Gender-specific Incidence Rates Research Articles

Significantly reduced rates of interpersonal violence in an urban Danish population 2003–2021

This study aimed to describe changes in annual incidence rates and the severity of deliberate interpersonal violence based on hospital and forensic data in a Danish urban population 2003–2021. Included in the study were local victims of violence admitted to Odense University Hospital and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine, University of Southern Denmark from 2003 to 2021. Based on population counts, we estimated overall and gender specific annual incidence rates in different age groups. For the 14,788 victims included in the study, the gender-specific incidence rates were 5.7 for males and 2.4 for females per 1000 population/year. The incidence rates decreased almost fourfold for both genders in all age groups. In both gender, the incidence rate of violence involving mild injuries decreased significantly, whereas incidence rate of violence involving severe injuries remained unchanged over the study period. The proportion of superficial lesions decreased and the proportion of wounds, bone fractures, and deep lesions increased. The proportion of victims with injuries from knifes increased from 3.0 to 5.4% in the study period. Overall, 0.3% died from their injuries. The present study showed a significant decreased in the incidence rate of violence based on hospital and forensic data. The decrease involved solely victims with less severe injuries. We recommend studies combining hospital, forensic, and police data.

Incidence of seropositive rheumatoid arthritis in population-based studies in Northern Savo, Finland, during 1980–2020

The objective is to evaluate the incidence of seropositive rheumatoid arthritis (RA) over 40-year period in Northern Savo, Finland. Data on new seropositive RA patients according to the American College of Rheumatology (ACR) 1987 classification criteria were collected in 2020–2021. In 2020 data on tobacco exposure, patient-reported dental health and living in residences with fluoridated tap water were gathered. Incidence rates were estimated and age- and gender-adjusted to Northern Savo population. The results were compared with data acquired in studies from 1980, 1990, 2000, and 2010. In 2020, 46 seropositive RA patients (21 females and 25 males) were recorded. The crude incidence of seropositive RA fulfilling the ACR 87 criteria in 2020 was 22.3 (95% CI 16.3 to 29.8)/100 000 and age and gender-adjusted 22.3 (95% CI 15.9 to 28.8)/100 000. Tobacco exposure > 5 pack years occurred 18% of females and 56% of males. Only 16% of males were full dentate. A total of 242 incident seropositive RA (age ≥ 16 years, 55% females) were identified in all study years. No differences in the gender-specific incidence rates in each cohort or in incidence between the studies every 10 years were recorded. The incidence of seropositive RA decreased in the age group < 55 years, p = 0.003. There was no change in the incidence of seropositive RA between genders or the study years. A declining trend for occurrence of seropositive RA in the young and early middle-aged population may reflect change in risk factors.

COVID-19 incidence in a cohort of public transport workers.

Previous research has shown an excess risk of COVID-19 among several occupations, but data on public transport workers are scarce. To investigate the occupational risk posed by contact with the public, we followed up the incidence of COVID-19 in a cohort of public transport workers. We identified the incident cases of COVID-19 between 1 September 2020 - 6 May 2021 in a cohort of 2,052 employees of a public transport agency in Sardinia, Italy. The diagnosis of COVID-19 was based on a positive molecular test. To calculate the expected events, we applied the age- and gender-specific incidence rates of the regional population in the same time period to the correspondent strata of the study cohort. We estimated the relative risk (RR) of COVID-19 as the ratio between the observed and the expected events and its 95% confidence interval (95% C.I.) among the total cohort and in two sub-cohorts: bus drivers, and the rest of the personnel (administrative staff, train and metro drivers, workers in the mechanical shop, and in the railroad maintenance, and security). Bus drivers run an elevated risk of COVID-19 (RR = 1.4, 95% C.I. 1.07 - 1.79). There was no excess risk among the sub-cohort including the rest of the personnel. Our study suggests an excess risk of COVID-19 among bus drivers even in a relatively low incidence area, which could imply inadequacy of the preventive measures in place. Further, larger size studies with detailed information on personal and lifestyle characteristics are warranted.

Incidence and clinical characteristics of paediatric keratitis

Background/aimsTo report the incidence and clinical characteristics of paediatric keratitis diagnosed over a 10-year period in a well-defined population.DesignRetrospective, population-based study.MethodsSetting: multicentre. Population: patients (<19 years) diagnosed with keratitis as...

