Extended report
Changes in the incidence and prevalence of rheumatoid arthritis
in Kamitonda, Wakayama, Japan, 1965-1996
Kanji Shichikawaa, Koji Inoueb, Shigenaga Hirotac, Akira Maedaa, Hiroshi Otad, Masami Kimurae, Toshio Ushiyamab, Masaki Tsujimotof
a Yukioka
Hospital, 2-2-3, Ukita Kita-ku,Osaka 530-0021, Japan, b Department of
Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga,
Japan, c Department of Orthopaedic Surgery, Hikone Chuo
Hospital, Hikone, Shiga, Japan, d Tezukayama
Hospital, Tezukayama, Abeno-ku, Osaka, Japan, e Kimura Clinic, Nishinomiya, Hyogo, Japan, f Tsujimoto Clinic,
Koryonishimachi, Sakai, Osaka, Japan
Correspondence to: Dr K Shichikawa.
Accepted for publication 27 July 1999
OBJECTIVE
To evaluate
secular trends in the incidence and prevalence of rheumatoid arthritis
(RA) in Japan.
METHODSThe incidence
and prevalence of RA were determined in a longitudinal population based
study in the Kamitonda district, Wakayama, Japan, from 1965 to 1996.
RESULTSIn the study
area consisting of about 3000 inhabitants, 16 incident cases,
satisfying definite RA by the Rome criteria were detected during the
study period. The age and sex adjusted incidence in both men and women
combined and the age adjusted incidence in women significantly
decreased (p<0.025 and p<0.01, respectively). The age and sex
adjusted prevalence in all inhabitants tended to decrease (p<0.1), and
the age adjusted prevalence in women significantly declined (p<0.025).
In men, however, neither incidence nor prevalence showed significant change.
CONCLUSIONSThe
decline of incidence and prevalence of female RA may be reducible to
some environmental changes preferentially occurring more obviously in
Japanese women than in men. Because the use of oral contraceptives has
been extremely low in Japan, the decline should be explained by other factors.
© 1999 by Annals of the Rheumatic Diseases
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