scholarly journals The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years

2017 ◽  
Vol 45 (4) ◽  
pp. 574-579 ◽  
Author(s):  
Mohanad M. Elfishawi ◽  
Nour Zleik ◽  
Zoran Kvrgic ◽  
Clement J. Michet ◽  
Cynthia S. Crowson ◽  
...  
Keyword(s):  
New York ◽  
Population Based ◽  
Incidence Rates ◽  
Comorbid Conditions ◽  
Population Based Study ◽  
Significant Public Health ◽  
Public Health Challenge ◽  
Rising Incidence ◽  
Adjusted Incidence ◽  
Incident Cases

Objective.To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions.Methods.The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989–December 31, 1992, and January 1, 2009–December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria.Results.A total of 158 patients with new-onset gout were identified during 1989–1992 and 271 patients during 2009–2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9–77.4) in 1989–1992 and 136.7/100,000 (95% CI 120.4–153.1) in 2009–2010. The incidence rate ratio was 2.62 (95% CI 1.80–3.83). At the time of their first gout flare, patients diagnosed with gout in 2009–2010 had higher prevalence of comorbid conditions compared with 1989–1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m2; 29% vs 10%).Conclusion.The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.

scholarly journals Changes in the Presentation of Incident Gout and the Risk of Subsequent Flares: A Population-based Study over 20 Years

2019 ◽  
Vol 47 (4) ◽  
pp. 613-618 ◽  
Author(s):  
Mohanad M. Elfishawi ◽  
Nour Zleik ◽  
Zoran Kvrgic ◽  
Clement J. Michet ◽  
Cynthia S. Crowson ◽  
...  
Keyword(s):  
New York ◽  
Kidney Disease ◽  
Cumulative Incidence ◽  
Population Based ◽  
Rome Criteria ◽  
Population Based Study ◽  
American Rheumatism Association ◽  
The Mean ◽  
Incident Cases ◽  
Gout Flares

Objective.To examine whether a change in the presentation of incident gout happened over the last 20 years and to determine the risk of subsequent gout flares after an initial gout attack.Methods.All incident cases of gout were identified among residents of Olmsted County, Minnesota, diagnosed in 1989–1992 and 2009–2010 according to the earliest date fulfilling the 1977 American Rheumatism Association preliminary criteria, or the New York or Rome criteria for gout. Patients in both cohorts were then followed for up to 5 years. Cumulative incidence and person-year methods were used to compare flare rates, and conditional frailty models were used to examine predictors.Results.A total of 429 patients with incident gout (158 patients in 1989–1992 and 271 patients in 2009–2010) were identified and followed for a mean of 4.2 years. The majority of patients were male (73%) and the mean age (SD) at gout onset was 59.7 (17.3) years. Classic podagra decreased significantly from 74% to 59% (p < 0.001). Cumulative incidence of first flare was similar in both cohorts (62% vs 60% by 5 yrs in 1989–1992 and 2009–2010, respectively; p = 0.70), but overall flare rate was marginally higher in 2009–2010 compared to 1989–1992 (rate ratio: 1.24). Hyperuricemia (HR 1.59) and kidney disease (HR 1.34) were significant predictors of future flares.Conclusion.Gout flares were common in both time periods. Hyperuricemia and kidney disease were predictors of future flares in patients with gout. Podagra as a presentation of gout has become relatively less frequent in recent years.

scholarly journals Incidence of aplastic anemia in metropolitan Baltimore: a population- based study

Blood ◽  
1985 ◽  
Vol 66 (1) ◽  
pp. 115-119 ◽  
Author(s):  
M Szklo ◽  
L Sensenbrenner ◽  
J Markowitz ◽  
S Weida ◽  
S Warm ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Occupational Exposures ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Metropolitan Statistical Area ◽  
Population Based Study ◽  
Etiologic Agents ◽  
Adjusted Incidence ◽  
Over Time

