Editing Ulcerative colitis (section)

==Epidemiology==

Together with [[Crohn's disease]], about 11.2 million people were affected {{as of|2015|lc=yes}}.<ref name="GBD2015Pre">{{cite journal |last1=Vos |first1=Theo |last2=Allen |first2=Christine |last3=Arora |first3=Megha |last4=Barber |first4=Ryan M. |last5=Bhutta |first5=Zulfiqar A. |last6=Brown |first6=Alexandria |last7=Carter |first7=Austin |last8=Casey |first8=Daniel C. |last9=Charlson |first9=Fiona J. |last10=Chen |first10=Alan Z. |last11=Coggeshall |first11=Megan |last12=Cornaby |first12=Leslie |last13=Dandona |first13=Lalit |last14=Dicker |first14=Daniel J. |last15=Dilegge |first15=Tina |date=October 2016 |title=Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 |journal=Lancet |volume=388 |issue=10053 |pages=1545–1602 |doi=10.1016/S0140-6736(16)31678-6 |pmc=5055577 |pmid=27733282 |collaboration=GBD 2015 Disease and Injury Incidence and Prevalence Collaborators |last16=Erskine |first16=Holly E. |last17=Ferrari |first17=Alize J. |last18=Fitzmaurice |first18=Christina |last19=Fleming |first19=Tom |last20=Forouzanfar |first20=Mohammad H. |last21=Fullman |first21=Nancy |last22=Gething |first22=Peter W. |last23=Goldberg |first23=Ellen M. |last24=Graetz |first24=Nicholas |last25=Haagsma |first25=Juanita A. |last26=Hay |first26=Simon I. |last27=Johnson |first27=Catherine O. |last28=Kassebaum |first28=Nicholas J. |last29=Kawashima |first29=Toana |last30=Kemmer |first30=Laura}}</ref> Each year it newly occurs in 1 to 20 per 100,000 people, and 5 to 500 per 100,000 individuals are affected.<ref name=BMJ2013/><ref name=NEJM2011/> The disease is more common in North America and Europe than other regions.<ref name=NEJM2011>{{cite journal | vauthors = Danese S, Fiocchi C | title = Ulcerative colitis | journal = The New England Journal of Medicine | volume = 365 | issue = 18 | pages = 1713–1725 | date = November 2011 | pmid = 22047562 | doi = 10.1056/NEJMra1102942 }}</ref> Often it begins in people aged 15 to 30 years, or among those over 60.<ref name=NIH2014/> Males and females appear to be affected in equal proportions.<ref name=BMJ2013/> It has also become more common since the 1950s.<ref name=BMJ2013/><ref name=NEJM2011/> Together, ulcerative colitis and Crohn's disease affect about a million people in the United States.<ref name="Elsevier Health Sciences">{{cite book| vauthors = Adams JG |title=Emergency Medicine E-Book: Clinical Essentials (Expert Consult – Online)|date=2012|publisher=Elsevier Health Sciences|isbn=978-1455733941|page=304|url=https://books.google.com/books?id=rpoH-KYE93IC&pg=PA304|language=en}}</ref> With appropriate treatment the risk of death appears the same as that of the general population.<ref name=Wan2016/> The first description of ulcerative colitis occurred around the 1850s.<ref name=NEJM2011/>

