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Kern I, Schoffer O, Richter T, Kiess W, Flemming G, Winkler U, Quietzsch J, Wenzel O, Zurek M, Manuwald U, Hegewald J, Li S, Weidner J, de Laffolie J, Zimmer KP, Kugler J, Laass MW, Rothe U. Current and projected incidence trends of pediatric-onset inflammatory bowel disease in Germany based on the Saxon Pediatric IBD Registry 2000–2014 –a 15-year evaluation of trends. PLoS One 2022; 17:e0274117. [PMID: 36084003 PMCID: PMC9462751 DOI: 10.1371/journal.pone.0274117] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Aims
An increasing number of children and adolescents worldwide suffer from inflammatory bowel disease (IBD) such as Crohn’s disease (CD) and ulcerative colitis (UC). The present work aims to investigate the incidence, prevalence and future trends of IBD in children and adolescents in Saxony, Germany.
Methods
The Saxon Pediatric IBD Registry collected data on patients up to 15 years of age from all 31 pediatric hospitals and pediatric gastroenterologists in Saxony over a 15-year period (2000–2014). In 2019, an independent survey estimated a registry completeness of 95.7%. Age-standardized incidence rates (ASR) per 100,000 person-years (PY) and prevalence per 100,000 children and adolescents were calculated. Evaluation was also been performed in sex and age subgroups. Joinpoint and Poisson regression were used for trend analyses and projections.
Results
532 patients with confirmed IBD during 2000–2014 were included in the epidemiological evaluation. 63.5% (n = 338) patients had CD, 33.1% (n = 176) had UC and 3.4% (n = 18) had unclassified IBD (IBD-U). The 15-year IBD prevalence was 111.8 [95%-CI: 102.3–121.3] per 100,000. The incidence ASR of IBD per 100,000 PY over the whole observation period was 7.5 [6.9–8.1]. ASR for the subtypes were 4.8 [4.3–5.3] for CD, 2.5 [2.1–2.9] for UC and 0.3 [0.1–0.4] for IBD-U. The trend analysis of ASR using the joinpoint regression confirmed a significant increase for incidence of IBD as well as CD. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8–6.3] in 2000 to 8.2 [7.5–13.6] in 2014; projected incidence rates for IBD in Germany are 12.9 [6.5–25.5] in the year 2025 and 14.9 [6.7–32.8] in 2030, respectively. Thus, the number of new IBD diagnoses in Germany would more than triple (325%) in 2030 compared to 2000. The increase is expected to be faster in CD than UC, and be more in males than in females. The expected number of newly diagnosed children with IBD in Germany is projected to rise to about 1,584 [1,512–1,655] in 2025, and to about 1,918 [1,807–2,29] in 2030.
Conclusion
The incidence of IBD in children and adolescents in Saxony increased at a similar rate as in other developed countries during the observation period. Given this trend, the health care system must provide adequate resources for the care of these young patients in the future.
