Highest Age-specific Incidence Rates Research Articles

Incidence of inflammatory bowel disease in Italy: a nationwide population-based study. Gruppo Italiano per lo Studio del Colon e del Retto (GISC)

The epidemiology of inflammatory bowel disease (IBD) in Southern Europe is still unclear. Sporadic reports suggest a lower incidence of IBD in Italy than in other Western Countries and the USA. A nationwide population-based study was carried out to estimate IBD incidence rates in eight Italian cities. All new cases of IBD diagnosed over 4 years in the target populations were collected from multiple information sources. From 1989 to 1992, 509 ulcerative colitis (UC), 222 Crohn's disease (CD) and 10 undefined IBD cases were collected, giving age-adjusted incidence rates (per 100,000 per year) of 5.2 for UC and 2.3 for CD. Using the capture-recapture method, an estimated completeness of 0.81 was obtained for case archives, without appreciable and significant differences between areas. The rates computed after correcting underestimation were 6.8 for UC and 2.8 for CD. The sex ratio M/F was 1.7 for UC and 1.0 for CD. The highest age-specific incidence rates were between 30 and 39 years for UC and between 20 and 29 years for CD. The incidence rate of CD in italy is homogeneous between the cities investigated and lower than those reported for other Mediterranean countries. In contrast, the UC incidence rate is within the range of those reported in European studies. A wide variability in the UC rates between the cities was also observed. These results could be related to different environmental factors or the genetic background of the populations, or both.

Cow, farm, and ecologic risk factors of clinical vesicular stomatitis on Costa Rican dairy farms.

Twenty-two Costa Rican dairy herds were actively monitored for vesicular diseases between November 1991 and March 1992, in anticipation of the annual dry season occurrence of vesicular stomatitis (VS). Thirty-nine confirmed cases of VS were concentrated on nine farms, resulting in an average herd incidence rate of 11.1% of mature cattle for the affected farms, or 2.6% for all farms. Affected cattle were generally older (average age = 5.4 years), with seven-year-old cows having the highest age-specific incidence rate (6.5%). The New Jersey serotype of VS was diagnosed for all but four cases, primarily manifesting as teat vesicles. Cases had high acute and convalescent antibody titers for both major VS serotypes, New Jersey and Indiana, with significant titer increases after clinical disease. Screening and multiple variable regression analyses of 140 cow, farm, and ecologic variables revealed that clinical disease was significantly associated with cows being in lactation, and with higher acute antibody titers to serotype Indiana, but not with any predisposing diseases. Significant farm factors were the presence of poultry and a longer calving interval on the farm, but not higher rates of other diseases. According to a prior epidemiologic hypothesis, two ecologic factors were forced to be included into the farm model: the reported presence of sand flies, and a higher proportion of the farm being in forest land, with subsequent stepwise regression. The resulting model containing only the two forced variables was significant (P < 0.003) and correctly classified 78% of farms into the correct group, as compared with 79% for the final stepwise model.(ABSTRACT TRUNCATED AT 250 WORDS)

Incidence of inflammatory bowel disease in northern France (1988-1990).

There were no data concerning the incidence of inflammatory bowel disease (IBD) in France. The aim of this study was to investigate the incidence of Crohn's disease and ulcerative colitis in northern France. This prospective population based study was realised through the gastroenterologists of the region Nord-Pas de Calais and the Somme Department. Each gastroenterologist referred patients consulting for the first time with clinical symptoms compatible with IBD. Data were collected by an interviewer practitioner present at the gastroenterologist's consulting room. Two independent expert gastroenterologists assessed each case in a blind manner and made a final diagnosis of Crohn's disease, ulcerative colitis, ulcerative proctitis, or unclassifiable chronic colitis. From 1988 to 1990, 1291 cases of IBD were recorded: 674 (52%) Crohn's disease, 466 (36%) ulcerative colitis including 162 proctitis (35%), and 151 (12%) unclassifiable chronic colitis. The mean annual incidence was 4.9 per 100,000 for Crohn's disease and 3.2 for ulcerative colitis. The sex ratio F/M was 1.3 for Crohn's disease and 0.8 for ulcerative colitis. The highest age specific incidence rate for Crohn's disease was between 20 and 29 years: 13.1 for women and 9.8 for men. The highest age specific incidence rate for ulcerative colitis was between 20 and 39 years: 5.5 for women and 6.5 for men. This first French prospective study has shown an incidence rate for Crohn's disease comparable with that seen in north European studies but lower than that seen for ulcerative colitis. These results could be related to the different environmental factors or the genetic background of the population studied, or both.