Total, gender- and age-specific incidence rates of upper extremity nerve injuries in Finland.

The aim of this study was to describe the epidemiology of nerve injuries of the upper extremity in the whole population of Finland (1998-2016). Data based on diagnosis codes were obtained from the Care Register for Health Care, including cases of median, radial, ulnar, musculocutaneous, axillary and digital nerves. Age- and gender-specific incidence rates, both crude and standardized (for the European normal population in 2011), were calculated. Our study included 13,440 patients with upper extremity nerve injury. The mean standardized annual incidence rate of any upper extremity nerve injury was 18.18 among men and 8.15 among women per 100,000 person-years over the study period. The incidence peaked among men at working age. Nerve injuries occurred most commonly in the fingers and thumb, with 5532 cases and mean standardized incidence rates per 100,000 person-years of 7.84 among men and 2.95 among women. The annual incidence did not change significantly over the study period.Level of evidence: III.

Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study.

Research on anxiety in oldest-old individuals is scarce. Specifically, incidence studies based on large community samples are lacking. The objective of this study is to assess age- and gender-specific incidence rates in a large sample of oldest-old individuals and to identify potential risk factors. The study included data from N = 702 adults aged 81 to 97 years. Anxiety symptoms were identified using the short form of the Geriatric Anxiety Inventory (GAI-SF). Associations of potential risk factors with anxiety incidence were analyzed using Cox proportional hazard models. Out of the N = 702 older adults, N = 77 individuals developed anxiety symptoms during the follow-up period. The incidence rate was 51.3 (95% CI: 41.2–64.1) per 1000 person-years in the overall sample, compared to 58.5 (95% CI: 43.2–72.4) in women and 37.3 (95% CI: 23.6–58.3) in men. Multivariable analysis showed an association of subjective memory complaints (HR: 2.03, 95% CI: 1.16–3.57) and depressive symptoms (HR: 3.20, 95% CI: 1.46–7.01) with incident anxiety in the follow-up. Incident anxiety is highly common in late life. Depressive symptoms and subjective memory complaints are major risk factors of new episodes. Incident anxiety appears to be a response to subjective memory complaints independent of depressive symptoms.

The decline of hip fracture incidence rates over a 10-year period: A single centre experience

AimsAccurate epidemiological hip fracture data is essential for healthcare planning and targeted prevention strategies. Limited reports of hip fracture incidence rates in the Republic of Ireland (ROI) exist. The aim is to calculate the current age- and gender-specific incidence of hip fractures in a level 1 Trauma Centre in the ROI, and the difference in these rates over a 10 year period. Materials and methodsThis was a retrospective, population-based, observational study. The local Hospital In-Patient Enquiry (HIPE) database was used to generate data for analysis; capturing all patients admitted for hip fracture in three time periods over 10 years. Patients < 55 years old, pathological fractures, and periprosthetic fractures were excluded. Age- and gender-specific incidence rate was calculated using HIPE and national census data. ResultsAbsolute number of hip fractures rose by 8.5% between 2008/09 (n = 800) and 2018/19 (n = 868) time periods. Cervical hip fractures dominated in all 3 time periods. The average age of patients remained at 80 years but length of stay for patients was reduced by 16% 5 years later and by 21% 10 years later from the initial study point. Both the entire and susceptible (> 55 years) population numbers increased by 13% and 30%, respectively, yet overall hip fracture incidence rate declined 10 years on. Hip fracture incidence rate in the entire population fell by 3.23 per 100,000 population, and by 65.11 per 100,000 population in the susceptible population. The majority of both male and female age groups exhibited declining annual incidence rates over the 10 year study period. ConclusionResults are consistent with the global experience of declining overall incidence rate of hip fractures, despite rising susceptible population numbers. This report adds to the sparse hip fracture incidence data available in the ROI which can be applied in future healthcare planning strategies.

A Nationwide Population-Based Study on the Incidence of Parapharyngeal and Retropharyngeal Abscess-A 10-Year Study.

