Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg)

Boström, Inger; Stawiarz, Leszek; Landtblom, Anne‐Marie

doi:10.1177/1352458512446169

Cited by 60 publications

(58 citation statements)

References 25 publications

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“…For example, a recent analysis of trends in the sex ratio in MS for individuals born between 1930 and 1989 found a marked increase in Northern Europe (not including the UK) (from 2.09 to 3.77), but only a moderate increase in Southern Europe (from 1.46 to 2.31) 16. In contrast, a study in Sweden found a mean female-to-male ratio for MS of 2.62, with no clear trend with year of birth for individuals born between 1931 and 1985 17. A recent review reported a significant increase in the MS prevalence female-to-male sex ratio in the UK between 1949 and 2009—a much longer time period than our study 18.…”

Section: Discussionmentioning

confidence: 85%

Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database

Mackenzie

Morant

Bloomfield³

et al. 2013

Journal of Neurology, Neurosurgery & Psychiatry

262

196

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ObjectivesTo estimate the incidence and prevalence of multiple sclerosis (MS) by age and describe secular trends and geographic variations within the UK over the 20-year period between 1990 and 2010 and hence to provide updated information on the impact of MS throughout the UK.DesignA descriptive study.SettingThe study was carried out in the General Practice Research Database (GPRD), a primary care database representative of the UK population.Main outcome measuresIncidence and prevalence of MS per 100 000 population. Secular and geographical trends in incidence and prevalence of MS.ResultsThe prevalence of MS recorded in GPRD increased by about 2.4% per year (95% CI 2.3% to 2.6%) reaching 285.8 per 100 000 in women (95% CI 278.7 to 293.1) and 113.1 per 100 000 in men (95% CI 108.6 to 117.7) by 2010. There was a consistent downward trend in incidence of MS reaching 11.52 per 100 000/year (95% CI 10.96 to 12.11) in women and 4.84 per 100 000/year (95% CI 4.54 to 5.16) in men by 2010. Peak incidence occurred between ages 40 and 50 years and maximum prevalence between ages 55 and 60 years. Women accounted for 72% of prevalent and 71% of incident cases. Scotland had the highest incidence and prevalence rates in the UK.ConclusionsWe estimate that 126 669 people were living with MS in the UK in 2010 (203.4 per 100 000 population) and that 6003 new cases were diagnosed that year (9.64 per 100 000/year). There is an increasing population living longer with MS, which has important implications for resource allocation for MS in the UK.

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Section: Discussionmentioning

confidence: 85%

Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database

Mackenzie

Morant

Bloomfield³

et al. 2013

Journal of Neurology, Neurosurgery & Psychiatry

262

196

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“…5 A recent study, based on several thousand MS patients, identified through the Swedish MS registry (SMSreg), contradicted this notion. 6 In this study there was no evidence for an increasing F/M ratio either in the prevalence proportion by year of birth (performed between 1931 and 1985) What are the reasons underlying the different results obtained in the first and second analysis? Thanks to the availability of a unique personal identifying number (PIN) which is assigned to everyone at birth or at immigration since 1961 in Sweden, the authors were able to gather information on the same person in several nationwide registries (SMSreg, PAR, Swedish National Population Registry and Cause of Death Registry).…”

mentioning

confidence: 53%

The use of multiple population-based data sources for estimating MS sex ratio trends over time

Trojano

2014

Mult Scler

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“…It has been difficult to objectively track 25(OH)D concentrations over time, because of high variability in laboratory assays. However, recent studies from Sweden show rising MS incidence [24] over a similar time course as decreasing 25(OH)D levels [25] in blood samples that had been stored and analyzed in a single laboratory at one time point (Figure 4). …”

Section: Ecological Studies Provide the First Links Between Exposumentioning

confidence: 92%

On the Nature of Evidence and ‘Proving’ Causality: Smoking and Lung Cancer vs. Sun Exposure, Vitamin D and Multiple Sclerosis

Lucas

Harris

2018

IJERPH

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If environmental exposures are shown to cause an adverse health outcome, reducing exposure should reduce the disease risk. Links between exposures and outcomes are typically based on ‘associations’ derived from observational studies, and causality may not be clear. Randomized controlled trials to ‘prove’ causality are often not feasible or ethical. Here the history of evidence that tobacco smoking causes lung cancer—from observational studies—is compared to that of low sun exposure and/or low vitamin D status as causal risk factors for the autoimmune disease, multiple sclerosis (MS). Evidence derives from in vitro and animal studies, as well as ecological, case-control and cohort studies, in order of increasing strength. For smoking and lung cancer, the associations are strong, consistent, and biologically plausible—the evidence is coherent or ‘in harmony’. For low sun exposure/vitamin D as risk factors for MS, the evidence is weaker, with smaller effect sizes, but coherent across a range of sources of evidence, and biologically plausible. The association is less direct—smoking is directly toxic and carcinogenic to the lung, but sun exposure/vitamin D modulate the immune system, which in turn may reduce the risk of immune attack on self-proteins in the central nervous system. Opinion about whether there is sufficient evidence to conclude that low sun exposure/vitamin D increase the risk of multiple sclerosis, is divided. General public health advice to receive sufficient sun exposure to avoid vitamin D deficiency (<50 nmol/L) should also ensure any benefits for multiple sclerosis, but must be tempered against the risk of skin cancers.

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Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg)

Abstract: There is no evidence for an increasing women-to-men ratio with time amongst Swedish multiple sclerosis patients.

Cited by 60 publications

References 25 publications

Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database

Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database

The use of multiple population-based data sources for estimating MS sex ratio trends over time

On the Nature of Evidence and ‘Proving’ Causality: Smoking and Lung Cancer vs. Sun Exposure, Vitamin D and Multiple Sclerosis

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