Inclusion

Study Period§


UC Prevalence

UC (UC+IBDU)

UC:CD Ratio

Kurti (2016)68 Hungary Nationwide all ages 2013 540 200 340 1·7

Africa (n=1)

Hammada (2011)69 Algeria Constantine ≥15 years 2007 31·59 19·02 10·57 (12·57) 0·56

§ Point prevalence is reported for a single year, whereas period prevalence is reported for year ranges.

* Value calculated from data presented in the paper when prevalence rates not reported in the manuscript.

▲ The source of data was from the Health Maintenance Organizations.

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Appendix 4: Quality assessment of manuscripts.

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Abakar-Mahamat (2007)1 Incidence a a

Abdul-Baki (2007)2 Incidence & Prevalence b b

Al-Ghamdi (2004)3 Incidence a b

Al-Shamali (2003)4 Incidence a b

Anton Martinez (2010)5 Incidence a a

Appleyard (2004)6 Incidence & Prevalence a a

Arin Letamendia (2008)7 Incidence a a

Asakura (2009)8 Prevalence a a

Azevedo (2010)9 Prevalence a a

Benchimol (2014)10 Incidence & Prevalence a a

Bengtson (2009)11 Incidence & Prevalence a a

Bernstein (1999)12 Prevalence a a

Bernstein (2006)13 Incidence & Prevalence a a

Bitton (2014)14 Incidence & Prevalence a a

Björnsson (2000)15 Incidence a a

Björnsson (2015)16 Incidence a a

Brullet (1998)17 Incidence a a

Buenavida (2011)18 Incidence a a

Burisch (2014)19 Incidence a a

Busch (2014)20 Prevalence b a

Cachia (2008)21 Incidence a b

Carr (1999)22 Incidence a b

Chen (2013)23 Incidence a a

Chouraki (2011)24 Incidence a a

Chow (2009)25 Incidence a a

45

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Chuang (2013)26 Incidence & Prevalence b a

Cottone (2006)27 Incidence a a

De Groof (2016)28 Incidence & Prevalence a b

Edouard (2005)29 Incidence a a

Edwards (2008)30 Incidence & Prevalence a a

Flamenbaum (1997)31 Incidence a a

Garcia Rodriguez (2005)32 Incidence a b

Garrido (2004)33 Incidence a a

Gearry (2006)34 Incidence & Prevalence a a

Genin (2013)35 Incidence a a

Gheorghe (2004)36 Incidence & Prevalence a a

Gheorghe (1997)37 Incidence a b

Gower-Rousseau (2013)38 Incidence a a

Green (2006)39 Incidence & Prevalence a a

Gunesh (2008)40 Incidence a a

Hammada (2011)41 Incidence & Prevalence b a

Hammer (2016)42 Incidence a a

Hein (2014)43 Prevalence a b

Herrinton (2007)44 Prevalence b a

Herrinton (2008)45 Incidence & Prevalence a b

Hilmi (2015)46 Incidence & Prevalence a a

Jacobsen (2006)47 Incidence & Prevalence a a

Jovanovic (1999)48 & Incidence & Prevalence NA NA

Juillerat (2008)49 Prevalence a a

Jussila (2012)50 Incidence b b

Jussila (2013)51 Prevalence b b

Kappelman (2007)52 Prevalence b a

46

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Kappelman (2013)53 Prevalence a b

Kasturiratne (2014)54 Incidence a a

Kim (2015)55 Incidence a a

Kiudelis (2012)56 Incidence a a

Klarin (2013)57 Incidence & Prevalence a b

Kuo (2015)58 Incidence b a

Kurti (2016)59 prevalence b a

Ladas (2005)60 Incidence a a

Lakatos (2003)61 Prevalence a a

Lakatos (2011)62 Incidence & Prevalence a a

Lapidus (2006)63 Incidence & Prevalence a a

Latour (1996)64 Incidence a a

Latour (1998)65 Incidence a a

Leddin (2014)66 Incidence a a

Leong (2004)67 Incidence a a

Lewis (2002)68 Prevalence a b

Linares (1999)69 Incidence a b

Lindgren (1996)70 Prevalence a a

Loftus (2007)71 Incidence & Prevalence a a

Loftus (1998)72 Prevalence a a

Loftus (2000)73 Prevalence a a

Lok (2007)74 Incidence & Prevalence a a

Lok (2008)75 Incidence & Prevalence a a

Lopez (1999)76 Incidence a a

Lowe (2009)77 Prevalence b a

Lucendo (2014)78 Incidence & Prevalence a a

Manninen (2010)79 Incidence & Prevalence a a

47

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Manousos (1996a)80 Incidence a a