This study aimed to investigate the annual incidence of parapharyngeal and retropharyngeal abscess (PRPA) based on 10-year population-based data. Patients with PRPA were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of over two million enrollees of the National Health Insurance system that covers over 99% of Taiwan’s citizens. During 2007–2016, 5779 patients received a diagnosis of PRPA. We calculated the population-wide incidence rates of PRPA by sex and age group (20–44, 45–64, and >64) as well as in-hospital mortality. The annual incidence rate of PRPA was 2.64 per 100,000 people. The gender-specific incidence rates per 100,000 people were 3.34 for males and 1.94 for females with a male:female gender ratio of 1.72. A slight increase in incidence rates among both genders over the study period was noted. Age-specific rates were lowest in the 20–44 age group with a mean annual incidence of 2.00 per 100,000 people, and the highest rates were noted in the age groups of 45–64 and >64 years with mean annual incidences of 3.21 and 3.20, respectively. We found that PRPA is common in Taiwan, males and older individuals are more susceptible to it, and incidence has increased in recent years.

Berufs- und branchenbezogene Analyse des COVID-19-Risikos in Deutschland

Analysis of the COVID-19 risk by occupational groups and industry in Germany Background: Cases of COVID-19 in healthcare professionals and employees in the nursing service who, as a result of their professional activities, are exposed to a significantly increased risk of infection compared to the general population can be recognised as an occupational disease (BK 3101). However, the question arises whether there is an increased risk of infection in occupational groups other than those mentioned in BK 3101. Methods: Based on the routine data of the BARMER health insurance fund for all employed regular insured persons in the age range from 15 to under 65 years, age- and gender-specific incidence rates for COVID-19 were calculated. On this basis, standardised incidence ratios (SIR) were analysed according to industry and occupational groups as well as according to the risk groups proposed by the Collegium Ramazzini. Results: A total of 15,167 cases of COVID-19 were identified for the more than 4.1 million regular insured persons, of which 2,890 were admitted to hospital (19.1%). For employees in the health and nursing care sector, a significantly increased risk was confirmed with SIR = 1.80 (95%CI: 1.62–1.99). But even for risk group 2 (very high risk) a significantly increased risk was detected: SIR = 1.34 (95%CI: 1.15–1.55). The highest risk was observed among contract workers in the industrial sector and in the postal and logistics sector. Conclusion: The analysis suggests that the risk of COVID-19 is highest among healthcare professionals, employees in the nursing service and in workplaces where inadequate occupational health and safety measures may have been implemented. In order to reduce the risk of COVID-19 in the future, the new SARS-CoV-2 occupational safety regulations must be implemented and strict monitoring of compliance with the internal policies based on these regulations must be ensured. Keywords: COVID-19 risk – occupational disease (BK 3101) – risk groups – occupational health and safety measures

The Incidence of Pediatric and Adolescent Concussion in Action Sports: A Systematic Review and Meta-Analysis.

Background: This was a systematic review and meta-analysis of the incidence of concussion risk in youth athletes involved in action sports (AS). Methods: A search of PubMed and Web of Science (from January 1980 to August 2020). Titles, abstracts, and full text were screened according to predefined inclusion criteria to find relevant studies. Moreover, the methodological quality of the studies selected was assessed. Results: Nineteen of 1.619 studies were included in the systematic review and 14 in the meta-analysis. Motocross, sailing and snowboarding presented the highest incidence rates per 1000 athlete exposure at 39.22, 3.73 and 2.77 respectively, whereas alpine skiing had the lowest incidence rates resulting in 0.30. Overall risk of concussion was estimated at 0.33 (CI: 0.22, 0.45). Regarding the methodological quality, we have to report that 26.3% of the studies reported the definition of concussion while 36.8% presented age and gender-specific incidence rates. The mechanism of injury and follow up were reported only in one study. Conclusions: There are significant differences in the rates of incident youth concussion across AS. Despite some limitations, the data from this research can serve as the current sport-specific baseline risk of concussion among youth athletes who practice action sports.

