THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY

Abstract

To better understand the etiology of childhood appendicitis, a case-control study of this disease was conducted among 135 children who underwent an appendectomy between November 1980 and December 1982. Two hundred twelve comparison children, matched to these cases by age, sex, and admission date, were selected from the orthopedic and short stay services of the same hospital. Children having one or more first degree relatives with a positive history of appendectomy for appendicitis were 1.2 times more likely to develop appendicitis (p > 0.10) than children without this history. No significant increase in risk for appendicitis was noted in children having parents with a positive history of appendectomy for appendicitis, but children with one or more siblings affected by this disease were 9.5 time more likely to have appendicitis (p < 0.05). As the proportion of family members with a positive history of appendectomy increased, the risk of childhood appendicitis increased (p = 0.002). A significant protective effect was demonstrated between intake of cereal fiber in the upper 50th percentile and risk of appendicitis (relative risk: 0.53, p < 0.05). A significant "dose-response" effect was also noted between increasing levels of whole-grain cereal intake and decreasing risk of appendicitis (p = 0.024). The roles of birthweight, growth indices, allergies, laxatives, and constipation were also investigated, and none of these factors was associated with childhood appendicitis.