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Epidemiology of inflammatory bowel disease in men with high-risk homosexual activity
  1. Emad Mansoor1,
  2. Scott A Martin2,
  3. Abe Perez2,
  4. Vu Quang Nguyen1,
  5. Jeffry A Katz1,
  6. Shubham Gupta3,
  7. Fabio Cominelli1
  1. 1 Digestive Health Institute, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
  2. 2 Clinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
  3. 3 Division of Reconstructive Urology, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
  1. Correspondence to Dr Fabio Cominelli, Case Western Reserve University, Cleveland, Ohio 44106, USA; fabio.cominelli{at}

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We read with great interest the epidemiological studies in inflammatory bowel disease (IBD) by Agrawal et al 1 and Cha et al 2 and would like to point out that the prevalence and natural history of IBD in the lesbian, gay, bisexual, transgender, queer (or questioning), intersex and asexual (or allies) (LGBTQIA+) population have not yet been reported.3 This is an important issue to address since, according to a 2022 Gallup poll, up to 7.1% of Americans identify as LGBTQIA+, up from 5.6% in 2020.4 In the present study, we used a large population-based database to evaluate the prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) in LGBTQIA+ individuals, describe the demographic distribution of IBD in this patient population and evaluate their disease behaviour, as well as medical and surgical utilisation from a therapeutic perspective.

We evaluated data sourced from 58 healthcare organisations located within the USA (ie, TriNetX, a global federated health research network with waiver from Western Institutional Review Board (IRB)) over the last 20 years, from 2002 to 2022. Adult patients (aged>18 years) were first identified based on self-reported sexual orientation, including those identifying as heterosexual or homosexual, and then further …

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  • Contributors Study conception and design: EM and FC. Acquisition of data: SAM and AP. Analysis and interpretation: EM, SAM, AP, SG and FC. Drafting of manuscript: EM, SAM, AP and FC. Critical revision: EM, VQN, JAK, SG and FC. Study supervision: EM, VQN, JAK and FC.

  • Funding This work was supported by the Clinical Component of the Administrative Core of the NIH Cleveland Digestive Diseases Research Core Center, DK097948, and administrative supplement DK097948-08S1 from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and Sexual and Gender Minority Research Office (SGMRO).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.