Epidemiology of Crohn's disease in Israel: A survey of Israeli kibbutz settlements

OBJECTIVE: The prevalence of Crohn's disease ranges from 10 to 70 cases per 100,000 population, and is 3-8 times more common among Jews. However, this excess risk is not evident in the Jewish population of Israel. Recently we have described a significant increase in the prevalence and incidence of C rohn's disease in the south of Israel. The aim of this study was to confirm this trend in a stable population found in communal (kibbutz) settlements. METHODS: We repeated a community-based survey in 124,400 kibbutz residents, 10 yr after our first study. This population represents 5% of the Jewish p opulation of Israel. All Crohn's disease patients were located by contactin g the kibbutz clinics of the 269 kibbutz settlements (100% compliance). Dat a was updated to December 31st, 1997, which was designated the point preval ence date, and included information on gender, age, origin, education, prof ession, extent of the inflammatory process, clinical spectrum of the diseas e, therapy, complications of the disease, and treatment. The average annual incidence for the 10 yr was calculated from the prevalence data. Only case s with a definite diagnosis of Crohn' s disease made in a recognized gastro enterology unit were accepted into the study. RESULTS: There were 81 confirmed cases of Crohn's disease and the prevalenc e rate rose from 25.5/100,000 in 1987 to 65.1/100,000 in 1997 (p < 0.001). The mean annual incidence rate for this period (1987-1997) is 5.0/ 100,000/ yr. Prevalence rates were higher in women than men, and in those born in Is rael or Europe/America than in Asia/Africa. The mean age at presentation of the disease was lower in 1997 than in 1987, 37.4 +/- 17.0 and 45.0 +/- 17. 0 yr, respectively (p = 0.041). Prevalence was highest in men with >16 yr o f education, and in women with 11-12 yr education, 119.7 and 100.3/100,000, respectively. CONCLUSIONS: During the decade 1987-1997, the prevalence of Crohn's disease has increased in Israel and is approaching the rates in Europe and America . (C) 1999 by Am. Coll. of Gastroenterology.