DOP41 Temporal Trends in the epidemiology of Inflammatory Bowel Diseases in the public healthcare system in Brazil: A large population-based study

Abstract Background Background: Population-based data on incidence and prevalence of Inflammatory Bowel Diseases (IBD) in newly industrialized countries such as Brazil are scarce. This study aims to define temporal trends of estimated incidence and prevalence rates of Crohn’s disease (CD) and ulcerative colitis (UC) in Brazil using unique public healthcare datasets. Methods Methods: All IBD patients (UC and CD) from the unique public healthcare national system (DATASUS) were included from January 2012 to December 2020 and identified according to ICD codes, medication use or IBD-relates procedures. Data extraction was performed with the platform “TT Disease Explorer” (Techtrials Healthcare Data Science, Brazil) and checked by 2 independent reviewers. The platform collects publicly available data from the ministry of health via electronic algorithms (ETLs and Webcrawlers) with automatic updates. The population of Brazil was calculated according to the national Brazilian Geographics and Statistics Institute (IBGE). Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using poisson (or negative binomial) regression for incidence and log binomial regression for prevalence. Results Results: A total of 212,026 IBD patients (UC: n=140,705; CD: n=92,326) were included, There was a higher proportion of females as opposed to males, and age at health system entry was similar to developed countries (figure 1). Estimated incidence rates of IBD were 9.41 per 100,000 in 2012 and 9.57 per 100,000 in 2020 (AAPC=0.80%; CI -0.37–1.99; p=0.18); for UC, incidence increased from 5.69 per 100,000 to 6.89 per 100,000 (AAPC=3.04; CI 1.51–4.58; p<0.001) and for CD incidence dropped from 3.71 per 100,000 to 2.68 per 100,000 (AAPC=-3.24%; CI -4.45- -2.02; p<0.001) in the same time period (figure 2). Estimated prevalence rates of IBD increased significantly from 30.01 per 100,000 in 2012 to 100.13 per 100,000 in 2020 (AAPC=14.87%; CI 14.78–14.95; p<0.001); For UC, from 17.4 per 100,000 to 66.45 per 100,000 (AAPC=16.51%; CI 16.41–16.62; p<0.001) and for CD from 14.24 per 100,000 to 43.6 per 100,000 (AAPC=13.49%; CI13.37-13.61; p<0.001) in the same time period (figure 3). Conclusion Conclusions: Estimated incidence rates of IBD have remained stable from 2012–2020. Incidence of CD is significantly decreasing whereas of UC is significantly increasing. There was a significant increase in estimated prevalence rates of CD and UC. This massive rise in prevalence can support planning for future strategies for public healthcare providers in our country towards better IBD care. This is the largest IBD epidemiological study from newly industrialized countries to date.

Download Full-text

Association between systolic blood pressure trajectories and hypertension risk at late adolescence: results from 10-year longitudinal follow-up in Chinese boys

BMJ Open ◽

10.1136/bmjopen-2020-042594 ◽

2021 ◽

Vol 11 (4) ◽

pp. e042594

Author(s):

Xijie Wang ◽

Bin Dong ◽

Sizhe Huang ◽

Zhaogeng Yang ◽

Jun Ma ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Late Adolescence ◽

Population Based ◽

Incidence Rates ◽

Hypertension Risk ◽

Logit Regression ◽

Binomial Regression ◽

Physical Examinations

ObjectiveTo identify various systolic blood pressure (SBP) trajectories in Chinese boys between 7 and 18 years of age, and to explore their high blood pressure (HBP) risk in their late adolescence years.Design and settingsA population-based cohort study in Guangdong, China.Participants4541 normal tensive boys who started primary school in 2005 in Zhongshan, Guangdong were included.OutcomesBlood pressure and relevant measurements were obtained by annual physical examinations between 2005 and 2016. HBP was defined by SBP or diastolic blood pressure ≥95th percentile for children under 13, and BP ≥130/80 mm Hg for children ≥13 years old. Logit regression for panel data and log-binomial regression model was used to estimate the risk of HBP among SBP trajectory groups.ResultsFour distinct SBP trajectory groups via group-based trajectory modelling: low stable (13.0%), low rising (42.4%), rising (37.4%) and high rising (7.3%). The overall incidence rates of HBP during the follow-up ranged from 40.24 (95% CI 36.68 to 44.19)/1000 person-years in the low stable group to 97.08 (95% CI 94.93 to 99.27)/1000 person-years in the high rising group. Compared with children with low stable SBP, those of other SBP trajectories suffered 3.05 (95% CI 2.64 to 3.46) to 4.64 (95% CI 4.18 to 5.09) times of higher risk of HBP in their late adolescence, regardless of their age, body mass index and BP level at baseline.ConclusionsSubgroups of SBP trajectories existed in Chinese boys, and are related to hypertension risk at late adolescence. Regular physical examinations could help identify those with higher risks at the beginning of pubertal growth.