Population-Level Projections for Multiple Myeloma Patients By Line of Therapy in the USA

Introduction: Treatment for multiple myeloma (MM) has evolved over time, leading to improved survival outcomes for patients. However, information on real world clinical practice, such as the proportion of patients receiving each treatment regimen or the number of patients eligible for a given line of therapy (LOT), is limited. The purpose of this analysis is to report the results of a patient epidemiology model for MM treatment by LOT in the USA. Methods: This study was a retrospective, population-based, secondary data analysis of MM in the USA combining data from the Surveillance, Epidemiology, and End Results (SEER) registry and physician survey results from the CancerMPact® (CMP) database. Age- and gender-specific incidence rates were obtained from SEER for all available years through 2016 using the ICD-O-3 histology codes of 9731 (solitary plasmacytoma of bone), 9732 (plasma cell myeloma), and 9734 (extraosseous plasmacytoma). Based on the observed trend in the historical incidence rates through 2016, the incidence rates were projected to 2025. These projected rates were multiplied by the respective age- and gender-specific USA population from the 2010 U.S. Census, moderate projection to calculate the estimated number of incident MM patients between 2020-2025. Complete prevalence was calculated using the National Cancer Institute's Complete Prevalence (ComPrev) software. Annual prevalent patients by LOT were defined as the number of MM patients who received a line therapy at any point in the given year, and who had not yet progressed to the next LOT. To calculate the number of unique patients during a given year who were on a specific LOT, the mean progression-free survival (PFS) of the LOT in months was calculated based on data from the 2018-2019 CMP Treatment Architecture (TA) physician surveys. The total estimate of MM patients on a LOT among prevalent patients was calculated using the annual estimate of patients initiating a line by year, divided by total months per year, then multiplied by the average PFS in months for that line. Results: Projected complete MM prevalence in the USA in 2020 was estimated at 144,922, further increasing to 162,339 by 2025. Projected unique MM patients by LOT in 2020 was estimated as 53,176 (1st LOT), 19,407 (2nd LOT), 6,481 (3rd LOT), 1,649 (4th LOT), and 426 (5th LOT) (refer to Table 1 for ranges). It is estimated the number of unique prevalent patients will increase over time for each line (total of 13% across 5 years). Conclusions: With different treatment options available, the choice of therapeutic approach for MM patients is an increasingly complex process. As more new anti-neoplastic agents are introduced and survival duration for patients with MM continues to increase with longer intervals between disease progression, patients are potentially able to receive multiple lines of therapy. In this study, the proportion of prevalent cases by line decreased with each additional LOT. The current study estimated overall lower proportions than previous studies for third line and beyond (Ruzafa 2016, Raab 2018). These differences can be attributed to the underlying assumptions and different methodologies used. The physicians responding to the TA survey are basing their responses on their own recall and clinical experience across all the multiple myeloma patients they treated over the past 6 months. Few published studies have reported on contemporary proportions of treated MM patients by LOT combining data from both registry sources and physician surveys in an epidemiology model. The results of this study show that incidence and prevalence by LOT for MM patients in the USA are estimated to increase between 2020-2025. While several factors can contribute to the increase of MM incidence and treated patients projected into the future, a key consideration is the underlying aging of the population (Vespa 2020). Between 2020-2025, the total incidence as well as the total unique patients treated by line increased substantially and the assumption is that this trend will continue. Funding: GSK (study: 213443). Disclosures Kanas: Kantar: Consultancy. Clark:Kantar: Consultancy, Current Employment, Honoraria. Keeven:Kantar: Consultancy, Current Employment. Nersesyan:Kantar: Consultancy, Current Employment. Sansbury:GSK: Current Employment, Current equity holder in publicly-traded company. Hoggea:GSK: Current Employment, Current equity holder in publicly-traded company.

The rise of metastatic bone disease in Ireland.

To describe the expected rise of metastatic bone disease in Ireland, the relative primary types, and the locations of spread within the skeleton. This was a population-based epidemiological study using cancer registry data. We included patients with known metastatic cancer to bone, within 1year of the primary diagnosis, during the years 1994 to 2012 inclusive. Our main outcome measures were age-specific, gender-specific and age-standardised incidence rates of bone metastasis, primary types and metastatic location within the skeleton. There were 14,495 recognised cases of bone metastasis in Ireland, 1994-2012 inclusive. Cases consistently rose over the time period, with 108% case increase and 51% age-standardised incidence rise. Annual percentage change increased across both genders and over all age groups. Most of this rise was not due to demographic population change. Breast, prostate and lung accounted for the majority of primary types. GI cancers were the fourth most common primary type. There were proportional increases in breast and lung, with proportional decreases in prostate. The spine was the major metastatic site. Bone metastasis is a significant and rising healthcare concern in Ireland. This rise is disproportionate to demographic changes. Breast, prostate and lung cancers account for the majority. GI cancers are implicated in an unexpectedly high number of cases. Spine is the most common location of bony metastasis, especially at presentation. Prudent healthcare planning is necessitated to prepare for the growing consequences of bone metastasis in cancer patients.

