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The trajectory of inflammatory bowel disease in east and southeast Asia: transitioning from acceleration in incidence to compounding prevalence

The Lancet Gastroenterology & Hepatology·August 12
Gastroenterology & HepatologyPractice changingCrohn'S DiseaseInflammatory Bowel DiseaseUlcerative ColitisNarrative ReviewMixed

Summary

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What was studied

This review traces the 100-year epidemiological trajectory of inflammatory bowel disease (IBD) across five east and southeast Asian regions — Japan, South Korea, China, Hong Kong, and Malaysia — from the first reported cases in 1920s Japan to 2026, using a four-stage framework (emergence → acceleration in incidence → compounding prevalence → prevalence equilibrium).

Key findings

Most early-industrialised regions (Europe, North America, Oceania) have reached stage 3 (compounding prevalence), while east and southeast Asian regions are currently in early, middle, or late phases of stage 2 (acceleration in incidence), with some poised to become the first non-early-industrialised regions to enter stage 3.

Study limitations

As a narrative review, it does not pool quantitative data or perform meta-analysis, limiting precision of incidence/prevalence estimates. Coverage is restricted to five selected regions, which may not represent all of east and southeast Asia.

Clinical implications

Clinicians in east and southeast Asia should anticipate a sustained rise in IBD diagnoses as their regions approach stage 3, and health systems should proactively build IBD care capacity. Cross-regional epidemiological data from this region can also inform preparedness planning in other newly industrialised and emerging areas.

Caveats

  • No sample size tag applied — this is a review article with no primary patient cohort. The 'impact_flag: practice_changing' tag reflects the public health and systems-planning implications highlighted by the authors, though the study itself does not test an intervention. The four-stage epidemiological framework is the authors' own model and has not been independently validated in a separate cohort.

Related Questions

Explore related topics

What is the current incidence and prevalence of IBD in east and southeast Asia compared to Western countries?How should gastroenterologists in newly industrialised countries prepare for rising IBD burden?What environmental and dietary factors are driving the increase in IBD incidence in Asia?

Publication Details

Year
2026
Journal
The Lancet Gastroenterology & Hepatology
Source
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