Acute appendicitis in nine British towns.

Barker, D. J. P.; Liggins, A

doi:10.1136/bmj.283.6299.1083

Cited by 17 publications

(10 citation statements)

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“…In einer Metaanalyse wurde beispielsweise ein Zusammenhang zwischen der Rate negativer Appendektomien und der Inzidenz einer Appendizitis nachgewiesen [3].Mit Daten aus der Diagnosestatistik (KrankenhausStatistikverordnung) konnte beispielsweise 1995/1996 für Deutschland gezeigt werden, dass die Rate von Krankenhausfällen mit akuter Appendizitis auf Kreisebene von der Dichte an Krankenhausbetten im Sinne einer höheren Rate und der Dichte an Vertragsärzten im Sinne einer niedrigeren Rate abhängt.Ein Einfluss der Region auf die Inzidenz der Appendizitis wurde in mehreren Studien gefunden (z.B. [2,10,27]. Weiterhin wurde der Versicherungsstatus des Patienten als möglicher Einflussfaktor für die Appendektomierate und als Risikofaktor für eine perforierte Appendizitis identifiziert.…”

Section: Geographische Varianz/ Versorgungssystemunclassified

“…Im Hinblick auf die Ätiologie und Epidemiologie der akuten Appendizitis wurden in den letzten 10 Erschwert wird die Betrachtung der Epidemiologie der Appendizitis durch die Abhängigkeit der Inzidenz von Zuweisung, Infrastruktur und chirurgischer Behandlungsstrategie. Die akute Appendizitis ist eine häufig benigne verlaufende Erkrankung mit Tendenz zur Spontanheilung.…”

Section: Diskussion Der Ergebnisseunclassified

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Neues zur Epidemiologie der akuten Appendizitis

Ohmann

Franke

Kraemer

et al. 2002

Chirurg

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The current incidence of appendicitis is about 100 per 100,000 person-years in Europe/America. Whereas the appendectomy rate is still decreasing, the incidence of appendicitis is now nearly stable. During the last 30 years the incidence of perforated appendicitis has not changed (approximately 20 per 100,000 person-years). Established risk factors for acute appendicitis are age (peak: 10-19 years), sex, and ethnic group/race. Classical theories (diet, hygiene) present illuminating models to explain the rise and fall of incidence in the last century; however, from a contemporary perspective the evidence is insufficient. The study of the epidemiology of appendicitis is complicated by the influence of referral, infrastructure, and surgical treatment strategy on the incidence of acute appendicitis. Therefore, there is a strong need for good prospective studies with high-quality data (e.g., studies directed by a central pathology department).

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Section: Geographische Varianz/ Versorgungssystemunclassified

Section: Diskussion Der Ergebnisseunclassified

Neues zur Epidemiologie der akuten Appendizitis

Ohmann

Franke

Kraemer

et al. 2002

Chirurg

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“…Further doubt is cast by the geographical distribution of appendicitis, in whose aetiology low intake of dietary fibre is also suspected (Burkitt, 1971). A detailed study of acute appendicitis in the nine towns, using clinical and pathology records, showed a pattern of incidence clearly different to that of colorectal cancer, with higher incidences in the three northern towns within each socioeconomic group and for both sexes (Barker & Liggins, 1981). This weighs against the hypothesis of similar, dominant dietary influences in the aetiology of both diseases.…”

Section: Discussionmentioning

confidence: 99%

Geographical variations in the incidence of colorectal cancer in Britain

Barker¹,

Godfrey²

1984

Br J Cancer

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Summary The incidence of colorectal cancer was compared in nine towns in England and Wales, chosen to encompass a range of socio-economic conditions and spread of latitude in the country. Cases were ascertained through pathology records, supplemented by clinical notes. The pattern of variation in incidence was different for men and women. Among men incidences were highest in towns with better socio-economic conditions, whereas among women the trend was reversed. This supports the hypothesis that the dominant aetiological influences causing colorectal cancer differ in the two sexes. Mortality rates did not correlate closely with incidence. This, together with the markedly different patterns of incidence of colorectal cancer and appendicitis in the nine towns, casts doubt on the significance of a reported inverse correlation between regional mortality from colonic cancer and the consumption of pentosic fibre.Geographical variation in the incidence of colorectal cancer within Britain offers a method of exploring the role of dietary influences in the aetiology of the disease. There is a reported inverse correlation between mortality from colonic, but not rectal cancer and the consumption of pentosic dietary fibre (Bingham et al., 1979). However, this correlation was based on mortality data by region. Survival in the disease is comparatively high, around 50 per cent one year after diagnosis and 30 per cent at 5 years, and varies from one part of the country to another (H.M.S. O., 1980). Mortality is therefore a varying underestimate of incidence. The value of regional analyses is also limited by regions being large and heterogeneous geographical units. This paper describes the incidence of colorectal cancer in nine British towns, as determined from the most detailed and complete data source available, that is pathology records supplemented where necessary by information from case notes. MethodsThe towns were selected to encompass a range of socio-economic conditions and latitude in England and Wales. The method of their selection has been described elsewhere (Barker et al., 1979). In summary the 83 largest county boroughs in England and Wales were classified into three equal groups having "better", "intermediate", and "worse" social and economic conditions. This classification was effected using a range of intercorrelated social and economic variables. The county boroughs were also divided into three groups according to latitude. December, 1980 were included. To conform with previous surveys residence was defined using the county borough boundaries in force before the 1974 boundary changes. Incidence rates were calculated using the 1981 census data adjusted to the pre-1974 boundaries. The rates were directly age-sex standardised using the total population of the nine towns as the standard: the same standard was used in the calculation of sex specific rates. Because the diagnosis of colorectal cancer is often not confirmed histologically in elderly patients, and in accord with other studies, this survey was confin...

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“…He published a cross-sectional study with team members at the Medical Research Council's Environmental Epidemiology Unit of the University of Southampton on the incidence of appendicitis in England and Wales. They found that despite similar dietary habits the distribution of appendicitis did not follow other diseases associated with low-fibre consumption (Barker & Liggins, 1981). In a subsequent case-control study they concluded that infection and familial predisposition, rather than the fibre-content of the diet, may enhance susceptibility to appendicitis (Nelson, et al, 1984(Nelson, et al, , 1986).…”

Section: Hygiene Hypothesismentioning

confidence: 98%

Epidemiologic Features of Appendicitis

Sanda¹

2012

Appendicitis - A Collection of Essays From Around the World

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Acute appendicitis in nine British towns.

Cited by 17 publications

References 4 publications

Neues zur Epidemiologie der akuten Appendizitis

Neues zur Epidemiologie der akuten Appendizitis

Geographical variations in the incidence of colorectal cancer in Britain

Epidemiologic Features of Appendicitis

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