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Affiliation(s)
- Ivana Kern
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
- * E-mail:
| | - Olaf Schoffer
- Center for Evidence-based Healthcare, University Hospital and Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Thomas Richter
- Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research, Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Gunter Flemming
- Center for Pediatric Research, Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Ulf Winkler
- Clinic for Children and Adolescents, Hospital Bautzen, Oberlausitz-Hospitals, Bautzen, Germany
| | - Jürgen Quietzsch
- Clinic for Children and Adolescents, DRK Hospital Lichtenstein, Lichtenstein, Germany
| | - Olaf Wenzel
- Clinic for Children and Adolescents, Helios Hospital Aue, Bad Schlema, Germany
| | - Marlen Zurek
- Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany
| | - Ulf Manuwald
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Janice Hegewald
- Department of Occupational, Social and Environmental Epidemiology, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Shi Li
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Jens Weidner
- Center for Medical Informatics, Institute for Medical Informatics and Biometry, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Jan de Laffolie
- Department of General Pediatrics, Children’s Gastroenterology/ Hepatology/ Nutrition, Justus-Liebig-University Gießen, CEDATA-GPGE Working Group, Gießen, Germany
| | - Klaus-Peter Zimmer
- Department of General Pediatrics, Children’s Gastroenterology/ Hepatology/ Nutrition, Justus-Liebig-University Gießen, CEDATA-GPGE Working Group, Gießen, Germany
| | - Joachim Kugler
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Martin W. Laass
- University Hospital for Children and Adolescents, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Ulrike Rothe
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, Dresden, Germany
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2
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Kern I, Schoffer O, Kiess W, Henker J, Laaß MW, Winkler U, Quietzsch J, Wenzel O, Zurek M, Büttner K, Fischer P, de Laffolie J, Manuwald U, Stange T, Zenker R, Weidner J, Zimmer KP, Kunath H, Kugler J, Richter T, Rothe U. Incidence trends of pediatric onset inflammatory bowel disease in the years 2000-2009 in Saxony, Germany-first results of the Saxon Pediatric IBD Registry. PLoS One 2021; 16:e0243774. [PMID: 33395450 PMCID: PMC7781364 DOI: 10.1371/journal.pone.0243774] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/28/2020] [Indexed: 02/06/2023] Open
Abstract
Aims In developed countries, the incidence of inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC) is increasing. Therefore, we aimed to investigate the incidence rates and trends over time in the population of children and adolescents in one of the federal states of Germany, in Saxony. Methods Over the 10-year period 2000–2009 all 31 children’s hospitals and pediatric gastroenterologists, respectively in Saxony reported all IBD patients up to 15 years of age to the Saxon Pediatric IBD Registry. The completeness of the registry was estimated as 96.7% by independent surveys in the years 2005–2009. Incidence rates were presented as age-standardized incidence rates (ASR) regarding New European Standard Population 1990 per 100,000 person-years (PY) with 95% confidence intervals [CI]. Joinpoint and linear regression was used for trend analyses. Results 344 patients with confirmed IBD between 2000–2009 were included in the epidemiological evaluation: 212 (61.6%) patients with CD, 122 (35.6%) with UC and 10 (2.9%) with unclassified IBD (IBD-U). The ASR per 100,000 PY over the whole observation period was 7.2 [6.4–7.9] for IBD, 4.4 [3.8–5.0] for CD, 2.6 [2.1–3.0] for UC and 0.2 [0.1–0.3] for IBD-U. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8–6.3] in 2000 to 10.5 [7.5–13.6] in 2009. The incidence trend analysis of ASRs using the joinpoint regression confirmed a significant increase of IBD as well as UC. The mean age at first diagnosis decreased significantly during the observation period from 11.5 (11.0–13.4) in 2000 to 9.6 (5.1–13.5) years in 2009. The median of the diagnostic latency among IBD patients was 3 months. Conclusion The incidence of IBD in children and adolescents in Saxony was slightly higher than the average of other countries in the same time period and followed the trend towards a general increase of IBD. The age at diagnosis was subject to a very unfavorable downward trend.