Incidence rates for aplastic anemia (AA) so far have been unavailable for defined populations in the United States. A study was carried out in the Baltimore Standard Metropolitan Statistical Area (SMSA) to examine the incidence rates for aplastic anemia from 1970 through 1978. Cases of AA (N = 118) were identified through medical records (N = 77) in SMSA hospitals and death certificates (N = 41). All medical charts were reviewed by an oncologist-hematologist for validation purposes. Among whites, average annual age-adjusted incidence rates per million were higher in males (7.1) than in females (5.4), whereas in nonwhites, females had a higher rate (7.3) than males (4.7). None of the sex differences was statistically significant. Age-specific incidence rates were consistently low in young ages, with an exponential increase after age 40. Examination of time trends did not suggest changes in whites, although in blacks, mainly in males, there was a suggestion of a temporal increase. However, rates in blacks were based on small numbers, and trends were not statistically significant. An inconsistent sex differential, as well as the relative stability of rates over time at least in whites, suggests that although sexes may have different types of exposures, occupational exposures and changes in environmental factors over time cannot entirely explain the occurrence of AA in the population. In addition, the age pattern suggests that future studies should examine etiologic agents separately for the younger and the older subjects with AA.

scholarly journals Epidemiology and Management of Immune Thrombocytopenia: A Nationwide Population-Based Study in Korea

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4934-4934
Author(s):  
Ji Yun Lee ◽  
Ju Hyun Lee ◽  
Jung-Ok Lee ◽  
Soo-Mee Bang
Keyword(s):  
Immune Thrombocytopenia ◽  
Conflicts Of Interest ◽  
Immunosuppressive Agents ◽  
Bimodal Distribution ◽  
Initial Therapy ◽  
Population Based ◽  
Incidence Rates ◽  
Population Based Study ◽  
Incident Cases ◽  
Gender Specific

Abstract The epidemiology of immune thrombocytopenia (ITP) is not well characterized in the general Korean population. ITP patients from 2010 to 2014 were identified using the Korean Health Insurance Review and Assessment Service (HIRA) database. Patients with diagnosis codes for secondary thrombocytopenia or secondary ITP were excluded if those codes coexisted with ITP code of D693.0 or D693.8. The prevalent cases before 1st July 2010 and incident cases from 1st July 2014 were also excluded to calculate the exact incidence of ITP. Overall age-standardized incidence rates of ITP were 5.42/100,000 person-years (95% CI: 5.33-5.51; women, 6.17 [95% CI, 6.03-6.30]; men, 4.69 [95% CI, 4.57-4.81]).The overall incidence rates of ITP appeared to have a bimodal distribution, with peaks among children (< 10 years) and in those > 70 years of age. Among adults, the age-specific incidence rates increased with age for man, but those were observed to be constant for women (figure 1). Overall, 75.2% of patients needed treatment with the median time from the diagnosis to treatment of 1.7 months (range, 0-53.3 months). First-line therapy consisted of steroids and/or immunoglobulin in 83.6%, immunoglobulin only in 14.5%, and other immunosuppressive agents such as cyclosporine A, azathioprine, mycophenolate mofetil, and danazol in 1.9%. Only 1.0% of patients underwent splenectomy and laparoscopic procedure accounted for 90.5% of these 108 patients. The median age was 46 years (range, 9-77 years) at the time of splenectomy, and 77.8% of patients were female. 58.8% of patients received treatment beyond 6months after initial therapy. Among these patients, the most frequently used therapy was steroid and/or immunoglobulin in 92.6% followed by other immunosuppressive agents in 6.9% and immunoglobulin in 0.5%. Platelet transfusions were given 13.7% of patients and the median numbers of platelets transfused were 12 units (range, 1-2,484 units) during study periods. The usage of thrombopoietin receptor agonists or rituximab couldn't be analyzed because these drugs have not been reimbursed for the treatment of ITP before 2016 in Korea. This population-based study firstly describes the incidence rates of ITP and treatment reality for patients with ITP in Korea. Figure Age/gender-specific incidence of ITP in Korea during the period from mid-2010 to mid-2014. Figure. Age/gender-specific incidence of ITP in Korea during the period from mid-2010 to mid-2014. Disclosures No relevant conflicts of interest to declare.

Incidence and trends of pancreatic cancer (PC) in Girona: A population-based study from the Girona Cancer Registry (1994-2015).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 225-225
Author(s):  
Adelaida Garcia-Velasco ◽  
Carmen Carmona ◽  
Antonia Bianca ◽  
Helena Teixidor ◽  
Marc Valero ◽  
...  
Keyword(s):  
Cancer Registry ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Neuroendocrine Neoplasms ◽  
Standard Population ◽  
European Standard Population ◽  
Drastic Increase ◽  
Adjusted Incidence ◽  
Incident Cases

