RT Journal Article
SR Electronic
T1 Epidemiology and health outcomes of sarcoidosis in a universal health care population: a cohort study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1900444
DO 10.1183/13993003.00444-2019
A1 Lee M. Fidler
A1 Meyer Balter
A1 Jolene H. Fisher
A1 Teresa To
A1 Matthew B. Stanbrook
A1 Andrea Gershon
YR 2019
UL http://erj.ersjournals.com/content/early/2019/07/24/13993003.00444-2019.abstract
AB Sarcoidosis related mortality appears to be rising in North America, with increasing rates in women and the elderly. We aimed to estimate trends in sarcoidosis incidence, prevalence and mortality in Ontario, Canada.We performed a cohort study using health administrative data from Ontario between 1996 and 2015. International Classification of Diseases and Ontario Health Insurance Plan codes were used for case detection. Three disease definitions were created; (1) sarcoidosis, >/=2 physician claims within 2 years; (2) chronic sarcoidosis, >/=5 physician claims within 3 years; (3) sarcoidosis with histology, >/=2 physician claims with a tissue biopsy performed between claims.Overall, 18 550, 9199, and 3819 individuals with sarcoidosis, chronic sarcoidosis and sarcoidosis with histology were identified. The prevalence of sarcoidosis was 143 per 100 000 in 2015, increasing by 116% (p<0.0001) from 1996. The increase in age-adjusted prevalence was higher in men than women (136% versus 99%, p<0.0001). The incidence of sarcoidosis declined from 7.9 to 6.8 per 100 000 between 1996 and 2014 (15% decrease, p=0.0009). A 30.3% decrease in incidence was seen amongst females (p<0.0001), compared to a 5.5% increase in men (p=0.47). Age- and sex-adjusted mortality rates of patients with sarcoidosis rose from 1.15% to 1.47% between 1996 and 2015 (28% increase, p=0.02), with the overall trend being non-significant (p=0.39). Mortality rates in patients with chronic sarcoidosis increased significantly over the study period (p=0.0008).The prevalence of sarcoidosis is rising in Ontario, with an apparent shifting trend in disease burden from women to men. Mortality is increasing in patients with chronic sarcoidosis.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Fidler has nothing to disclose.Conflict of interest: Dr. Balter has nothing to disclose.Conflict of interest: Dr. Fisher has nothing to disclose.Conflict of interest: Dr. To has nothing to disclose.Conflict of interest: Dr. Stanbrook has nothing to disclose.Conflict of interest: Dr. Gershon has nothing to disclose.