{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:05:41Z","timestamp":1789477541492,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2020-02002"],"award-info":[{"award-number":["2020-02002"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Regional Agreement on Medical Training and Clinical Research","award":["FoUI-1002495"],"award-info":[{"award-number":["FoUI-1002495"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The use of advanced therapies in pediatric-onset inflammatory bowel disease (PIBD) has increased substantially over the past two decades, while corresponding changes in surgical risk remain insufficiently studied. We aimed to compare the use of PIBD-related surgery across calendar periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using nationwide, population-based registers in Sweden, we identified all patients with PIBD, including Crohn\u2019s disease (CD) and ulcerative colitis (UC). We compared the cumulative incidence of IBD-related surgery by calendar period of first PIBD diagnosis (2002-2011 vs 2012-2022), with follow-up through adulthood. Trends in the use of advanced therapies were described for the same periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 8200 patients with PIBD, with a median follow-up of 13.9\u2009years for those diagnosed in 2002-2011 (n\u2009=\u20093751) and 4.3\u2009years for 2012-2022 (n\u2009=\u20094449). The 5-year cumulative incidence of luminal surgical intervention decreased over time (9.6% vs 6.1%, P\u2009&amp;lt;\u2009.001). This reduction was observed for colectomy in UC (P\u2009=\u2009.044) but not in CD (P\u2009=\u2009.121). Patients with CD showed marked declines in small bowel surgery, including ileocecal resections, and in segmental colonic resections (P\u2009&amp;lt;\u2009.001 and P\u2009=\u2009.006). Between the first and second calendar period, the annual proportion of patients starting advanced therapies increased 2-fold for first-line use and 4-fold for second-line use, while third-line therapy was only observed in the later period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over the past two decades, the cumulative incidence of several types of IBD-related surgery in PIBD has declined in parallel with a pronounced increase in the use of advanced therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag127","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:48:02Z","timestamp":1786016882000},"source":"Crossref","is-referenced-by-count":0,"title":["Declining rates of surgery in pediatric-onset inflammatory bowel disease: a Swedish nationwide register-based cohort study 2002-2022"],"prefix":"10.1093","volume":"20","author":[{"given":"Helena","family":"Rolandsdotter","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, Karolinska Institutet, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]},{"name":"Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , 171 64 Stockholm,","place":["Sweden"]},{"name":"Pediatric Gastroenterology and Nutrition Unit, Sachs\u2019 Children and Youth Hospital, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K\u00e1ri","family":"Kristj\u00e1nsson","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , 171 64 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0311-8894","authenticated-orcid":false,"given":"\u00c5sa H","family":"Everhov","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, Karolinska Institutet, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]},{"name":"Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , 171 64 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5112-8894","authenticated-orcid":false,"given":"Caroline","family":"Nordenvall","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , 171 76 Stockholm,","place":["Sweden"]},{"name":"Department of Pelvic Cancer, Karolinska University Hospital , 171 76 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Swibreg Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter","family":"Malmborg","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, Karolinska Institutet, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]},{"name":"Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , 171 64 Stockholm,","place":["Sweden"]},{"name":"Pediatric Gastroenterology and Nutrition Unit, Sachs\u2019 Children and Youth Hospital, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-9213","authenticated-orcid":false,"given":"P\u00e4r","family":"Myrelid","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Link\u00f6ping University , 581 85 Link\u00f6ping,","place":["Sweden"]},{"name":"Clinical Department of Surgery in Link\u00f6ping, Region \u00d6sterg\u00f6tland , 581 85 Link\u00f6ping,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilda","family":"Br\u00e4utigam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Queen Silvia Children\u2019s Hospital, Sahlgrenska University Hospital , 416 50 Gothenburg,","place":["Sweden"]},{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University , 405 30 Gothenburg,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas F","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , 171 65 Stockholm,","place":["Sweden"]},{"name":"Department of Pediatrics, Orebro University Hospital , 703 82 Orebro,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Ol\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, Karolinska Institutet, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]},{"name":"Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , 171 64 Stockholm,","place":["Sweden"]},{"name":"Pediatric Gastroenterology and Nutrition Unit, Sachs\u2019 Children and Youth Hospital, S\u00f6dersjukhuset , 118 83 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091508151011300_jjag127-B1","first-page":"S0016-5085(26)00032-6","article-title":"Forecasting the incidence and prevalence of inflammatory bowel disease across nine epidemiologic stage 3 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