Epidemiology of inflammatory bowel disease in southern Spain � A population-based study of native and migrant populations (2012-2022)

BACKGROUND: The epidemiology of inflammatory bowel disease (IBD) among migrant populations in southern Spain has been scarcely explored. This study analyses the incidence, prevalence, and severity of IBD among native and migrant populations in Granada over a decade. METHODS: A retrospective, multicenter, population-based study (2012-2022) including 2,764 IBD patients. A subset of 144 cases (111 natives, 33 migrants) was selected using age-, sex-, and disease-type matching. Multivariate logistic regression identified independent predictors of severe disease. RESULTS: Most migrant patients originated from Africa (57.5%), followed by Latin America (27.3%) and Central Europe (15.2%). Migrants were diagnosed at a younger age than Spaniards (38.8 ± 12.1 vs 47.7 ± 15.0 years; p = 0.002). Prevalence increased among natives (295/100,000) but remained stable among migrants (41/100,000). Incidence was higher in natives (6.49 vs 1.32 per 100,000/year). Severe IBD affected 34% of all patients, being more frequent among Spaniards (37.8%) than migrants (21.2%). Independent predictors of severity included Crohn's disease (OR 2.36; 95% CI 1.00-5.40), ≥3 colonoscopies (OR 7.02; 95% CI 2.35-20.98), ≥3 hospitalizations (OR 7.75; 95% CI 2.27-26.47), and Spanish nationality (OR 3.24; 95% CI 1.00-10.49). CONCLUSIONS: The prevalence and incidence of IBD in Granada have increased over the last decade but remain lower than those in northern Europe. Migrant populations exhibit lower disease severity. The Mediterranean diet and universal healthcare access may mitigate differences in disease progression.