Læknablaðið - 15.09.1982, Page 14
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LÆKNABLAÐID
hjá körlum. Erfitt er að benda á ástæðu fyrir
þessari aukningu, enda orsök sjúkómsins
ókunn.
Hjá okkur vistuðust um 75 % sjúklinganna
einhvern tíma á sjúkrahúsi vegna sjúkdómsins,
en 25 % lögðust aldrei inn. Tölur frá Englandi
áætla að aðeins um helmingur sjúklinga með
sjúkdóminn leggist inn (10).
Nokkrar rannsóknir sýna hærra nýgengi hjá
borgarbúum en sveitafólki (11). Á tímabilinu
1950 til 1974 voru 56 % sjúklinganna búsettir í
Reykjavík og Kópavogi við greiningu, en
aðeins 16% í sveitum, en 1975 til 1979 voru
45 % búsettir í Reykjavík og Kópavogi en
aðeins 11 % í sveitum. Árið 1950 bjuggu 27 %
íslendinga í sveitum, en á miðju tímabilinu,
1964, aðeins 18%, og árið 1969 hafði sveita-
fólki fækkað í 15%. Árið 1964 bjuggu 41 %
landsmanna í Reykjavík og árið 1969 um
40 %. Nýgengi sjúkdómsins hér á landi virðist
ívið hærra meðal borgar- og bæjarbúa en
sveitafóks.
Höfundar vilja pakka Pórði Harðasyni, yfirlækni, fyrir
góðar ábendingar og Gerði Helgadóttur, læknaritara. fyrir
vélritun.
SUMMARY
This study describes the incidence and prevalence of
ulcerative colitis in Iceland during a 30 year period,
1950 to 1979. Diagnosis of new patients was based
on clinical signs and proctosigmoidoscopy and in
addition in most cases by biopsy (82 %) and X-ray
of the large bowel. Total of 316 patients were
diagnosed, 175 men, 55.4 %, and 141 women, 44.6 %.
The male-female ratio for the total period was 1.24,
but changed from 0.6 the first decade to 1.5 the last
decade. The most frequent age was 31 to 40 years
and the second frequent 21 to 30 years in both men
and women. The disease was classified into four
stages according to distribution of the disease at
diagnosis, proctitis, proctosigmoiditis, distal colitis
and total colitis. The most frequent stage of
distribution was proctosigmoiditis and the second
most frequent proctitis but least frequent total
colitis. There were more men in all stages except
total colitis, where there were more women.
The average annual incidence of the disease was
2.8 the first decade, 1950 to 1959, 4.7 the second
decade, 1960 to 1969, and 7.4 per 100.000 the last
decade, 1970 to 1979. The average annual incidence
of proctitis during the same period was o.6 the first
decade, 1.4 the second decade, and 2.7 per 100.000
the last decade. The prevalence in the end of the
year 1950 was 8.4 but increased to 122.2 per 100.000
in the end of the year 1979.
The study indicates, that there has been a steady
and definite increase in the diagnosis of the disease
during the whole study period, especially the last
five years. This increase can mostly, but not wholly,
be accounted for by more frequent diagnosis of less
extensive disease, proctitis and proctosigmoiditis,
especially amongst men.
HEIMILDIR
1. Björnsson S, Þorgeirsson Þ, Guðnasson Þ. Mor-
bus Crohn á íslandi 1950-1979. Faraldsfræðileg
könnun á 30 ára tímabili. Læknablaðið 1981; 67:
238-244.
2. Sinclair TS, Brunt PW, Mowat NAG. Natural
history of proctocolitis in the North-East of
Scotland: A community study. Gut 1980; 21 (10);
A-924.
3. Evans JG, Acheson ED. An epidemiological study
of ulcerative colitis and regional enteritis in the
Oxford area. Gut 1965;6:311-324.
4 Myren J, Gjone R, Hertzberg JN, Rygvold O,
Semb LS, Fretheim B. Epidemiology of ulcerati-
ve colitis and regional enterocolitis (Crohns-
disease) in Norway. Scand J Gastroent 1971; 6:
511-514.
5. Bonnevie O, Riis P, Anthoniesen P. An epidemi-
ological study of ulcerative colitis in Copenha-
gen county. Scand J Gastroent 1968; 3: 432-438.
6. Brahme F, Lindström C, Wenckert A. Crohns-
disease in a defined population. Gastroenterolo-
gy 1975;69:342-351.
7. Monk M, Mendeloff AJ, Siegel CI, Lilienfeld A.
An epidemiological study of ulcerative and
regional enteritis among adults in Baltimore.
Gastroenterology 1967; 53: 198-210.
8. Gilat T, Ribak J, Benavoy J et al. Ulcerative
colitis in the Jewish population of Tel Aviv-Jafo.
Gastroenterology 1974; 66: 335-342.
9. Wigley RD, MacLaurin B. A study of ulcerative
colitis in New Zealand showing a low incidence
in Maoris. Brit Med J 1962; 2: 228-231.
10. Langman MJS. In the epidemiology of chronic
digestive disease. Edward Arnold publ., 41
Bedford Square, London. Chapter 4, 80-102.
11. Mendeloff AI. The epidemiology of inflammato-
ry bowel disease in Clinics in Gastroenterology
1980;3:259-270.
12. Munro A. MS Thesis Univ. of Aberdeen 1978.
13. Myers A, Humphreys DM, Cox EV. A ten year
follow-up of haemorrhagic proctitis. Postgrad
Med J 1976;52;224-228.
14. Lennard-Jones JE, Cooper GW, Newell AC,
Wilson CWE, Avery Jones F. Observation of an
idiopathic proctitis. Gut 1962; 3: 201.
15. Powell-Tuck J, Ritchie JK, Lennard-Jones JE.
The prognosis of idiopathic proctitis. Scand J
Gastroent 1977; 12: 727-732.
16. Ritchie JK, Powell-Tuck J, Lennard-Jones JE.
Clinical outcome of the first ten years of
ulcerative colitis and proctitis. Lancet 1978; i:
1140-1143.