Cancer incidence in Behçet's Disease.

e13583 Background: Previous studies demonstrated increased risk of cancer in systemic autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE) and sjögren syndrome due to uncontrolled inflammation. Behçet’s disease (BD) was also reported to be associated with an increased risk of cancer, although data is limited and differences in study designs was an important issue. In this study, we aimed to assess cancer incidence in a large cohort of BD patients and to compare with the data of the Turkish National Cancer Registry (TNCR) in the same age and gender groups. Methods: The study cohort consisted of BD patients of &gt; 18 years old age and without a prior cancer diagnosis who were prospectively recorded in Hacettepe University Vasculitis Center. Data on any cancer was collected from the patient files. Cancer incidence was compared with age- and gender-specific cancer incidence rates of the normal population retrieved from the 2014 Turkish National Cancer Registry (TNCR) data using standardized incidence rates (SIR). Results: Totally 451 adult cases with BD were included in the study. The median age of the cohort was 43 (20-75) and 52.5% of the patients were males. Eleven cancer cases were observed during a median 124 months follow up. Behçet’s Disease was associated with an increase in cancer risk compared to expected counts in the corresponding age and sex group (SIR 2.84, 95% CI 1.50-4.94, p &lt; 0.001). Cancer risk was particularly increased in men (SIR: 5.63, 95% CI: 2.62–10.70, p &lt; 0.001) compared to TNCR data. Patients with papulopustular lesions had a trend towards a decreased risk of cancer (p = 0.060) and patients using azathioprine had a significantly decreased cancer risk (p = 0.031). Conclusions: This study revealed the cancer risk of patients BD was increased approximately three times compared to corresponding age and sex group. Besides the routine care, increased attention for cancer surveillance is required in the follow-up of BD patients.

Cancer incidence in Behçet’s disease

Previous studies demonstrated an increased cancer risk in autoimmune diseases. Behçet's disease (BD) was also reported to be associated with an increased risk of cancer, although the data is limited. In this study, we aimed to assess cancer incidence in a large cohort of BD patients and to compare with the data of the same age and gender groups. The study cohort consisted of BD patients of > 18years of age who were prospectively recorded in the Hacettepe University Vasculitis Center. Data on any cancer was collected from the patient files. Cancer incidence was compared with age- and gender-specific cancer incidence rates of the normal population retrieved from the 2014 Turkish National Cancer Registry (TNCR) data using standardized incidence rates (SIR). Totally, 451 adult cases with BD were included. The median age of the cohort was 43 (20-75), and 52.5% of the patients were males. Eleven cancer cases were observed during a median of 124months follow-up. Behçet's disease was associated with an increase in cancer risk compared with expected counts in the corresponding age and sex group (SIR 2.84, 95% CI 1.50-4.94, p < 0.001). Patients with papulopustular lesions had a trend toward a decreased risk of cancer (p = 0.060), and patients using azathioprine had a significantly decreased cancer risk (p = 0.031). This study revealed BD patients had approximately three times increased cancer risk compared with corresponding age and sex groups. Besides the routine care, increased attention for cancer surveillance is required in the follow-up of BD patients.

Ethnic and gender-specific incidence rates for hip fractures in South Africa: A multi-centre study.

