INCIDENCE AND PREVALENCE OF INFLAMMATORY BOWEL DISEASES IN HISPANICS IN THE UNITED STATES, 2011-2020

Background & Aims: Hispanics account for 19% (62 million) of the US population, of whom 2/3^rd are US born; with global and regional immigration patterns, Hispanics are expected to increase to 30% of the US population (111 million) by 2060. Western lifestyle with changes in diet and environment lead to increased risk of IBD in first-generation Hispanic immigrants. Through secondary analysis of the INPUT study (Lewis et al. Gastroenterology 2023;165:1197-1205), we sought to estimate trends in age- and sex-stratified incidence and prevalence of physician-diagnosed IBD in Hispanics the United States.
Methods: We used 2 administrative claims data sets: a 20% random sample of national fee-for-service Medicare data (2007 to 2017) and commercial health insurance data from Optum's deidentified Clinformatics Data Mart (CDM) (2007 to 2020). We used validated combinations of medical diagnoses, diagnostic procedures, and prescription medications to identify incident and prevalent diagnoses. We computed pooled age-, and sex-specific insurance-weighted estimates and pooled estimates standardized to 2018 United States Census estimates with 95% confidence intervals (CIs).
Results: In CDM, the 2020 incidence of IBD, CD and UC in Hispanics was 5.33 (95% CI, 4.09-6.58), 1.64 (0.94-2.35) and 3.33 (2.36-4.31) per 100,000 person-years respectively. The prevalence of IBD in Hispanics steadily increased from 381 (95% CI, 363-400) per 100,000 persons in 2011, to 411 (393-429) in 2014 and 416 (399-433) in 2017, and then declined to 387 (372-402) in 2020. Age- and sex-specific prevalence estimates are shown in Figure 1. Prevalence of IBD was 1.1-1.4 times higher in females vs. males in those aged 40y or higher, but ratio was <1 in younger patients. The prevalence of UC was 1.3-2.3 times higher than CD in Hispanic adults, whereas the ratio was ~1 in pediatric participants. Prevalence was highest in the Northeast (620 per 100,000 persons) region, and lowest in the West (353 per 100,000 persons). Extrapolated to the 2020 United States Census, 240,000 Hispanic Americans are estimated to be diagnosed with IBD.
In the fees-for-service Medicare database of adults >65y age, the prevalence of CD was 761-1266 per 100,000 persons (males and females), and of UC, was 2650-3295 per 100,000 persons in adults 65-80y in 2017. The prevalence increased slightly from 2011 (CD: 585-1218; UC: 1715-2570) and 2014 (CD: 616-1292; UC: 2137-3031).
Conclusions: IBD affects 0.36% of Hispanic Americans, with a gradual rise in prevalence. The prevalence is higher in females, in Hispanics living in the Northeast, and UC is more common than CD. Understanding the burden and impact of IBD in Hispanics is vital to inform US health policy.