Download Full-text

Striking Racial/Ethnic Disparities in Liver Cancer Incidence Rates and Temporal Trends in California, 1988–2012

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djy051 ◽

2018 ◽

Vol 110 (11) ◽

pp. 1259-1269 ◽

Cited By ~ 15

Author(s):

Christopher Pham ◽

Tse-Ling Fong ◽

Juanjuan Zhang ◽

Lihua Liu

Keyword(s):

Asian American ◽

Temporal Trends ◽

Ethnic Disparities ◽

Population Based ◽

Incidence Rates ◽

Annual Percent Change ◽

Southeast Asians ◽

Ethnic Populations ◽

Race Ethnicity ◽

Racial Ethnic

AbstractBackgroundHepatocellular carcinoma (HCC) is characterized by disparate risk patterns by race/ethnicity. We examined HCC incidence patterns and temporal trends among detailed racial/ethnic populations, including disaggregated Asian-American subgroups.MethodsUsing data from the population-based California Cancer Registry, we identified 41 929 invasive HCC cases diagnosed during 1988–2012. Patients were grouped into mutually exclusive racial/ethnic groups of non-Hispanic (NH) white, NH black, Hispanic, and NH Asian/Pacific Islander (API), as well as Asian subgroups of Chinese, Filipino, Japanese, Korean, Vietnamese, Cambodian, Laotian, and South Asian. Age-adjusted and age-specific incidence rates by sex, race/ethnicity, and time period were calculated. The average annual percent change (AAPC) in incidence rates was estimated using joinpoint regression. All estimates were provided with the 95% confidence intervals (CIs).ResultsAggregated NH API had higher HCC risk than NH whites, NH blacks, and Hispanics. When disaggregated, Southeast Asians (Vietnamese, Cambodians, and Laotians) had overall HCC incidence rates eight to nine times higher than NH whites and more than twice that of other ethnic Asians. Statistically significant rising temporal trends of HCC were found in NH whites, NH blacks, and Hispanics, especially those older than age 50 years. Overall HCC risk declined in Chinese males (AAPC = –1.3%, 95% CI = –2.0 to –0.6), but rose in Filipino (AAPC = +1.2%, 95% CI = 0.3 to 2.1) and Japanese males (AAPC = +3.0%, 95% CI = 0.4 to 5.6) and Vietnamese (AAPC = +4.5%, 95% CI = 0.7 to 8.5) and Laotian (+3.4%, 95% CI = 0.1 to 6.8) females.ConclusionsOur findings provide valuable information for the identification of at-risk ethnic subgroups of Asian Americans while underscoring the importance of disaggregating ethnic populations in cancer research.

Download Full-text

The concept of risk and fundamental measures of disease frequency: Incidence and prevalence

10.1093/med/9780198739685.003.0007 ◽

2016 ◽

Author(s):

Raj S. Bhopal

Keyword(s):

Risk Factor ◽

Disease Risk ◽

Population Data ◽

Incidence Rates ◽

Prevalence Rates ◽

Disease Risk Factor ◽

Time Period ◽

Prevalence Proportion ◽

Age And Sex ◽

Time Point

In epidemiology, risk refers to the likelihood, or in statistical language probability, of an individual in a defined population developing a disease or other adverse health problem. The prime measures of disease frequency, including probability of outcomes, in epidemiology are incidence rates and prevalence proportions. The incidence rate is the number of new cases in relation to a population, time, and place. Prevalence proportion measures all disease or a risk factor in a population, either at a particular time (point prevalence) or over a time period (period prevalence, lifetime prevalence). Rates and proportions are most accurately presented by age and sex groups (‘specific’ rates and proportions), but for ease of interpretation they may be grouped as overall, actual (crude) rates. The collection of both disease, risk factor and population data to achieve accurate figures of incidence rates and prevalence proportions is problematic, and remains a major challenge.