Limited data exist on the incidence of hip fractures in South Africa (SA). We report gender and ethnic specific incidence rates of hip fractures in SA. In a multicentre prospective study, conducted in geographically defined municipalities of three provinces in SA, a structured questionnaire was administered to all subjects aged 40years and over, presenting with a new atraumatic hip fracture, from 1 April 2017 to 31 March 2018. Gender and ethnic specific incidence rates (IR) of hip fractures were calculated using population statistics from Statistics SA. Of the 2767 subjects enrolled, 1914 (69·2%) were women and 853 (30·8%) were men. The majority of subjects were from the White population (40·9%) followed by those from the African (26·4%), Coloured (18·7%) and Indian (13·9%) populations. Men with hip fractures were significantly younger than women in the total group (69 [IQR 59-79] versus 77years [IQR 68-84], p<0·001) and in each ethnic group. White subjects were significantly older (p<0·0001) and Africans significantly younger (p<0·0001) than the other ethnic groups. In women, the highest IR was noted in the White population (176·0 per 100,000), followed by that in the Indian (147·7 per 100,000), Coloured (73·2 per 100,000) and African populations (43·6 per 100,000). A similar pattern was seen in men albeit at lower rates, with the highest rate in White men at 76·5 per 100,000. In the total study population and the African population, the IR was higher in men compared to women in subjects under 60years. In the White population, the IR was higher in men compared to women in the 40-44years age group. While in the Coloured and Indian populations the IR was higher in men compared to women in the 40-49years and 45-54years age groups, respectively. There was an increase in the relative risk ratios with age in the total study population, and in all ethnic groups in both women and men. Hip fractures occur in all ethnic groups in South Africa with higher IRs in the White and Indian populations compared to the Coloured and African populations. Consistent with the published literature, the overall hip fracture IR was higher in women than in men, except in the younger age groups, and increased with age. South African Medical Research Council and the University of KwaZulu-Natal Competitive Research Grant.

Trends in the utilisation of aged care services in Australia, 2008\u20132016

BackgroundAged care support services in Australia are delivered through home care packages, permanent residential care, respite care and transition care. This study aimed to determine age and gender specific incidence rates of aged care service utilisation in Australia between 2008-09 and 2015–16.MethodsThis is a population-based epidemiological study of people accessing aged care services in Australia. The trends and characteristics of people (over the age of 65 years old) accessing aged care services in Australia were evaluated, using data (2008–09 and 2015–16) from the Australian Institute of Health and Welfare and Australian Bureau of Statistics. The yearly utilisation incidence rates (per 1000 people) per service type were calculated and changes in incidence rate ratios (IRR) of service utilisation for the study period were estimated using Poisson regression models.ResultsThe proportion of older Australians aged ≥65 years who used aged care services remained similar between 2008-09 (5.4%, N = 208,247) and 2015–16 (5.6%, N = 248,669). However, the incidence use of specific services changed during the study period. Specifically, admissions into permanent residential care decreased (from 23.8/1000 people in 2008–09 to 19.6/1000 in 2015–16, at a IRR of 0.84/year, p < 0.001) but increased for transition care (from 4.3/1000 in 2008–09 to 6.6/1000 in 2015–16, at a IRR of 1.57/year, p < 0.001) and home care packages (from 8.04/1000 in 2008–09 to 12.0/1000 per 1000 in 2015–16, at a IRR of 1.52/year, p < 0.001). Between 2008-09 and 2015–16, the greatest changes in IRR were observed in males aged 80–89 years accessing transition care (IRR = 1.68/year, p < 0.001). A higher proportion of people aged between 80-89 years (≥45%), females (≥60%), Australia born (≥ 60%) and English speakers (≥80%) used all the service types.ConclusionsPatterns of service utilisation for aged care services changed over the study period with a decrease in incidence of individuals accessing permanent residential care but increased for other service types. This finding reflects changes in attitudes regarding ageing in place and policies. These findings are helpful to inform key stakeholders on service planning to further improve quality of the aged-care services in Australia.