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Affiliation(s)
- Ivana Kern
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
- * E-mail:
| | - Olaf Schoffer
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Wieland Kiess
- Department of Women and Child Health, Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
| | - Jobst Henker
- Children's Center Dresden-Friedrichstadt, Dresden, Germany
| | - Martin W. Laaß
- Faculty of Medicine “Carl Gustav Carus”, University Hospital for Children and Adolescents, TU Dresden, Dresden, Germany
| | - Ulf Winkler
- Clinic for Children and Adolescents, Hospital Bautzen, Oberlausitz-Hospitals, Bautzen, Germany
| | - Jürgen Quietzsch
- Clinic for Children and Adolescents, DRK Hospital Lichtenstein, Lichtenstein, Germany
| | - Olaf Wenzel
- Clinic for Children and Adolescents, Helios Hospital Aue, Aue, Germany
| | - Marlen Zurek
- Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany
| | - Katrin Büttner
- Medical Care Centre—Polyclinic Spremberg, Spremberg, Germany
| | - Peter Fischer
- General Pediatrics for Children and Adolescents, Naunhof, Germany
| | - Jan de Laffolie
- Department of General Pediatrics, Children's Gastroenterology/Hepatology/Nutrition, Justus-Liebig-University Gießen, CEDATA-GPGE Working Group, Gießen, Germany
| | - Ulf Manuwald
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Thoralf Stange
- Institute for Medical Informatics and Biometry, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Ronny Zenker
- Department of General Practice, Medical Clinic 3, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Jens Weidner
- Department of General Practice, Medical Clinic 3, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Klaus-Peter Zimmer
- Department of General Pediatrics, Children's Gastroenterology/Hepatology/Nutrition, Justus-Liebig-University Gießen, CEDATA-GPGE Working Group, Gießen, Germany
| | - Hildebrand Kunath
- Faculty of Medicine “Carl Gustav Carus“, TU Dresden, Dresden, Germany
| | - Joachim Kugler
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
| | - Thomas Richter
- Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany
| | - Ulrike Rothe
- Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine “Carl Gustav Carus”, TU Dresden, Dresden, Germany
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Genin M, Fumery M, Occelli F, Savoye G, Pariente B, Dauchet L, Giovannelli J, Vignal C, Body-Malapel M, Sarter H, Gower-Rousseau C, Ficheur G. Fine-scale geographical distribution and ecological risk factors for Crohn's disease in France (2007-2014). Aliment Pharmacol Ther 2020; 51:139-148. [PMID: 31588597 DOI: 10.1111/apt.15512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/14/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Geographical variations in Crohn's disease (CD) suggest that the environment has a role in the pathogenesis of this condition. AIMS To describe the spatial distribution and the clustering of CD cases in France, and to assess the relationship between the prevalence of CD and environmental risk factors. METHODS We identified all patients with CD included in the French hospital discharge database from 2007 to 2014. Age- and gender-smoothed standardised prevalence ratios over this period were computed for 5610 spatial units. An ecological regression analysis was used to assess the relationship between the risk of CD and ecological variables (health care, latitude, socio-economic deprivation, urbanisation, proportion of agricultural surfaces and density of industries). Local spatial clusters of high-CD prevalence were searched for using elliptic spatial scan statistics and characterised in a hierarchical ascendant classification based on the same ecological variables. RESULTS About 129 089 patients with CD were identified, yielding a crude prevalence of 203 per 100 000 inhabitants. The overall spatial heterogeneity was statistically significant (P < .001). An elevated risk of CD was found to be significantly associated with high-social deprivation (relative risk [95% confidence interval] = 1.05 [1.02-1.08]) and high urbanisation (1.09 [1.04-1.14]). Sixteen significant spatial clusters of high-CD prevalence were identified; there were no common ecological variables. CONCLUSIONS The geographical distribution of CD prevalence in France is not uniform, and is associated with high levels of social deprivation and urbanisation. Larger ecological databases integrating more detailed environmental and clinical information are needed.