Download Full-text

The impact of risk factor trends on intracerebral hemorrhage incidence over the last two decades—The Tromsø Study

International Journal of Stroke ◽

10.1177/1747493018789996 ◽

2018 ◽

Vol 14 (1) ◽

pp. 61-68 ◽

Cited By ~ 2

Author(s):

Maria Carlsson ◽

Tom Wilsgaard ◽

Stein Harald Johnsen ◽

Liv-Hege Johnsen ◽

Maja-Lisa Løchen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Intracerebral Hemorrhage ◽

Proportional Hazards ◽

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Intracerebral Hemorrhages ◽

The Impact

Background Studies on the relationship between temporal trends in risk factors and incidence rates of intracerebral hemorrhage are scarce. Aims To analyze temporal trends in risk factors and incidence rates of intracerebral hemorrhage using individual data from a population-based study. Methods We included 28,167 participants of the Tromsø Study enrolled between 1994 and 2008. First-ever intracerebral hemorrhages were registered through 31 December 2013. Hazard ratios (HRs) for intracerebral hemorrhage were analyzed by Cox proportional hazards models, risk factor levels over time by generalized estimating equations, and incidence rate ratios (IRR) by Poisson regression. Results We registered 219 intracerebral hemorrhages. Age, male sex, systolic blood pressure (BP), diastolic BP, and hypertension were associated with intracerebral hemorrhage. Hypertension was more strongly associated with non-lobar intracerebral hemorrhage (HR 5.08, 95% CI 2.86–9.01) than lobar intracerebral hemorrhage (HR 1.91, 95% CI 1.12–3.25). In women, incidence decreased significantly (IRR 0.46, 95% CI 0.23–0.90), driven by a decrease in non-lobar intracerebral hemorrhage. Incidence rates in men remained stable (IRR 1.27, 95% CI 0.69–2.31). BP levels were lower and decreased more steeply in women than in men. The majority with hypertension were untreated, and a high proportion of those treated did not reach treatment goals. Conclusions We observed a significant decrease in intracerebral hemorrhage incidence in women, but not in men. A steeper BP decrease in women may have contributed to the diverging trends. The high proportion of untreated and sub-optimally treated hypertension calls for improved strategies for prevention of intracerebral hemorrhage.

Download Full-text

Incidence rates and temporal trends of cervical cancer relating to opportunistic screening in two developed metropolitan regions of Brazil: a population-based cohort study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2018.0306220719 ◽

2019 ◽

Vol 137 (4) ◽

pp. 322-328

Author(s):

Júlio César Teixeira ◽

Carlos Afonso Maestri ◽

Helymar da Costa Machado ◽

Luiz Carlos Zeferino ◽

Newton Sérgio de Carvalho

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

Opportunistic Screening ◽

Metropolitan Regions

Download Full-text

Sex-specific temporal trends in the incidence of atrial fibrillation in a large Norwegian population-based study 1986–2014

European Heart Journal ◽

10.1093/ehjci/ehaa946.0509 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Sharashova ◽

T Wilsgaard ◽

J Ball ◽

E Gerdts ◽

A Rosengren ◽

...

Keyword(s):