225 Background: PC is the third leading-cause of cancer death in Spain. In this study we aim to investigate PC’s incidence and trends during 1994-2015 in Girona. Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases were classified using the ICD-O-3 Third Edition. Age-adjusted incidence rates (ASRE) to the European standard population and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Results: We identified 1590 PC incident cases, 45.8% females and 54.2%. Patients > 64 years old represented a 72.6% of cases. According to histology, epithelial tumors stand for a 44% of cases and neuroendocrine neoplasms represented only the 3% of all cases, being most of PC tumors’ histology non-specified. Cases detected only by death certificates (DCO) were 7.7% in males and 7.4% in females. For the whole study population, crude rate (CR) cancer incidence was 11.26 cases per 100,000 inhabitants/year (12.17 men; 10.34 women). Regarding the ASR, results show an ASRE13 of 12.99 (95% CI 12.36;13.65) and ASRW of 5.58 (95% CI 5.8;13.655.91). Age-specific rates reflected a drastic increase with age, having the population over 85 years the highest rate (74.5 cases per 100,000 inhabitants/year). We also found a significant increase in incidence of PC cases over the study period, with an EAPC of 1.41% per year, present in both men (EAPC = 1.30%) and women (EAPC = 1.37%). Conclusions: Incidence rates of PC in Girona are within the European average, and likewise they have been increasing for the last two decades. There is an increase of incidence in the elderly population reflected in age-specific rates, reason whereby we believe there are a high proportion of unspecific histologies. These results can be used as baseline for further research.

scholarly journals Trends in incidence and mortality of tuberculosis in Japan: a population-based study, 1997–2016

2018 ◽  
Vol 147 ◽  
Author(s):  
H. Hagiya ◽  
T. Koyama ◽  
Y. Zamami ◽  
Y. Minato ◽  
Y. Tatebe ◽  
...  
Keyword(s):  
Mortality Rates ◽  
Population Based ◽  
Vital Statistics ◽  
Incidence Rates ◽  
Population Based Study ◽  
Specific Analysis ◽  
Incidence And Mortality ◽  
Rate Of Decline ◽  
Adjusted Incidence ◽  
Related Mortality

AbstractJapan is still a medium-burden tuberculosis (TB) country. We aimed to examine trends in newly notified active TB incidence and TB-related mortality in the last two decades in Japan. This is a population-based study using Japanese Vital Statistics and Japan Tuberculosis Surveillance from 1997 to 2016. We determined active TB incidence and mortality rates (per 100 000 population) by sex, age and disease categories. Joinpoint regression was applied to calculate the annual percentage change (APC) in age-adjusted mortality rates and to identify the years showing significant trend changes. Crude and age-adjusted incidence rates reduced from 33.9 to 13.9 and 37.3 to 11.3 per 100 000 population, respectively. Also, crude and age-adjusted mortality rates reduced from 2.2 to 1.5 and 2.8 to 1.0 per 100 000 population, respectively. Average APC in the incidence and mortality rates showed significant decline both in men (−6.2% and −5.4%, respectively) and women (−5.7% and −4.6%, respectively). Age-specific analysis demonstrated decreases in incidence and mortality rates for every age category, except for the incidence trend in the younger population. Although trends in active TB incidence and mortality rates in Japan have favourably decreased, the rate of decline is far from achieving TB elimination by 2035.

scholarly journals Time Trends in Epidemiology and Characteristics of Psoriatic Arthritis Over 3 Decades: A Population-based Study

2009 ◽  
Vol 36 (2) ◽  
pp. 361-367 ◽  
Author(s):  
FLORANNE C. WILSON ◽  
MURAT ICEN ◽  
CYNTHIA S. CROWSON ◽  
MARIAN T. McEVOY ◽  
SHERINE E. GABRIEL ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Time Trends ◽  
Population Based ◽  
Incidence Rates ◽  
Population Based Study ◽  
Physician Awareness ◽  
Adjusted Incidence ◽  
Diagnosis Date ◽  
Age And Sex

