{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:48:51Z","timestamp":1792439331817,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23DK117058"],"award-info":[{"award-number":["K23DK117058"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R03DK129631"],"award-info":[{"award-number":["R03DK129631"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Perianal Crohn\u2019s disease (pCD) is a potentially severe phenotype of CD. We conducted a systematic review with meta-analysis to estimate cumulative incidence, risk factors, and outcomes of pCD in population-based cohort studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Through a systematic literature review through March 1, 2021, we identified population-based inception cohort studies reporting cumulative incidence of perianal disease (primarily abscess and\/or fistula) in patients with CD. We estimated the cumulative incidence of pCD at presentation and 1-, 5-, and 10-year follow-up, and risk factors for perianal disease and outcomes including risk of major (bowel resection, proctectomy, ostomy) and minor perianal (incision and drainage, seton placement, etc.) surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 12 population-based studies, prevalence of pCD was 18.7% (95% confidence interval [CI], 12.5%-27.0%) with 1-, 5-, and 10-year risk of perianal disease being 14.3% (95% CI, 7.9%-24.6%), 17.6% (95% CI, 11.3%-26.5%), and 18.9% (95% CI, 15.0%-23.4%), respectively. Approximately 11.5% of patients (95% CI, 6.7%-19.0%) had perianal disease at or before CD diagnosis. Colonic disease location and rectal involvement were associated with higher risk of pCD. Overall, 63.3% of patients (95% CI, 53.3-72.3) required minor perianal surgery and 6.4% of patients (95% CI, 1.8%-20.6%) required major abdominal surgery for pCD. Use of biologic therapy for pCD is common and has steadily increased throughout the years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately 1 in 5 patients with CD develops perianal disease within 10 years of CD diagnosis, including 11.5% who have perianal disease at presentation. Approximately two-thirds of patients require perianal surgery, with a smaller fraction requiring major abdominal surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izab287","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T08:37:11Z","timestamp":1637224631000},"page":"1477-1484","source":"Crossref","is-referenced-by-count":161,"title":["Epidemiology and Natural History of Perianal Crohn\u2019s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts"],"prefix":"10.1093","volume":"28","author":[{"given":"Lester","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, University of California San Diego , La Jolla, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"McCurdy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, University of Ottawa , Ottawa, ON , Canada"},{"name":"Ottawa Hospital Research Institute , Ottawa, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4698-9948","authenticated-orcid":false,"given":"Christopher","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary , Calgary, AB , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-898X","authenticated-orcid":false,"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Western University , London, Ontario , Canada"},{"name":"Division of Gastroenterology, Western University , London, ON , Canada and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-7269","authenticated-orcid":false,"given":"Siddharth","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, University of California San Diego , La Jolla, CA , USA"},{"name":"Division of Biomedical Informatics, Department of Medicine, University of California San Diego , La Jolla, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"2023112212505706700_CIT0001","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1038\/nrgastro.2017.104","article-title":"Perianal fistulizing Crohn\u2019s disease: pathogenesis, diagnosis and therapy.","volume":"14","author":"Pan\u00e9s","year":"2017","journal-title":"Nat Rev Gastroenterol 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