Atrial Fibrillation ◽

General Population ◽

Linear Time ◽

Population Aging ◽

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

University Hospital ◽

Funding Source

Abstract Background Due to population aging, increasing prevalence of obesity and enhanced detection, the prevalence of atrial fibrillation (AF) worldwide is increasing steadily. Considerable sex differences in the epidemiology of AF such as lower prevalence and later onset in women compared to men have been reported. However, little is known about sex-specific temporal trends in AF incidence within the general population. Purpose To explore sex-specific age-adjusted secular trends in the incidence of AF in a general population from Norway between 1986 and 2014. Methods A total of 16,865 men and 15,413 women aged 20 years or older and without AF were enrolled in a longitudinal population study between 1986 and 2008 and followed up for incident AF to the end of 2014. Follow-up was from the date of attendance to the date of AF, emigration or death, whichever came first. All AF cases were validated by an independent endpoint committee using hospital and death records. AF incidence rates were calculated for each calendar year by dividing the number of AF cases per year by the corresponding person-time at risk. To allow for non-linear time trends, calendar year was fitted using fractional polynomials. Poisson regression was used to estimate calendar year-specific AF incidence rates adjusted for age. All analyses were stratified by sex. Results A total of 911 AF events in women and 1,139 AF events in men occurred over 324,090 person-years and 294,531 person-years of follow-up, respectively. During the study period AF incidence rates in men were at least double that in women (Figure). Age-adjusted AF incidence rates in women increased from 1986, peaked at 0.87 per 1000 person-years in 1998 and then decreased slightly towards 2014. In men AF incidence rates increased up to 2.18 per 1000 person-years in 2005 and then steeply decreased. Conclusion(s) AF incidence rates decreased in both women and men towards the end of the study period. The decrease was more profound in men compared to that in women. One possible explanation is more pronounced reduction in incidence and better treatment of myocardial infarction in men compared to women given that the aetiology of AF in men is mainly ischemic heart disease-related. However, further epidemiological analyses should be undertaken to identify explanatory factors. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Hospital of North Norway, Northern Norway Regional Health Authority

Download Full-text

Long-term outcomes of adult out-of-hospital cardiac arrest in Queensland, Australia (2002–2014): incidence and temporal trends

Heart ◽

10.1136/heartjnl-2020-317333 ◽

2020 ◽

pp. heartjnl-2020-317333

Author(s):

Katherine Pemberton ◽

Richard C Franklin ◽

Emma Bosley ◽

Kerrianne Watt

Keyword(s):

Cardiac Arrest ◽

Temporal Trends ◽

Population Data ◽

Population Based ◽

Incidence Rates ◽

Long Term Outcomes ◽

Australian Bureau Of Statistics ◽

Hospital Cardiac Arrest ◽

Over Time

ObjectiveTo describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES).MethodsThis is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (Surv<30 days); (2) survival from 30 to 364 days (Surv30–364 days); and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES. Temporal trends were analysed.ResultsOver the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13; p<0.01), Surv30–364 days (0.18–0.42; p<0.05) and Surv365+ days (1.94–4.02; p<0.001) increased significantly over time; no trends were observed for Surv<30 days. An increase in Surv365+ days over time was observed in all remoteness categories and most SES categories.ConclusionEvidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.

Download Full-text

The Changing Epidemiology of Inflammatory Bowel Disease: What Goes Up May Come Down

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz186 ◽

2019 ◽

Vol 26 (4) ◽

pp. 591-592 ◽

Cited By ~ 2

Author(s):

Hamed Khalili

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Disease Incidence ◽

Temporal Trends ◽

Epidemiologic Studies ◽

Incidence Rates ◽

Western World ◽

Geographic Variations ◽

Newly Industrialized Countries ◽

Inflammatory Bowel

Abstract Recent epidemiologic studies have shown that although the incidence of inflammatory bowel disease (IBD) is rapidly increasing in newly industrialized countries, at the turn of the 21st century the incidence had stabilized in the Western world. In this issue of Inflammatory Bowel Diseases, Torabi and colleagues present their findings on the temporal trends and geographic variations in IBD incidence in Manitoba from 1990 to 2012 using the Manitoba Health population registry and the University of Manitoba IBD epidemiology database. Their results demonstrate an overall decrease in the incidence of IBD during the study period. They also found significant regional variations in disease incidence within Manitoba, with rates of new diagnosis of IBD remaining high in several regions. Lastly, the study found that a higher proportion of the indigenous population had a lower rate of IBD. These findings provide new insights on the changing epidemiology of IBD in the Western world. The overall declining incidence of IBD and identification of persistently low and high-risk populations in Manitoba, which traditionally has had some of the highest incidence rates of IBD, is intriguing and can provide new avenues of research for epidemiologists in the field.

Download Full-text

Pregnancy-associated cancers: frequency and temporal trends in Italy

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-000828 ◽

2019 ◽

Vol 30 (2) ◽

pp. 241-244

Author(s):

Fabio Parazzini ◽

Angiolo Gadducci ◽

Ettore Cicinelli ◽

Tiziano Maggino ◽

Fedro Peccatori ◽

...