Objective.To determine time trends in incidence, prevalence, and clinical characteristics of psoriatic arthritis (PsA) over a 30-year period.Methods.We identified a population-based incidence cohort of subjects aged 18 years or over who fulfilled ClASsification of Psoriatic ARthritis (CASPAR) criteria for PsA between January 1, 1970, and December 31, 1999, in Olmsted County, Minnesota, USA. PsA incidence date was defined as the diagnosis date of those who fulfilled CASPAR criteria. Age- and sex-specific incidence rates were estimated and age- and sex-adjusted to the 2000 US White population.Results.The PsA incidence cohort comprised 147 adult subjects with a mean age of 42.7 years, and 61% were men. The overall age- and sex-adjusted annual incidence of PsA per 100,000 was 7.2 [95% confidence interval (CI) 6.0, 8.4] with a higher incidence in men (9.1, 95% CI 7.1, 11.0) than women (5.4, 95% CI 4.0, 6.9). The age- and sex-adjusted incidence of PsA per 100,000 increased from 3.6 (95% CI 2.0, 5.2) between 1970 and 1979 to 9.8 (95% CI 7.7, 11.9) between 1990 and 2000 (p for trend < 0.001). The point prevalence per 100,000 was 158 (95% CI 132, 185) in 2000, with a higher prevalence in men (193, 95% CI 150, 237) than women (127, 95% CI 94, 160). At incidence, most PsA subjects had oligoarticular involvement (49%) with enthesopathy (29%).Conclusion.The incidence of PsA has been rising over 30 years in men and women. Reasons for the increase are unknown, but may be related to a true change in incidence or greater physician awareness of the diagnosis.

scholarly journals Incidence of aplastic anemia in metropolitan Baltimore: a population- based study

Blood ◽  
1985 ◽  
Vol 66 (1) ◽  
pp. 115-119 ◽  
Author(s):  
M Szklo ◽  
L Sensenbrenner ◽  
J Markowitz ◽  
S Weida ◽  
S Warm ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Occupational Exposures ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Metropolitan Statistical Area ◽  
Population Based Study ◽  
Etiologic Agents ◽  
Adjusted Incidence ◽  
Over Time

Abstract Incidence rates for aplastic anemia (AA) so far have been unavailable for defined populations in the United States. A study was carried out in the Baltimore Standard Metropolitan Statistical Area (SMSA) to examine the incidence rates for aplastic anemia from 1970 through 1978. Cases of AA (N = 118) were identified through medical records (N = 77) in SMSA hospitals and death certificates (N = 41). All medical charts were reviewed by an oncologist-hematologist for validation purposes. Among whites, average annual age-adjusted incidence rates per million were higher in males (7.1) than in females (5.4), whereas in nonwhites, females had a higher rate (7.3) than males (4.7). None of the sex differences was statistically significant. Age-specific incidence rates were consistently low in young ages, with an exponential increase after age 40. Examination of time trends did not suggest changes in whites, although in blacks, mainly in males, there was a suggestion of a temporal increase. However, rates in blacks were based on small numbers, and trends were not statistically significant. An inconsistent sex differential, as well as the relative stability of rates over time at least in whites, suggests that although sexes may have different types of exposures, occupational exposures and changes in environmental factors over time cannot entirely explain the occurrence of AA in the population. In addition, the age pattern suggests that future studies should examine etiologic agents separately for the younger and the older subjects with AA.

scholarly journals Incidence and Trends of the Leading Cancers with Elevated Incidence Among American Indian and Alaska Native Populations, 2012–2016

2020 ◽  
Author(s):  
Stephanie C Melkonian ◽  
Hannah K Weir ◽  
Melissa A Jim ◽  
Bailey Preikschat ◽  
Donald Haverkamp ◽  
...  
Keyword(s):  
American Indian ◽  
Cancer Incidence ◽  
Alaska Native ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Breast Cancers ◽  
Age Adjusted Rates ◽  
Incident Cases ◽  
Hispanic White

Abstract Cancer incidence varies among American Indian and Alaska Native (AI/AN) populations, as well as between AI/AN and White populations. This study examined trends for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations and estimated potentially avoidable incident cases among AI/AN populations. Incident cases diagnosed during 2012–2016 were identified from population-based cancer registries and linked with the Indian Health Service patient registration databases to improve racial classification of AI/AN populations. Age-adjusted rates (per 100,000) and trends were calculated for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations (rate ratio &gt;1.0), by region. Trends were estimated using joinpoint regression analyses. Expected cancers were estimated by applying age-specific cancer incidence rates among non-Hispanic White populations to population estimates for AI/AN populations. Excess cancer cases among AI/AN populations were defined as observed minus expected cases. Liver, stomach, kidney, lung, colorectal and female breast cancers had higher incidence rate among AI/AN populations across most regions. Between 2012 and 2016, nearly 5,200 excess cancers were diagnosed among AI/AN populations, with the largest number of excess cancers (1,925) occurring in the Southern Plains region. Culturally informed efforts may reduce cancer disparities associated with these and other cancers among AI/AN populations.

