Epidemiology of ulcerative colitis in Israel: A survey of Israeli kibbutz settlements

OBJECTIVE: The incidence of ulcerative colitis ranges from 3 to 15 cases pe r 100,000 persons per year with a prevalence of 50-80 cases per 100,000, an d the disease is 3-5 times more common among Jews. In Israel, Ashkenazi Jew s have a higher incidence than Sephardi Jews, but a lower incidence than As hkenazi Jews in the United States or Northern Europe. The aim of this study was to examine the prevalence, mean annual incidence, and clinical pattern s of ulcerative colitis in a stable population of communal settlements (kib butz). METHODS: We repeated a community-based survey in 124,400 kibbutz residents, 10 yr after our first study. This population represents 2.5% of the Jewish population of Israel. All ulcerative colitis patients were located by cont acting the kibbutz clinics of the 269 kibbutz settlements (100% compliance) . Data were updated to December 31st, 1997, which was designated the point prevalence date, and included information on gender, age, origin, education , profession, extent of the inflammatory process, clinical spectrum of the disease, therapy, complications of the disease, and treatment. The mean ann ual incidence for the 10 yr was calculated from the prevalence data. Only c ases with a definite diagnosis of ulcerative colitis made in a recognized g astroenterology unit were accepted into the study. RESULTS: There were 208 confirmed cases of ulcerative colitis disease, 113 women and 95 men (female:male ratio = 1.19). The prevalence rate rose from 121.0/100,000 in 1987 to 167.2/100,000 in 1997 (p < 0.001). The prevalence rates were higher in women than men. Prevalence was highest in Israeli-born members in 1987 but in European/American-born members in 1997. The average annual incidence rate for the 10-yr period was 5.04/100,000/yr. In 1987, 1 46 cases of ulcerative colitis were collected. During 10 yr of surveillance 17 patients left the kibbutz, 12 died, and 62 new cases were added. The me an age at presentation of the disease was lower in 1987 than in 1997, 46.14 +/- 11.10 and 51.43 +/- 16.67 yr, respectively. Prevalence was highest in men with >16 yr and in women with 9-10 yr of education, 259.3 and 242.9/100 ,000, respectively. CONCLUSIONS: The prevalence of ulcerative colitis in this Israeli populatio n increased and has reached the upper range for European and American popul ations. The mean annual incidence rate of ulcerative colitis is in the lowe r range of that reported for the Western countries. (Am J Gastroenterol 200 0;95:693-698. (C) 2000 by Am. Coll. of Gastroenterology).