Heilsa - Sjúkrakassagrunnurin
Causes and costs of the high incidence of Inflammatory Bowel Disease in the Faroe Islands
Deildin fyri Arbeiðs og Almannaheilsu
Pál Weihe, Maria Skaalum Petersen, Marin Strøm, Kári Rubek Nielsen, Jóngerð Midjord, Johan Burisch, Søren N. Lophaven, Amanda Vang og Ebbe Langholz- .
Stuðul úr Granskingargrunninum:
Crohn’s disease (CD) and ulcerative colitis (UC) are the two main idiopathic disorders collectively termed inflammatory bowel disease (IBD) with chronic inflammation of the gastrointestinal tract due to an exaggerated immune response. The aetiology of IBD is unknown but believed to be caused by a multifaceted interaction between genetic susceptibility and environmental influences. The incidence of IBD has risen to the extent that today IBD is a global disease occurring in almost every country. IBD is most common in the industrialized parts of the world with the highest incidence and prevalence rates found in North America, Europe and Oceania. At present day, the highest incidence of IBD in the world is found in the Faroe Islands. The increase in the Faroese IBD incidence has been documented in population-based studies in the periods 1964-83, 1981-1988 and 2005-2009. In 2010 and 2011, the European Crohn’s & Colitis Organization’s Epidemiological Committee study (ECCO-EpiCom) documented the incidence of IBD in the Faroe Islands to be 84 per 100,000 person-years. In our study of the Faroese IBD incidence over a 54-year period from 1960 to 2014, we investigated how the incidence of IBD had developed before and after the findings from the ECCO-EpiCom study and the early Faroese studies. We found the increasing incidence to be a relatively new phenomenon emerging in the 1960s onwards to the present record high incidence. Both CD and UC are characterized by an unpredictable disease course with periodically relapses and remissions. Age at onset for CD is usually at age 20-30 and for UC at age 30-40, but IBD can be diagnosed in patients of any age. Therefore, IBD is costly, both from a societal and from an individual point of view. An IBD diagnosis permeates the life of the individual. The diseases often have an early age of onset, which results in reduced work ability, possibly disability and impaired quality of life. The cost for the health care system is also considerable, as the patients will require lifelong expensive medication and/or surgical procedures regardless of disease phenotype. This project is based on patient registrations and population data and aims at assessing the consequences of the high IBD incidence and to provide Faroese numbers on outcomes such as treatment, socioeconomic factors or rates of hospitalisation and surgery. Vital and unique statistics on e.g. the magnitude of the health economic burden of these disorders and an in-depth insight into the environmental characteristics of the patients are currently missing. This is fundamental knowledge in optimal health policy planning targeting disease prevention or earlier diagnosis. Right now we do not know if the incidence of IBD is declining, plateauing or even increasing, thus we do not know how best to prepare for the future.
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