1512-P: Incidence of Type 1 and Type 2 Diabetes in Hong Kong: Analysis of the Hong Kong Diabetes Surveillance Database

Objective: Over two thirds of the world’s population with diabetes reside in Asia but data on time trends of diabetes incidence in this region is limited. Using population-wide data, we report trends in the incidence of type 1 and type 2 diabetes (T2D) in Hong Kong over a 14-year period. Methods: The Hong Kong Diabetes Surveillance Database (HKDSD) hosts clinical information of people with diabetes under the care of the Hong Kong Hospital Authority, a statutory body governing all public hospitals and out-patient clinics locally. Diabetes type was determined using a validated algorithm that considers both encounter codes and prescription data. Gender-specific incidence rates (per 100,000 person-year) separated by age categories were standardized to age structure of the World Health Organization population. Average annual percentage change (AAPC) was calculated using joinpoint regression analysis to describe incidence trends over time. Results: The HKDSD included 2426 cases of type 1 diabetes (T1D) and 535490 cases of T2D newly detected between 2002-2015. Among youth (age&amp;lt;20 years), incidence of both T1D and T2D increased linearly (T1D: 4.6 to 6.4 [AAPC 4.7%] in girls, 2.8 to 5.3 [AAPC 3.6%] in boys; T2D: 4.1 to 8.5 [AAPC 4.2%] in girls, 2.6 to 7.5 [AAPC 5.4%] in boys). In young adults (age 20-&amp;lt;40 years), incidence of T1D remained stable but incidence of T2D increased over time (48.1 to 62.1 [AAPC 3.3%] in women, 77.6 to 110.8 per 100,000 person-year [AAPC 4.2%] in men). In older adults (age ≥40 years), incidence of T2D increased between 2005-2011 but stabilized thereafter, whereas incidence of T1D was unchanged. Conclusions: We observed an increase in incidence of T2D in youth and young adults and stabilization in older adults. Incidence of T1D continued to climb in youth but remained constant in adults. This study highlights the emerging problem of young-onset diabetes and calls for effective strategy for diabetes prevention in young people. Disclosure A. Luk: None. C. Ke: None. E.S. Lau: None. R.C. Ma: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; AstraZeneca, Bayer AG, Pfizer Inc. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; AstraZeneca. E. Chow: Research Support; Self; Powder Pharmaceuticals Inc., Sanofi-Aventis. A.P. Kong: Advisory Panel; Self; Lilly Diabetes. Research Support; Self; AstraZeneca, Lilly Diabetes. Speaker's Bureau; Self; Abbott. Other Relationship; Self; AstraZeneca, Novartis Pharmaceuticals Corporation, Sanofi. J.C. Chan: Board Member; Self; Asia Diabetes Foundation. Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Medtronic, Merck Sharp &amp; Dohme Corp., Sanofi-Aventis. Research Support; Self; Amgen Inc., AstraZeneca, Lee Powder, Lilly Diabetes, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; Ascensia Diabetes Care. Stock/Shareholder; Self; GemVCare. W. So: None.

Time trends in gender-specific incidence rates of road traffic injuries in Iran.

ObjectivesEvery day, an average of 3,400 deaths and tens of millions of injuries occur as a result of traffic accidents. This study aims to model and validate road traffic injury (RTI) times series, specifically considering gender.Study designTime trend studies of monthly road traffic injuries (RTI) in Iran from March 2005 to February 2016, as well as those of males and females from March 2009 to February 2016 were performed.MethodsThe seasonal auto-regressive integrated moving average method (SARIMA) was employed to predict RTI time series. The final model was selected from various SARIMA models based on the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). To examine whether the residuals were white noise, the Ljung-Box (LB) test and residuals plots were used for un-correlation, and the zero mean and stationarity, respectively. Additionally, smoothing methods were utilized to validate the SARIMA models for fitting and out-of-range prediction of the time series models under study. The sample auto-correlation function (ACF) and the partial autocorrelation function (PACF) with 20 lags were employed to determine the order of models and to ascertain if the residuals of the model were uncorrelated.ResultsBased on the obtained results, SARIMA (2,1,0)(0,1,1)12, SARIMA (0,1,1)(0,1,1)12, SARIMA (1,1,1)(0,0,1)12, and SARIMA (2,0,0)(1,0,0)12 were chosen for the time series including incidence rates of total road traffic injuries (IRTI), IRTI of males, females, and males-to-females, respectively. The AIC values were -87.57, 413.38, -732.91, and -85.32, respectively. The LB test for the residuals of the time series models of (0.539) IRTI, (0.3) IRTI of males, (0.23) females, and (0.237) males-to-females indicated that residuals were uncorrelated. Furthermore, prediction values for the next 24 months (2016 to 2018) showed no decline in the incidence rate of male and female traffic injuries. Results of the predictions using exponential smoothing methods indicated out-of-range prediction validity of the SARIMA models.ConclusionThis study exemplified the high efficiency of SARIMA models in predicting road traffic injuries (RTIs). Based on observations, the IRTI mean in Iran was 35.57 in 2016. The predicted values of the IRTI for 2016–2018 by the SARIMA model showed no decreasing trend. During the studied period, the observed values of IRTI for males were two to three times the female values. Thus, prediction of RTI can provide a useful tool for traffic safety policymaking by simulating interrupted time series when applying new traffic enforcement interventions and regulations in the future. Additionally, IRTI analysis of males and females showed that men had a non-increasing trend but higher incidence of traffic injuries, whereas the IRTI for women revealed an increasing trend from 2009 to 2012 with a lower incidence of injuries. This growth could be attributed to the impact of increased outdoor activities of women and the increased number of issued driving licenses in the period of 2009–2012.

