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Race and Inflammatory Bowel Disease in an Urban Healthcare System
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Race and Inflammatory Bowel Disease in an Urban Healthcare System
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Journal Article
Race and Inflammatory Bowel Disease in an Urban Healthcare System
2010
Overview
Background Inflammatory bowel disease (IBD) is increasingly common among non-Caucasian populations, but interracial differences in disease characteristics and management are not well-characterized. Aims We tested the hypothesis that disease characteristics and management vary by race among IBD patients in an ethnically diverse healthcare system. Methods A retrospective study of the safety net healthcare system of San Francisco, CA, from 1996 to 2009 was undertaken. Patient records with International Classification of Diseases, 9th Revision (ICD9) codes 555.xx, 556.xx, and 558.xx were reviewed. Adult patients with confirmed IBD diagnoses were included. Interracial variations in disease characteristics and management were assessed broadly; focused between-race comparisons identified specific differences. Results The 228 subjects included 77 (33.4%) with Crohn's disease (CD), 150 (65.8%) with ulcerative colitis, and 1 (0.4%) with IBD, type unclassified. The race distribution included 105 (46.1%) white, 34 (14.9%) black, 35 (15.4%) Hispanic, and 51 (22.4%) Asian subjects. Asians and Hispanics were diagnosed at older ages (41.0 and 37.1 years, respectively) and had shorter disease durations (5.4 and 5.2 years, respectively) than whites (30.5 years at diagnosis and 8.6 years duration, P < 0.05) and blacks (31.7 years at diagnosis and 12.1 years duration, P < 0.05). CD was more common among blacks (50% of subjects) than Asians (25.5% of subjects, P = 0.015). The Montreal classification of IBD was similar among races. Hispanics were less likely than others to be treated with 5-aminosalicylates (5-ASA), immunomodulators, and steroids. Medical and surgical management was otherwise similar among races. Conclusions Modest race-based differences in IBD characteristics exist in this racially diverse healthcare system, but the management of IBD is similar among race groups.
Publisher
Boston : Springer US,Springer US,Springer,Springer Nature B.V
Subject
/ Analysis
/ Biological and medical sciences
/ Colitis, Ulcerative - ethnology
/ Colitis, Ulcerative - therapy
/ Female
/ Fundamental and applied biological sciences. Psychology
/ Gastroenterology. Liver. Pancreas. Abdomen
/ Health Services Accessibility - organization & administration
/ Humans
/ Male
/ Medicine
/ Oncology
/ Original
/ Racial distribution (Demography)
/ San Francisco - epidemiology
/ Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
/ Urban Population - statistics & numerical data
/ Vertebrates: anatomy and physiology, studies on body, several organs or systems