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Affiliation(s)
- Michaël Genin
- EA2694 - Santé Publique: épidémiologie et qualité des soins, University of Lille, Lille, France.,Department of Methodology and Biostatistics, Maison régionale de la Recherche Clinique, CHU Lille, Lille, France
| | - Mathurin Fumery
- Gastroenterology Unit, Epimad Registry, Amiens University Hospital, Amiens, France
| | - Florent Occelli
- EA 4483, Faculté de Pharmacie de Lille, Université Lille Nord de France, Lille, France
| | - Guillaume Savoye
- Gastroenterology Unit, Epimad Registry, Rouen University Hospital, Rouen, France
| | - Benjamin Pariente
- Gastroenterology Unit, Epimad Registry, Lille University Hospital, Lille, France
| | - Luc Dauchet
- Univ. Lille , U116 7 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Jonathan Giovannelli
- Public Health, Epidemiology and Economic Health Unit, Epimad Registry, Maison régionale de la Recherche Clinique, Lille University Hospital, Lille, France
| | - Cécile Vignal
- Inserm, LIRIC UMR 995, Lille University, Lille, France
| | | | - Hélène Sarter
- Public Health, Epidemiology and Economic Health Unit, Epimad Registry, Maison régionale de la Recherche Clinique, Lille University Hospital, Lille, France.,Inserm, LIRIC UMR 995, Lille University, Lille, France
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health Unit, Epimad Registry, Maison régionale de la Recherche Clinique, Lille University Hospital, Lille, France.,Inserm, LIRIC UMR 995, Lille University, Lille, France
| | - Grégoire Ficheur
- EA2694 - Santé Publique: épidémiologie et qualité des soins, University of Lille, Lille, France.,Department of Methodology and Biostatistics, Maison régionale de la Recherche Clinique, CHU Lille, Lille, France
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4
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Detourmignies L, Leroyer A, Ligier K, Plouvier S, Genin M. Population-based incidence of lymphomas in the French Nord-Pas-de-Calais region between 2001 and 2005: Annual estimations and spatial analysis. Rev Epidemiol Sante Publique 2019; 67:319-327. [PMID: 31327522 DOI: 10.1016/j.respe.2019.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Non-Hodgkin's lymphomas (NHL) are the seventh most commonly diagnosed cancer in France. Nord-Pas-de-Calais is ranked as the region with the highest incidence of cancers and deaths by cancer in France. With its rich industrial past and its contrasted population densities between urban and rural territories, Nord-Pas-de-Calais represents a geographic area of interest to study the overall incidence of NHL and examine spatial variation of NHL incidence between the 170 cantons of the region. METHODS LYMPHONOR was a population-based multicentre retrospective study of patients residing in the Nord-Pas-de-Calais region and diagnosed with NHL between January 2001 and December 2005. Spatial distribution of NHL incidence in Nord-Pas-de-Calais was explored using two complementary approaches: adjusted smoothed standardised incidence ratio (SIR) and spatial scan statistics (detection of atypical clusters). RESULTS Between 2001 and 2005, 2132 new cases of NHL were diagnosed in the Nord-Pas-de-Calais region. In 2005, age-standardised NHL incidence rates were 10.2 and 7.0 cases per 100,000 person-years in male and female residents, respectively. No significant spatial disparities in NHL incidence were found within the Nord-Pas-de-Calais region. The age-adjusted smoothed SIR varied from 0.82 to 1.25 between cantons. Consistently, spatial scan statistics did not detect any significant atypical cluster of high NHL incidence. CONCLUSION Comparison with national data collected during the same period does not show an overincidence of NHL in the Nord-Pas-de-Calais region. In addition, no evidence for spatial heterogeneity and clustering of NHL incidence was found within this region. Future epidemiological research using large-scale registries is needed to better appraise spatial variation of NHL incidence in France and to investigate possible reasons for significant clusters.
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Affiliation(s)
- L Detourmignies
- Service d'hématologie clinique, Hôpital de Roubaix, 11-17, boulevard Lacordaire, 59056 Roubaix, France.