Each year, ulcerative colitis newly occurs in 1 to 20 per 100,000 people (incidence), and there are a total of 5–500 per 100,000 individuals with the disease (prevalence).<ref name=BMJ2013>{{cite journal | vauthors = Ford AC, Moayyedi P, Hanauer SB | title = Ulcerative colitis | journal = BMJ | volume = 346 | pages = f432 | date = February 2013 | pmid = 23386404 | doi = 10.1136/bmj.f432 | s2cid = 14778938 }}</ref><ref name=NEJM2011/> In 2015, a worldwide total of 47,400 people died due to inflammatory bowel disease (UC and Crohn's disease).<ref name=GBD2015De>{{cite journal | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459–1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/s0140-6736(16)31012-1 | collaboration = GBD 2015 Mortality and Causes of Death Collaborators | last1 = Wang | first1 = Haidong | last2 = Naghavi | first2 = Mohsen | last3 = Allen | first3 = Christine | last4 = Barber | first4 = Ryan M. | last5 = Bhutta | first5 = Zulfiqar A. | last6 = Carter | first6 = Austin | last7 = Casey | first7 = Daniel C. | last8 = Charlson | first8 = Fiona J. | last9 = Chen | first9 = Alan Zian | last10 = Coates | first10 = Matthew M. | last11 = Coggeshall | first11 = Megan | last12 = Dandona | first12 = Lalit | last13 = Dicker | first13 = Daniel J. | last14 = Erskine | first14 = Holly E. | last15 = Ferrari | first15 = Alize J. | last16 = Fitzmaurice | first16 = Christina | last17 = Foreman | first17 = Kyle | last18 = Forouzanfar | first18 = Mohammad H. | last19 = Fraser | first19 = Maya S. | last20 = Fullman | first20 = Nancy | last21 = Gething | first21 = Peter W. | last22 = Goldberg | first22 = Ellen M. | last23 = Graetz | first23 = Nicholas | last24 = Haagsma | first24 = Juanita A. | last25 = Hay | first25 = Simon I. | last26 = Huynh | first26 = Chantal | last27 = Johnson | first27 = Catherine O. | last28 = Kassebaum | first28 = Nicholas J. | last29 = Kinfu | first29 = Yohannes | last30 = Kulikoff | first30 = Xie Rachel }}</ref> The peak onset is between 30 and 40 years of age,<ref name=Ungaro /> with a second peak of onset occurring in the 6th decade of life.<ref>{{cite journal | vauthors = Karlinger K, Györke T, Makö E, Mester A, Tarján Z | title = The epidemiology and the pathogenesis of inflammatory bowel disease | journal = European Journal of Radiology | volume = 35 | issue = 3 | pages = 154–167 | date = September 2000 | pmid = 11000558 | doi = 10.1016/s0720-048x(00)00238-2 }}</ref> Ulcerative colitis is equally common among men and women.<ref name=Ungaro>{{cite journal | vauthors = Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF | title = Ulcerative colitis | journal = Lancet | volume = 389 | issue = 10080 | pages = 1756–1770 | date = April 2017 | pmid = 27914657 | pmc = 6487890 | doi = 10.1016/S0140-6736(16)32126-2 }}</ref><ref name=BMJ2013/> With appropriate treatment the risk of death appears similar to that of the general population.<ref name=Wan2016/> UC has become more common since the 1950s.<ref name=BMJ2013/><ref name=NEJM2011/>

The geographic distribution of UC and Crohn's disease is similar worldwide,<ref name=Podolsky>{{cite journal | vauthors = Podolsky DK | title = Inflammatory bowel disease | journal = The New England Journal of Medicine | volume = 347 | issue = 6 | pages = 417–429 | date = August 2002 | pmid = 12167685 | doi = 10.1056/NEJMra020831 }}</ref> with the highest number of new cases a year of UC found in [[Canada]], [[New Zealand]] and the [[United Kingdom]].<ref>{{cite journal | vauthors = Schmidt JA, Marshall J, Hayman MJ | title = Identification and characterization of the chicken transferrin receptor | journal = The Biochemical Journal | volume = 232 | issue = 3 | pages = 735–741 | date = December 1985 | pmid = 3004417 | pmc = 1152945 | doi = 10.1042/bj2320735 }}</ref> The disease is more common in North America and Europe than other regions.<ref name=NEJM2011/> In general, higher rates are seen in northern locations compared to southern locations in [[Europe]]<ref>{{cite journal | vauthors = Shivananda S, Lennard-Jones J, Logan R, Fear N, Price A, Carpenter L, van Blankenstein M | title = Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD) | journal = Gut | volume = 39 | issue = 5 | pages = 690–697 | date = November 1996 | pmid = 9014768 | pmc = 1383393 | doi = 10.1136/gut.39.5.690 | df = dmy-all }}</ref> and the United States.<ref name=Sonneberg>{{cite journal | vauthors = Sonnenberg A, McCarty DJ, Jacobsen SJ | title = Geographic variation of inflammatory bowel disease within the United States | journal = Gastroenterology | volume = 100 | issue = 1 | pages = 143–149 | date = January 1991 | pmid = 1983816 | doi = 10.1016/0016-5085(91)90594-B }}</ref> UC is more common in western Europe compared with eastern Europe.<ref>{{cite journal | vauthors = Burisch J, Pedersen N, Čuković-Čavka S, Brinar M, Kaimakliotis I, Duricova D, Shonová O, Vind I, Avnstrøm S, Thorsgaard N, Andersen V, Krabbe S, Dahlerup JF, Salupere R, Nielsen KR, Olsen J, Manninen P, Collin P, Tsianos EV, Katsanos KH, Ladefoged K, Lakatos L, Björnsson E, Ragnarsson G, Bailey Y, Odes S, Schwartz D, Martinato M, Lupinacci G, Milla M, De Padova A, D'Incà R, Beltrami M, Kupcinskas L, Kiudelis G, Turcan S, Tighineanu O, Mihu I, Magro F, Barros LF, Goldis A, Lazar D, Belousova E, Nikulina I, Hernandez V, Martinez-Ares D, Almer S, Zhulina Y, Halfvarson J, Arebi N, Sebastian S, Lakatos PL, Langholz E, Munkholm P | title = East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort | journal = Gut | volume = 63 | issue = 4 | pages = 588–597 | date = April 2014 | pmid = 23604131 | doi = 10.1136/gutjnl-2013-304636 | hdl-access = free | s2cid = 25069828 | hdl = 2336/325171 }}</ref>  Worldwide, the prevalence of UC varies from 2 to 299 per 100,000 people.<ref name=Molodecky>{{cite journal | vauthors = Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, Benchimol EI, Panaccione R, Ghosh S, Barkema HW, Kaplan GG | title = Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review | journal = Gastroenterology | volume = 142 | issue = 1 | pages = 46–54.e42; quiz e30 | date = January 2012 | pmid = 22001864 | doi = 10.1053/j.gastro.2011.10.001 | url = http://www.gastrojournal.org/article/S0016508511013783/pdf }}</ref> Together, ulcerative colitis and Crohn's disease affect about a million people in the United States.<ref name="Elsevier Health Sciences"/>

