Two waves of coeliac disease incidence in Sweden: a nationwide population-based cohort study from 1990 to 2015
| Autor: | Mark S. Clements, Bjorn Roelstraete, James King, Joseph A. Murray, Gilaad G. Kaplan, Jonas F. Ludvigsson, David Bergman, Benjamin Lebwohl, Peter H.R. Green |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Duodenum Biopsy Population Gastroenterology Coeliac disease Cohort Studies Jejunum 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Epidemiology medicine Humans Intestinal Mucosa education Sweden education.field_of_study medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) medicine.disease Celiac Disease medicine.anatomical_structure Female 030211 gastroenterology & hepatology business Cohort study |
| Zdroj: | Gut. 71:1088-1094 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gutjnl-2021-324209 |
| Popis: | ObjectivesTo assess the incidence of biopsy-verified coeliac disease (CD) in Sweden and examine the incidence of duodenal/jejunal biopsies with normal mucosa over time as a proxy for CD awareness and investigation.DesignNationwide population-based cohort study 1990–2015 based on biopsy reports indicating villous atrophy (VA) or normal mucosa in the duodenum/jejunum.ResultsWe identified 44 771 individuals (63% females) with a biopsy report specifying VA and 412 279 (62% females) with a biopsy report indicating normal mucosa (without a prior biopsy indicating VA). The median age at diagnosis of CD was 28 years. The mean age-standardised incidence rate during the study period was 19.0 per 100 000 person-years (95% CI 17.3 to 20.8). The incidence reached a peak in 1994 for both sexes and a second higher peak in 2002–2003 for females and in 2006 for males. The lifetime risk of developing CD was 1.8% (2.3% in females and 1.4% in males).Prior to 2015, there was a parallel rise in rates for biopsies showing normal duodenal/jejunal mucosa.ConclusionsIn Sweden, the incidence of CD increased until 2002–2003 in females and until 2006 in males. Since then, the incidence of CD has declined despite increasing duodenal/jejunal biopsies, suggesting that increased awareness and investigation are unlikely to elevate the incidence of the disease in Sweden. Across a lifetime, 1 in 44 females and 1 in 72 males are expected to be diagnosed with CD in Sweden, indicating a relatively high societal burden of disease. |
| Databáze: | OpenAIRE |
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