The prevalence of Crohn's disease in Israel: A 20-Year survey

Objectives This is the third survey that we have performed in the kibbutz population in Israel. The previous two surveys were 10 years apart, in 1987 and 1997, demonstrating an increase in Crohn's disease prevalence. The aim of the present study was to confirm the trend for increasing Crohn's disease prevalence in Israel. Methods There are 269 kibbutz settlements in Israel, with a total of 117,700 people, accounting for 2.4% of the Jewish Israeli population. The local physician for each kibbutz was contacted by mail, e-mail, telephone, and fax in order to obtain information on Crohn's disease patients. Data was retrieved and updated to 31st December 2007, the point prevalence date. Details of gender, age, origin, clinical spectrum of the disease, therapy, and complications were recorded. Results There were 133 confirmed cases of Crohn's disease. The prevalence rate rose from 25.53/100,000 in 1987 to 65.11/100,000 in 1997, and then to 112.99 in 2007 (P < 0.0001). The prevalence rate was higher in women than men, and Israeli- or European/American-born than Asian/African-born individuals. The rise in prevalence was steady from 1987 to 1997 and then to 2007 in all subgroups, except for Asian/African-born kibbutz members. In the last group, a decrease in prevalence was demonstrated between 1987 and 1997, and then a sharp increase between 1997 and 2007. Conclusions We conclude that the incidence and prevalence of Crohn's disease increased in the three ethnic groups of Israeli Jews. Differences still exist but become smaller, maybe due to the strong environmental influence that overcame genetic preponderance.