scholarly journals POS0803 TRENDS IN THE INCIDENCE OF GIANT CELL ARTERITIS ACROSS SEVEN DECADES AND CHANGES IN DIAGNOSTIC MODALITIES: A POPULATION-BASED STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 654.1-654
Author(s):  
T. Garvey ◽  
C. S. Crowson ◽  
M. Koster ◽  
K. J. Warrington
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Population Based ◽  
Incidence Rates ◽  
Large Vessel ◽  
Vessel Imaging ◽  
Group 3 ◽  
Group 2 ◽  
Diagnostic Modalities ◽  
Incident Cases

Background:Diagnostic methods for giant cell arteritis (GCA) have evolved over recent decades, and large vessel imaging plays an increasing role in disease detection.Objectives:This study aims to estimate the incidence of GCA over the past 10 years in a population and compare it to preceding incidence estimates. It also explores trends in the diagnostic modalities used to identify GCA.Methods:A pre-existing population-based cohort of patients diagnosed with GCA between 1950 and 2009 was extended with incident cases from 2010 to 2019. The diagnosis of GCA was confirmed by review of medical records of patients with ICD9/10 codes for GCA between 1/1/2010 and 12/31/2019. Incident cases that met either one of the following sets of inclusion criteria were added to the cohort: one, American College of Rheumatology 1990 GCA classification criteria; or two, patients aged ≥50 years with elevation of erythrocyte sedimentation rate or C-reactive protein and radiographic evidence of large vessel vasculitis attributed to GCA. Incident cases were classified into one of three groups: group 1, temporal artery biopsy (TAB) positive; group 2, TAB negative or not done with positive large-vessel imaging; or group 3, clinical diagnosis of GCA.Results:The study cohort included 305 patients diagnosed with GCA from 1950 until 2019. Fifty-five incident cases were diagnosed between 2010 and 2019; 37 females (67%) and 18 males (33%). The age and sex adjusted incidence rates (95% CI) per 100,000 between 2010 and 2019 for females, males, and the total population were 13.0 (8.8, 17.3), 8.6 (4.6, 12.7), and 10.8 (8.0, 13.7), respectively. The corresponding incidence rates from 2000-2009 were 28.0 (21.0, 35.1), 10.2 (5.0, 15.5), and 20.5 (15.9, 25.1), respectively. This represents a significant decline in the incidence rates in females (p<0.001) and the total group (p<0.001) between the 2000-2009 and 2010-2019 cohorts but no change in males (p=0.64). Of the 55 patients diagnosed between 2010 and 2019, there were 37 (67%) in group 1, 10 (18%) in group 2, and 8 (15%) in group 3. In contrast, of the 250 patients diagnosed between 1950 and 2009 there were 209 (84%) in group 1, 4 (2%) in group 2, and 37 (15%) in group 3. There was a significant difference between the 1950-2009 and 2010-2019 cohorts in the composition of these groups (p<0.001).Conclusion:In this population-based cohort of patients with GCA diagnosed over a 70-year period, the incidence of GCA has declined in recent years. The total decline is driven by a decline in females but not in males. The reasons for this are unclear but should be followed over time and investigated in other population-based cohorts. There has also been a shift in the diagnostic modalities for GCA. In recent years, there are fewer TAB positive patients, and more patients diagnosed with large vessel imaging. This is the first population-based incidence cohort demonstrating a trend towards increased use of large vessel imaging for the diagnosis of GCA.References:[1]Chandran AK, et al. Incidence of Giant Cell Arteritis in Olmsted County, Minnesota, over a 60-year period 1950-2009. Scand J Rheumatol. 2015;44(3):215-218.[2]Gonzalez-Gay MA, et al. Giant cell arteritis: is the clinical spectrum of the disease changing? BMC Geriatr. 2019; Jul 29;19(1):200.[3]Rubenstein E, et al. Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systemic literature review and meta-analysis. Rheumatology (Oxford). 2020 May 1:59(5):1011-1020.Figure 1.Trends in the incidence of GCA in Olmsted County by sex (1950-2019).Acknowledgements:This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health (NIH) under Award Number R01 AG034676, and CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Disclosure of Interests:Thomas Garvey: None declared, Cynthia S. Crowson: None declared, Matthew Koster: None declared, Kenneth J Warrington Grant/research support from: Clinical research support from Eli Lilly and Kiniksa

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