Cancer incidence in familial Mediterranean fever patients: a retrospective analysis from central Anatolia.

Although chronic inflammation has been associated with increased cancer risk in various disease including hepatitis or inflammatory bowel disease, a lower incidence of cancer has been reported recently in familial Mediterranean fever (FMF) which is an auto-inflammatory disease with persistent inflammation. We have assessed cancer incidence among FMF patients with or without amyloidosis to investigate this hypothesis. We performed a retrospective review of FMF patients, diagnosed and treated in Hacettepe University hospitals between 2001 and 2018. We identified patients from the hospital medical records using the ICD-10 code for FMF. We collected data on demographic and clinical features, drug history, the presence of amyloidosis and subsequent diagnosis of cancer. The expected cancer incidence was estimated using age- and gender-specific standardized incidence rates (SIRs) in comparison with the general Turkish population according to Turkish National Cancer Registry data at 2014. Total of 3899 FMF patients (120 patients had also amyloidosis) were included. Median age was 22 and 56% were females. Thirty-eight patients were diagnosed with cancer during 100,283 person-years of follow-up. The most common cancer was breast cancer in females (7/28 patients) and leukemia (2/10 patients) in males. The overall cancer incidence among patients with FMF was significantly lower in both males {SIR 0.42 [95% confidence interval; (CI) 0.21-0.75], p = 0.019} and females [SIR 065 (95% CI 0.44-0.93), p = 0.002]. The overall cancer incidence among patients with FMF and amyloidosis was [SIR 1.21 (95% CI 0.49-2.52), p = 0.73] without gender difference. Cancer incidence was significantly lower in FMF patients compared with the general Turkish population. We found no increased cancer incidence in FMF patients having amyloidosis. Possible underlying mechanisms need to be explained.

Incidence of adult traumatic spinal cord injury in Saint Petersburg, Russia.

Retrospective population-based cohort study. To characterise the epidemiology of traumatic spinal cord injury (TSCI) among the inhabitants of Saint Petersburg, Russia. All hospitals in Saint Petersburg. Charts for all individuals admitted to city hospitals from 1st January 1 2012 to 31st December 2016 with acute TSCI were reviewed. Incidence rates were calculated for the whole period and for each year separately. Gender-specific and age-specific incidence rates were calculated, and epidemiological characteristics and possible risk factors were analysed. A total of 361 people were identified. The average annual incidence rate was 17.6 per million, varying from 21.2 (2013) to 13.6 (2016), and 70.9% were men. Mean age at injury was 42.1 years. Injuries from falls represented 49.8% of cases, and motor vehicle accidents 18.9%. The male:female ratio in the low-falls group was 1.2:1, and among the elderly patients, it was 0.5:1. Lesions at the cervical level were involved in 49.3%, thoracic in 24.7%, and lumbar/sacral in 23.5%. TSCI was complete in 16.9%. Concomitant injuries occurred in 47.2% of cases, and traumatic brain injuries in 37.7%. TSCI incidence decreased during the observation period and was 2.4 times more common among men than women. In half of the cases, injuries involved the cervical level, and a fall was the most frequent injury cause. Elderly women more often had falls from a low height than men. Multiple injuries-most frequently traumatic brain injuries-were common.