Keyword(s):

Hospital Discharge ◽

Time Trends ◽

Temporal Trends ◽

Population Based ◽

Linkage Study ◽

Limited Data ◽

Clear Trend ◽

Time Period ◽

Italian Regions ◽

Southern European Countries

ObjectiveLimited data are available on the frequency and time trends of pregnancy-associated cancers, particularly from Southern European countries. The aim of this study was to analyze the frequency and time trends of pregnancy-associated cancer in Italy.MethodsThis was a population-based linkage study using the regional hospital discharge forms database of four Italian regions with more than 17 million inhabitants. All resident women with a hospital discharge form reporting a birth or abortion in the time period under consideration were identified. The time period of the study was 2003–2015 for the Piemonte and Puglia region, 2006–2015 for the Tuscany region, and 2005–2015 for the Veneto region. Risk of developing a pregnancy-associated cancer was calculated as the ratio of the number of pregnancy-related cancers to the total number of pregnancies.ResultsA total of 2 297 648 pregnancies were identified. Overall, the pregnancy-associated cancer frequency was 134.8 per 100 000 pregnancies: the frequency ranged from 127.1 in Puglia to 157.3 in Tuscany. The frequency for 100 000 pregnancies was 66.4 in women aged <30 years; the risk increased with age, with a frequency of 275.6 among women aged 40+ years. Approximately two-thirds of cancers were associated with pregnancies resulting in a delivery and one-third with pregnancies resulting in a termination of pregnancy or spontaneous pregnancy loss. No clear trend emerged in the risk of pregnancy-associated cancer per 100 000 pregnancies and calendar year.ConclusionNo clear time trend was observed in the frequency of pregnancy-associated cancers in Italy during the last 10 years, the rates being 104, 164, and 130 per 100 000 pregnancies, respectively, in 2003, 2010, and 2015.

Download Full-text

Abstract T P365: Childhood Stroke: ICD-9 Code Positive Predictive Values for Identifying Hemorrhagic and Ischemic Events

Stroke ◽

10.1161/str.46.suppl_1.tp365 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Jane C Khoury ◽

Kathleen Alwell ◽

J, Michael Taylor ◽

Heidi Sucharew ◽

Charles J Moomaw ◽

...

Keyword(s):

Temporal Trends ◽

Epidemiological Studies ◽

Population Based ◽

Incidence Rates ◽

Administrative Databases ◽

Childhood Stroke ◽

Stroke Event ◽

Primary Position ◽

Predictive Values ◽

Percent Correct

Introduction: Childhood stroke event rates have been reported both using administrative databases and population-based epidemiological studies. The latter include verification of stroke as a case and categorization of type. Administrative databases allow cheaper, quicker estimation of rates and possible extrapolation of estimated rates to population-based rates. However, these estimations rely on the accuracy and interpretation of the ICD-9 coding. Methods: The Greater Cincinnati/Northern Kentucky Stroke Study measures temporal trends in the incidence rates in a biracial population of 1.3 million. Discharge lists with primary and secondary ICD-9 codes 430-436 from 16 area hospitals for 2010 were obtained; 437-438, 674 and 747 were also included at the Children’s hospital. Detailed information from medical records of potential cases was abstracted by trained research nurses and reviewed by stroke physicians, who determined if the event was a case and, also the event type (hemorrhagic stroke, infarction or transient ischemic attack(TIA)). Results: A total of 89 potential events in children <20 years of age were reviewed, yielding 19 confirmed cases. Positive predictive values (PPV) for the primary ICD-9 codes for specific types varied from 0% to 100%. Primary and secondary ICD-9 codes, event types, and percent correct are presented in the Table. Conclusions: Childhood stroke cases captured through selected ICD-9 codes: 430-432, 434.x1, 434.9 and 435.9 (marked with an asterisk in the table) in the primary position would yield 14 strokes/TIAs, and underestimate the number of events by 26%. However, using both primary and secondary codes they would yield 34 strokes//TIAs, and overestimate the number of events by 79%. Population-based epidemiology studies are essential to monitor the validity of using ICD-9 codes to estimate childhood stroke/TIA incidence.

Download Full-text