Manousos (1996b)81 Incidence a a

Martinez (2005)82 Incidence a b

Molinie (2004)83 Incidence a a

Monferrer Guardiola (1999)84 Incidence c b

Morita (1995)85 Incidence & Prevalence a b

Moum (1995)86 Incidence a a

Moum (1996a)87 Incidence a a

Moum (1996b)88 Incidence a a

Nerich V (2006)89 Incidence b a

Ng SC (2013)90 Incidence a a

Ng SC (2016)91 Incidence a a

Niriella (2010)92 Incidence & Prevalence a a

Norgard (2014)93 Incidence b a

Odes (1994)94 Prevalence a a

Ott (2008)95 Incidence a a

Pagenault (1997)96 Incidence a a

Parente (2015)97 Incidence & Prevalence a b

Pavlovic-Calic (2008)98 Incidence & Prevalence a a

Petritsch (2013)99 Incidence a a

Pezerovi (2014)100 Incidence & Prevalence c a

Pozzati (2002)101 Incidence a b

Prikazska (1996)102 Prevalence b b

Probert (1993)103 Prevalence b b

Ranzi (1996)104 Incidence a a

Rivera (2007)105 Incidence a a

Rodrigo (2004)106 Incidence a a

Romberg-Camps (2009)107 Incidence a a

48

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Ronnblom (2010)108 Incidence a a

Rubin (2000)109 Incidence & Prevalence a a

Salkic (2010)110 Incidence & Prevalence a a

Salupere (2001)111 Incidence a a

Sardu (2012)112 Prevalence b b

Saro Gismera (2000)113 Prevalence a a

Saro Gismera (2003)114 Prevalence a a

Shapiro (2016)115 Incidence a A

Shivashankar (2016)116 Incidence & Prevalence a a

Siddique (2014)117 Prevalence a b

Sincic (2006)118 Incidence a a

Sjoberg (2013)119 Incidence a a

Sjoberg (2014)120 Incidence a a

Sood (2003)121 Incidence & Prevalence a a

Souza (2002)122 Incidence a b

Stone (2003)123 Prevalence a a

Studd (2016)124 Incidence & Prevalence a a

Su (2016)125 Incidence a a

Sung (1994)126 Prevalence a b

Tezel (2003)127 Incidence & Prevalence a a

Thompson (1998)128 Incidence a b

Timmer (1999)129 Incidence a a

Timmer (1999)130 Incidence a a

Tozun (2009)131 Incidence a b

Trallori (1996)132 Prevalence a a

Tursi (2013)133 Incidence & Prevalence a a

Van Gossum (1996)134 Incidence c b

49

First Author (Publication Year) Data reported Is the patient definition adequate?* Representativeness of the population** Vegh (2014)135 Incidence a a

Vendrell (2013)136 Prevalence b b

Victoria (2009)137 Incidence & Prevalence a a

Wei (2013)138 Incidence & Prevalence b a

Wilson (2010)139 Incidence a a

Yang (2014)140 Incidence a b

Yang (2000)141 Prevalence a a

Yang (2008)142 Incidence & Prevalence a a

Yao (2000)143 Incidence & Prevalence a a

Yapp (2000)144 Incidence a a

Zahedi (2014)145 Incidence a a

Zeng (2013)146 Incidence a a

Zhao (2012)147 Incidence a a

According to NEWCASTLE - OTTAWA QUALITY ASSESSMENT SCALE: *a=yes, with independent validation; b=yes, e.g. record linkage or based on self reports; c=no description **a=consecutive or obviously representative series of population; b=potential for selection biases or not stated &Full text not available

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Supplementary appendix - thelancet.com · Supplementary appendix. ... Southern Europe, Western Europe, and Africa. CD – Crohn’s disease; UC – ulcerative colitis; ... British