Is the peak in breast cancer incidence in sight? A study conducted in the southeastern Netherlands

Breast cancer is the most frequent malignancy in the western world, and increases in the incidence have been observed worldwide. We investigated temporal trends in breast cancer incidence in the southeastern Netherlands between 1960 and 1989 by birth cohort analysis, using data of the Eindhoven Cancer Registry. An overall time-trend in incidence rate was estimated, based on age and year of diagnosis. Rate ratios were calculated, as the ratio of the observed versus the expected incidence rates, which was based on the estimated time-trend. In this unscreened population the age-specific incidence increased for every successive birth cohort in the period 1880-1949. Women born between 1940 and 1949 had the highest age-specific incidence rates with an excess of 10% (relative risk 1.10, 95% confidence interval 1.01-1.22). The incidence rates in women born after 1949 declined and were 21% lower than expected by the estimated secular trend (relative risk 0.79, 95% confidence interval 0.64-0.96). This decrease in incidence for women aged under 40 suggests that the peak in incidence of female breast cancer may be in sight. It remains unclear which risk factors are responsible for this changing trend.

Anorexia Nervosa in Rochester, Minnesota: A 45-Year Study

The incidence of anorexia nervosa during a 45-year period (1935 through 1979) was determined for the population of Rochester, Minnesota, from the epidemiology archives at the Mayo Clinic. The medical records of local residents with the diagnosis of anorexia nervosa were the primary source for case ascertainment, although records of those whose diagnoses might have been shielding anorexia nervosa were also screened. Standard criteria for diagnosis were applied. We identified 140 (128 female and 12 male) residents of the community who fulfilled the diagnostic criteria for anorexia nervosa. No significant long-term trend in rates was ascertained. The overall age- and sex-adjusted incidence rate was 7.3 per 100,000 person-years. The highest age-specific incidence rate (56.7 per 100,000 person-years) occurred in female residents 15 to 19 years old. The prevalence rate on Jan. 1, 1980, for Rochester residents with a history of the disease, age- and sex-adjusted to the 1970 US white population, was 113.1 per 100,000 (203.9 for female and 16.9 for male residents).

International mortality from primary nervous system neoplasms: distribution and trends.

International comparisons of average annual age-adjusted mortality rates for primary tumours of the nervous system for 1951 through 1958 and 1967 through 1973 showed marked geographical variation for both study periods. For the majority of countries, the mortality rates increased by at least 40% in the in the intervening 15-year period, while in 20% of the countries the rates increased by over 100%. The percentage increases varied from 12.2 to 345.5. The improvement in the diagnosis of these tumours, particularly among elderly individuals (who have the highest age-specific incidence rates for these neoplasms), presumably accounts for most of this change. However, it is possible that the increase may not be fully accounted for by these factors alone. It is therefore suggested that further epidemiological studies are undertaken to determine more accurately the causes and implications of this worldwide increase in mortality rates from primary tumours of the nervous system.

A person to person hepatitis A outbreak.

A person to person outbreak of hepatitis A is described: 90 cases of hepatitis A occurred in a small town in Calabria, southern Italy; all cases were under 18 years of age with the highest age-specific incidence rate in the 6-10 year age group. Transmission was identified by tracing close contacts with other incubating or active cases; only eight out of 90 cases were not identified as having a very probable or possible contact with an infecting case. Transmission was high between family members leading to a secondary family attack rate of 51% in children under 16. An enteric disease educational campaign was carried out together with IgG and no cases of hepatitis A were reported in the two years following the investigation.

International Mortality from Primary Nervous System Neoplasms: Distribution and Trends

International comparisons of average annual age-adjusted mortality rates for primary tumors of the nervous system for 1951–1958 and 1967–1973 showed marked geographic variation for both study periods. For the majority of countries, the mortality rates increased by at least 40% in the intervening 15-year period, while in 20% of the countries the rates increased by over 100%. The percentage increases varied from 12.2 to 345.5. The improvement in the diagnosis of these tumors, particularly among elderly individuals (who have the highest age-specific incidence rates for these neoplasms), presumably accounts for most of this change. However, it is possible that the increase may not be fully accounted for by these factors alone. It is therefore suggested that further epidemiologic studies should be undertaken to determine more accurately the causes and implications of this worldwide increase in mortality rates from primary tumors of the nervous system.