As with Crohn's disease, the rates of UC are greater among [[Ashkenazi|Ashkenazi Jews]] and decreases progressively in other persons of Jewish descent, non-Jewish Caucasians, Africans, Hispanics, and Asians.<ref name="ISBN 0071599916"/> Appendectomy prior to age 20 for appendicitis<ref>{{cite journal | vauthors = Andersson RE, Olaison G, Tysk C, Ekbom A | title = Appendectomy and protection against ulcerative colitis | journal = The New England Journal of Medicine | volume = 344 | issue = 11 | pages = 808–814 | date = March 2001 | pmid = 11248156 | doi = 10.1056/NEJM200103153441104 | doi-access = free }}</ref> and current tobacco use<ref name="Boyko">{{cite journal | vauthors = Boyko EJ, Koepsell TD, Perera DR, Inui TS | title = Risk of ulcerative colitis among former and current cigarette smokers | journal = The New England Journal of Medicine | volume = 316 | issue = 12 | pages = 707–710 | date = March 1987 | pmid = 3821808 | doi = 10.1056/NEJM198703193161202 }}</ref> are protective against development of UC.<ref name=Ungaro /> However, former tobacco use is associated with a higher risk of developing the disease.<ref name="Boyko" /><ref name=Ungaro />

===United States===
{{As of|2004}}, the number of new cases of UC in the United States was between 2.2 and 14.3 per 100,000 per year.<ref name=":0">{{cite web|url=https://www.cdc.gov/ibd/ibd-epidemiology.htm|title=Epidemiology of the IBD|website=[[Centers for Disease Control and Prevention]] (CDC)|access-date=23 February 2017|url-status=dead|archive-url=https://web.archive.org/web/20170223213840/https://www.cdc.gov/ibd/ibd-epidemiology.htm|archive-date=23 February 2017}}</ref> The number of people affected in the United States in 2004 was between 37 and 246 per 100,000.<ref name=":0" />

=== Canada ===
In Canada, between 1998 and 2000, the number of new cases per year was 12.9 per 100,000 population or 4,500 new cases. The number of people affected was estimated to be 211 per 100,000 or 104,000.<ref>{{cite journal | vauthors = Makhlouf GM, Zfass AM, Said SI, Schebalin M | title = Effects of synthetic vasoactive intestinal peptide (VIP), secretin and their partial sequences on gastric secretion | journal = Proceedings of the Society for Experimental Biology and Medicine | volume = 157 | issue = 4 | pages = 565–568 | date = April 1978 | pmid = 349569 | doi = 10.3181/00379727-157-40097 | s2cid = 40543366 }}</ref>

=== United Kingdom ===
In the United Kingdom 10 per 100,000 people newly develop the condition a year while the number of people affected is 243 per 100,000. Approximately 146,000 people in the United Kingdom have been diagnosed with UC.<ref>{{cite web |title=Ulcerative colitis: management |url=https://www.nice.org.uk/guidance/ng130 |website=National Institute for Health and Care Excellence |date=3 May 2019 }}</ref>