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Two waves of coelia...
Two waves of coeliac disease incidence in Sweden : a nationwide population-based cohort study from 1990 to 2015
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- Bergman, David (author)
- Karolinska Institutet
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- King, James (author)
- Centre for health informatics, University of Calgary Cumming School of Medicine, Calgary Alberta, Canada
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- Lebwohl, Benjamin (author)
- Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York NY, USA
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- Clements, Mark S. (author)
- Karolinska Institutet
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- Roelstraete, Bjorn (author)
- Karolinska Institutet
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- Kaplan, Gilaad G. (author)
- Department of Medicine, University of Calgary, Calgary Alberta, Canada
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- Green, Peter Hr (author)
- Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York NY, USA
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- Murray, Joseph A. (author)
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester Minnesota, USA
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- Ludvigsson, Jonas F., 1969- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
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(creator_code:org_t)
- 2021-07-28
- 2022
- English.
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In: Gut. - : BMJ Publishing Group Ltd. - 0017-5749 .- 1468-3288. ; 71:6, s. 1088-1094
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Abstract
Subject headings
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- Objectives: To 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.Design: Nationwide population-based cohort study 1990-2015 based on biopsy reports indicating villous atrophy (VA) or normal mucosa in the duodenum/jejunum.Results: We 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.Conclusions: In 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- coeliac disease
- epidemiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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