37%, but the cumulative incidence was comparable to that of Western countries. It is likely that with the rising incidence and increasing proportion of patients with longer follow-up in Asian countries the prevalence of CRC will increase. Disease location.  In the West, CD has been found to occur in the ileum, colon, and both ileum and colon in equal proportions of patients;85 however, a number of studies from the West have reported isolated colonic disease as the most common type of CD.158–161 Ileo-colonic disease appears to be

https://www.selleckchem.com/products/CAL-101.html the most common CD location in Asia13,30,52,70,72,73,75–77,139,162–164 (Table 4). A study comparing patients from China and America reported that the Chinese patients had significantly higher rates of ileo-cecal disease

than the Americans.71 In contrast a predominance of colonic disease was seen in two studies in Sri Lanka,35,79 and ileal disease in India78 and Japan.52 Upper gastrointestinal (UGIT) disease has not been routinely reported. However, a study from Hong Kong found that 22.7% of patients had UGIT disease at diagnosis,26 a higher figure than in the West.88,165–167 UGIT disease independently predicted the need for hospitalization. A similar rate of UGIT disease has been reported in previous Indian78 and Chinese72 studies. Disease behavior and course.  Studies from the West have shown rates at diagnosis of inflammatory, stricturing, penetrating and perianal CD as 62–81%, 5–27%, 8–14%, 11–27%,160,161,167,168 respectively. Comparing these data with Asian studies is difficult Benzatropine as they have usually selleck chemical not used a standardized classification system or reported CD behavior at diagnosis. Studies from China, Hong Kong, Korea, Singapore and India, which are mostly hospital based, have reported inflammatory disease in 40–69%,

stricturing disease in 20–28%, and penetrating disease in 10–31% of patients with CD.33,35,70,72,73,75,77,79,164,169 Two studies documenting behavior at diagnosis have reported a high proportion of perianal disease at diagnosis in Hong Kong (33.3%)75 and Korea (36.7%).77 These figures are higher than that reported in large Caucasian CD studies.109,169 The evolution from inflammatory behavior to a more complicated disease behavior (stricturing or penetrating) is well demonstrated in the Western literature,165,170 and has also now been shown in an Asian study from Hong Kong.75 A study from China171 has identified similar risk factors for developing disabling disease as in the West, namely age < 40 years at diagnosis, steroid requirement for treating acute exacerbation and perianal disease at diagnosis.109,161 Other disease features that are similar between the West and Asia include less severe disease in Crohn’s colitis compared to those with ileal involvement,76 and a more severe disease course in younger patients.33 Surgery.