GLOBAL EPIDEMIOLOGY OF SARCOIDOSIS: What Story Do Prevalence and Incidence Tell Us?
Section snippets
THE ROLE OF EPIDEMIOLOGY
Textbooks of clinical medicine often begin with “epidemiology” of the disease, by describing the distribution of patients' characteristics in terms of age, gender, race, and so on. As a result, many clinicians erroneously think the description of such distribution is a role only for epidemiology. The real role of epidemiology, however, is to search for the determinants of and ways to prevent the disease. There are two areas in epidemiology: One is the study of the distribution of disease
SCALES TO MEASURE FREQUENCIES OF SARCOIDOSIS39
Disease frequencies are measured by two scales in addition to death: (1) Incidence is the scale to measure only new cases that occur in a period of time (e.g., in 1996). The incidence rate is the number of new persons with a disease in a specified period divided by the number of a given population during that period. (2) Prevalence is the scale to measure all cases at hand, either newly or previously detected, at a specific point of time (e.g., January 1, 1996). The prevalence rate is the total
DIAGNOSTIC CRITERIA FOR THE EPIDEMIOLOGIC STUDY OF SARCOIDOSIS
The 1990 descriptive definition of sarcoidosis65 by the World Association of Sarcoidosis and Other Granulomatous Disorders is as follows: Sarcoidosis is a multisystem disorder of unknown cause(s). It commonly affects young and middle-age adults and frequently presents with bilateral hilar lymphadenopathy (BHL), pulmonary infiltration, and ocular and skin lesions. Liver, spleen, lymph nodes, salivary glands, heart, nervous system, muscles, bones, and other organs may also be involved. The
COLLECTION OF SARCOIDOSIS CASE INFORMATION
Symptomatic cases: Prevalence and incidence of symptomatic cases will be collected from hospital records.
Asymptomatic cases: Asymptomatic cases will be collected in two ways. One is the mass radiograph in which BHL is a clue; the other is incidental detection in association with medical examinations for other disease. Unless mass radiographs are conducted, the majority of cases would remain undetected.
The best incidence study of sarcoidosis therefore is based on the sarcoidosis registration
RECENT PREVALENCE AND INCIDENCE OF SARCOIDOSIS
The global prevalence and incidence studies of this disease have been reported in the proceedings of the international conferences on sarcoidosis8, 12, 15, 16, 32, 34, 40, 41, 43, 45, 51, 56, 57, 62 and elsewhere, as shown in Figure 1.37 In addition, recent prevalence and incidence data are described as reported in Scandinavian countries, the former German Democratic Republic, and Japan, because those countries have or had a similar mass-radiography system with a little racial mixture (Table 1).
WHAT THE EPIDEMIOLOGIC DATA TELL US
The data obtained from prevalence and incidence surveys may mirror overall character istics influenced by host and environmental (place, time) indicators, which are too closely interrelated to be studied separately without multivariate analysis. For the convenience of discussion, the following single indicators are observed.
A WORKING HYPOTHESIS OF THE CAUSE OF SARCOIDOSIS
In epidemiology, statistics are widely used for data analysis. Some laymen, who are so enthusiastic toward statistics, often have become P-value (probability) believers. Statistical methods cannot establish proof of a causal relationship in an association, however. Because epidemiology is not statistics, but medicine, an association must be judged by medical or biologic principles. When multiple comparisons are made between exposed and control groups, resulting in a 5% P level, for example, the
References (65)
- et al.
Incidence and clinical picture of sarcoidosis in a circumscribed geographical area
Br J Dis Chest
(1986) - et al.
Course and prognosis of sarcoidosis around the world
Am J Med
(1974) A comparative study of sarcoidosis in white, black and coloured South Africans
- et al.
On incidence of sarcoidosis in Italy
Prevalence of intrathoracic sarcoidosis among ethnic groups in northern London during 1958–1967
Familial association in sarcoidosis: A report to the research committee of the British Thoracic and Tuberculosis Association
Tubercle
(1973)Epidemiological investigations of sarcoidosis
American Journal of Hygiene
(1961)- et al.
Transmission of sarcoidosis via cardiac transplantation
Lancet
(1993) - et al.
Clinical study of tuberculosis
Primary infection
(1950)
Sarcoidosis in the United States Army, 1952 through 1956
Am Rev Respir Dis
Concepts of epidemiology of sarcoidosis: Preliminary report of 1194 cases reviewed with special reference to geographical ecology
Postgrad Med
Sarcoidosis in six European cities
Causation and disease, the Helene Koch postulates revised
Yale J Biol Med
Genetic factors
Sarcoidosis in the United States Navy
Am Rev Respir Dis
Familial sarcoidosis: Analysis of 91 families
The epidemiology of sarcoidosis in Rochester, Minnesota: A population-based study of incidence and survival
Am J Epidemiol
Sarcoidosis: Epidemiology and prognosis. A 15-year European study
Am Rev Respir Dis
Epidemiology of sarcoidosis, state of the art
Consensus conference, epidemiology of sarcoidosis
Sarcoidosis
A world survey of the diagnostic criterion of sarcoidosis in cases with no histological evidence
A cooperative study of sarcoidosis in Asia and Africa: Analytic epidemiology
Ann N Y Acad Sci
Recent epidemiological features of sarcoidosis in Japan
A cooperative study of sarcoidosis in Asia and Africa: Descriptive epidemiology
Ann N Y Acad Sci
Report of the Medical Group
Am Rev Respir Dis
Cited by (84)
Geoepidemiology of Sarcoidosis
2018, Sarcoidosis: A Clinician's GuideSarcoidosis
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionSarcoidosis
2012, Immunology and Allergy Clinics of North AmericaCitation Excerpt :For example, in an autopsy study from northeast Ohio, the prevalence rate was estimated to be 320 per 100,000, a 10-fold higher rate than that predicted by death certificate data from the same period.6 In countries with population-based mass chest radiographic (CXR) screening programs, approximately 50% of the diagnoses of sarcoidosis are made in asymptomatic individuals.7 The cause of sarcoidosis remains unknown.
Pathogenesis of sarcoidosis
2012, Presse MedicaleCitation Excerpt :The prevalence rates range from 64 patients per 100,000 population in Sweden to 0,2 per 100,000 population in Portugal with in-between numbers observed in Denmark; (53 per 100,000); Germany (43), Ireland (40), Norway (27), The Netherlands (22), the United Kingdom (20), Switzerland (16), France (10), Hungary (5) and Spain (1,2). The prevalence for the Caucasian population of North America is 3 and for Afro-Americans 47 per 100,000 [8,9]. Sarcoidosis is found in all races affecting slightly more women than men.
Characteristics and survival of patients diagnosed with cardiac sarcoidosis: A case series
2022, Frontiers in MedicinePerspective of sarcoidosis in terms of rheumatology: a single-center rheumatology clinic experience
2022, Rheumatology International
Address reprint requests to Yutaka Hosoda, MD Institute of Radiation Epidemiology Radiation Effects Association Higashinakanol-41-4 Nakano Tokyo 164-0003 Japan