Advanced

Microscopic colitis in Denmark and Sweden : incidence, putative risk factors, histological assessment and endoscopic activity

Davidson, Sanna; Sjöberg, Klas LU ; Engel, Peter J.H.; Lo¨rinc, Esther LU ; Fiehn, Anne Marie K.; Vigren, Lina LU and Munck, Lars K. (2018) In Scandinavian Journal of Gastroenterology p.1-7
Abstract

Objective: The significantly higher incidence rates of microscopic colitis (MC) in Denmark compared to Sweden remains unexplained. Methods: Consecutive patients with newly diagnosed MC in the neighbouring regions of Skåne in 2011–2015 and Zealand in 2010–2016 were prospectively identified. Data on large bowel endoscopies and biopsies rates were retrieved. Information on putative factors were obtained from registers and literature. Interobserver agreement between pathologists from both regions on 40 blinded hematoxylin and eosin (H&E)-stained colon biopsies (collagenous colitis (CC), lymphocytic colitis (LC), non-specific inflammation and normal) was evaluated using kappa statistics. Results: The mean annual incidence per... (More)

Objective: The significantly higher incidence rates of microscopic colitis (MC) in Denmark compared to Sweden remains unexplained. Methods: Consecutive patients with newly diagnosed MC in the neighbouring regions of Skåne in 2011–2015 and Zealand in 2010–2016 were prospectively identified. Data on large bowel endoscopies and biopsies rates were retrieved. Information on putative factors were obtained from registers and literature. Interobserver agreement between pathologists from both regions on 40 blinded hematoxylin and eosin (H&E)-stained colon biopsies (collagenous colitis (CC), lymphocytic colitis (LC), non-specific inflammation and normal) was evaluated using kappa statistics. Results: The mean annual incidence per 105 inhabitants in Skåne and Zealand 2010–2015 was 5.9 (95% CI 4.6–7.3) versus 16.4 (95% confidence intervals (95% CI) 13.6–19.2) for CC and 2.7 (95% CI 1.0–4.3) versus 11.1 (95% CI 8.8–13.4) for LC, respectively. Number of endoscopies with biopsy per 1000 and the rate of MC per endoscopy with biopsy was higher in Zealand (34–52/1000) than in Skåne (12–21/1000). The kappa value for overall agreement between pathologists was good (0.72; 95% CI 0.64–0.79). Prescription of proton pump inhibitors and selective serotonin reuptake inhibitors was higher in Skåne in the relevant age groups and prescription of non-steroidal anti-inflammatory drugs and smoking rate higher in Zealand. Alcohol consumption was higher in Denmark than in Sweden. Conclusion: The incidence of MC and number of cases per colonic biopsy was higher in Zealand and could not be readily explained by endoscopy or biopsy rates, differences in histological assessment or putative risk factors.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
endoscopy, epidemiology, Microscopic colitis, pathology
in
Scandinavian Journal of Gastroenterology
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85047916134
ISSN
0036-5521
DOI
10.1080/00365521.2018.1476583
language
English
LU publication?
yes
id
89b69c48-99a4-4cb2-8755-8f910b0b39f0
date added to LUP
2018-06-13 13:56:23
date last changed
2018-06-14 03:00:05
@article{89b69c48-99a4-4cb2-8755-8f910b0b39f0,
  abstract     = {<p>Objective: The significantly higher incidence rates of microscopic colitis (MC) in Denmark compared to Sweden remains unexplained. Methods: Consecutive patients with newly diagnosed MC in the neighbouring regions of Skåne in 2011–2015 and Zealand in 2010–2016 were prospectively identified. Data on large bowel endoscopies and biopsies rates were retrieved. Information on putative factors were obtained from registers and literature. Interobserver agreement between pathologists from both regions on 40 blinded hematoxylin and eosin (H&amp;E)-stained colon biopsies (collagenous colitis (CC), lymphocytic colitis (LC), non-specific inflammation and normal) was evaluated using kappa statistics. Results: The mean annual incidence per 10<sup>5</sup> inhabitants in Skåne and Zealand 2010–2015 was 5.9 (95% CI 4.6–7.3) versus 16.4 (95% confidence intervals (95% CI) 13.6–19.2) for CC and 2.7 (95% CI 1.0–4.3) versus 11.1 (95% CI 8.8–13.4) for LC, respectively. Number of endoscopies with biopsy per 1000 and the rate of MC per endoscopy with biopsy was higher in Zealand (34–52/1000) than in Skåne (12–21/1000). The kappa value for overall agreement between pathologists was good (0.72; 95% CI 0.64–0.79). Prescription of proton pump inhibitors and selective serotonin reuptake inhibitors was higher in Skåne in the relevant age groups and prescription of non-steroidal anti-inflammatory drugs and smoking rate higher in Zealand. Alcohol consumption was higher in Denmark than in Sweden. Conclusion: The incidence of MC and number of cases per colonic biopsy was higher in Zealand and could not be readily explained by endoscopy or biopsy rates, differences in histological assessment or putative risk factors.</p>},
  author       = {Davidson, Sanna and Sjöberg, Klas and Engel, Peter J.H. and Lo¨rinc, Esther and Fiehn, Anne Marie K. and Vigren, Lina and Munck, Lars K.},
  issn         = {0036-5521},
  keyword      = {endoscopy,epidemiology,Microscopic colitis,pathology},
  language     = {eng},
  month        = {05},
  pages        = {1--7},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Microscopic colitis in Denmark and Sweden : incidence, putative risk factors, histological assessment and endoscopic activity},
  url          = {http://dx.doi.org/10.1080/00365521.2018.1476583},
  year         = {2018},
}