| | - A Leroyer
- Université de Lille, CHU de Lille, Institut Pasteur de Lille, EA 4483, IMPECS, IMPact of Environmental Chemicals on human health, 59000 Lille, France; CHU de Lille, Pôle de Santé Publique, 59000 Lille, France; Institut Pasteur de Lille, 59000 Lille, France
| | - K Ligier
- Registre général des cancers de Lille et de sa région, C2RC, 59037 Lille, France; Conseil Départemental du Pas-de-Calais, 62018 Arras, France
| | - S Plouvier
- Registre général des cancers de Lille et de sa région, C2RC, 59037 Lille, France
| | - M Genin
- Université de Lille, EA 2694 - Santé Publique : épidémiologie et qualité des soins, 59000 Lille, France
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5
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Socioeconomic status and incidence of cardiac arrest: a spatial approach to social and territorial disparities. Eur J Emerg Med 2019; 26:180-187. [DOI: 10.1097/mej.0000000000000534] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Epidemiology and care structures for children and adolescents and young adults up to the 26th year of life with inflammatory bowel diseases (IBD) in Leipzig/Saxony/Germany. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-017-0884-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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7
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Carbonnel F, Boutron MC. Incidence, Phenotype, and Mortality of Inflammatory Bowel Disease 'Twenty Years After'. J Crohns Colitis 2017; 11:1159-1160. [PMID: 28525593 DOI: 10.1093/ecco-jcc/jjx072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/17/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Franck Carbonnel
- Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.,CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France
| | - Marie Christine Boutron
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France
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8
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Beuscart JB, Genin M, Dupont C, Verloop D, Duhamel A, Defebvre MM, Puisieux F. Potentially inappropriate medication prescribing is associated with socioeconomic factors: a spatial analysis in the French Nord-Pas-de-Calais Region. Age Ageing 2017; 46:607-613. [PMID: 28064169 DOI: 10.1093/ageing/afw245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Indexed: 11/12/2022] Open
Abstract
Background potentially inappropriate medication (PIM) prescribing is common in older people and leads to adverse events and hospital admissions. Objective to determine whether prevalence of PIM prescribing varies according to healthcare supply and socioeconomic status. Methods all prescriptions dispensed at community pharmacies for patients aged 75 and older between 1 January and 31 March 2012 were retrieved from French Health Insurance Information System of the Nord-Pas-de-Calais Region for patients affiliated to the Social Security scheme. PIM was defined according to the French list of Laroche. The geographic distribution of PIM prescribing in this area was analysed using spatial scan statistics. Results overall, 65.6% (n = 207,979) of people aged 75 years and over living in the Nord-Pas-de-Calais Region were included. Among them, 32.6% (n = 67,863) received at least one PIM. The spatial analysis identified 16 and 10 clusters of municipalities with a high and a low prevalence of PIM prescribing, respectively. Municipalities with a low prevalence of PIM were characterised by a high socioeconomic status whereas those with a high prevalence of PIM were mainly characterised by a low socioeconomic status, such as a high unemployment rate and low household incomes. Markers of healthcare supply were weakly associated with high or low prevalence clusters. Conclusion significant geographic variation in PIM prescribing was observed in the study territory and was mainly associated with socioeconomic factors.
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Affiliation(s)
- Jean-Baptiste Beuscart
- Univ. Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
- CHU Lille, Geriatric Department, F-59000 Lille, France
| | - Michael Genin
- Univ. Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - Corrine Dupont
- Agence Régionale de Santé Nord-Pas-de-Calais, Lille, France
| | - David Verloop
- Agence Régionale de Santé Nord-Pas-de-Calais, Lille, France
| | - Alain Duhamel
- Univ. Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
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9
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Sloan CD, Nordsborg RB, Jacquez GM, Raaschou-Nielsen O, Meliker JR. Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark. PLoS One 2015; 10:e0120285. [PMID: 25756204 PMCID: PMC4355495 DOI: 10.1371/journal.pone.0120285] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 02/02/2015] [Indexed: 11/18/2022] Open
Abstract
Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population.
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Affiliation(s)
- Chantel D. Sloan
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Department of Health Science, Brigham Young University, Provo, Utah, United States of America
- * E-mail:
| | | | - Geoffrey M. Jacquez
- BioMedware, Inc., Ann Arbor, Michigan, United States of America
- Department of Geography, State University of New York at Buffalo, Buffalo, New York, United States of America
| | | | - Jaymie R. Meliker
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
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10
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Identifying strains that contribute to complex diseases through the study of microbial inheritance. Proc Natl Acad Sci U S A 2015; 112:633-40. [PMID: 25576328 DOI: 10.1073/pnas.1418781112] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
It has been 35 y since Carl Woese reported in PNAS how sequencing ribosomal RNA genes could be used to distinguish the three domains of life on Earth. During the past decade, 16S rDNA sequencing has enabled the now frequent enumeration of bacterial communities that populate the bodies of humans representing different ages, cultural traditions, and health states. A challenge going forward is to quantify the contributions of community members to wellness, disease risk, and disease pathogenesis. Here, we explore a theoretical framework for studies of the inheritance of bacterial strains and discuss the advantages and disadvantages of various study designs for assessing the contribution of strains to complex diseases.
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