Eosinophilic oesophagitis in Denmark: Population‐based incidence and prevalence in a nationwide study from 2008 to 2018

Abstract

Background Eosinophilic oesophagitis (EoE) is a chronic immune‐mediated or antigen‐mediated oesophageal disease characterised by symptoms related to oesophageal dysfunction and eosinophil‐predominant inflammation. Objective We aimed to estimate the incidence and prevalence of EoE in Denmark during the period 2008–2018. Methods Based on data from nationwide registers we identified cases of EoE using two definitions: a broad definition based solely on oesophageal biopsies registered in the Danish Pathology Register and a narrow definition also including symptoms of oesophageal dysfunction registered in the Danish National Patient Registry. The annual incidence and prevalence were standardised by sex and age in 5‐year intervals to the 2013 study population. Results From 2008 to 2011, the standardised incidence of EoE was stable, but from 2011 to 2018 it increased from 3.9 (95% CI 3.3–4.4) to 11.7 (95% CI 10.8–12.6) per 100,000 person‐years. Similar temporal trends were observed when using the narrow EoE definition. The increase in incidence was most pronounced in men and in individuals above 40 years of age. In children, the EoE incidence was a fourth of the incidence in adults aged 40–64 years: 4.4 (95% CI 3.2–5.6) versus 17.6 (95% CI 15.7–19.5) per 100,000 person‐years. The EoE incidence varied substantially across the five regions in Denmark. Overall, the biopsy rate as well as the proportion of oesophageal biopsies with detected eosinophilia increased during the study period. Conclusion This study of the entire population of Denmark during the period 2008 to 2018 shows that the incidence and prevalence of EoE is not yet plateauing and that EoE could be severely underdiagnosed, especially in children.

Incidence and prevalence of eosinophilic oesophagitis across Europe: A systematic review and meta‐analysis

“…Figure 2a and Table 3 show highest incidence of EoE for adult or all age groups from small regional studies in Castilla‐La‐Mancha, Spain (11.9 per 100,000 person‐years during 2015–2017), 16 and Cáceres, Spain (10.5 in 2014–2016), 18 followed by a nationwide study across Denmark (7.8 in 2016–2018), 14 and two regional studies from Olten County, Switzerland (7.4 in 2007–2009), 24 and north Denmark (7.1 in 2015–2017) 15 . Lowest EoE incidence refers to nationwide studies in Denmark (1.9 in 2009–2012), 23 and The Netherlands (1.9 in 2012–2015), 20 a regional study from Navarra, Spain (2.1 in 2002–2008), 26 and two nationwide studies from The Netherlands (2.6 in 2015–2019), 13 and Sweden (2.8 in 2013–2015) 19 .…”

“…Of 11 longitudinal studies that reported on trends in incidence, all show increases (Figure 4a), with larger increases evident during more recent years and in regional studies from Spain, 16,18 Switzerland, 22,24 and from regional, 15 and nationwide studies from Denmark. 14 Nationwide studies from The Netherlands, 13,20,21 Sweden, 19 and Denmark, 23 show more moderate increases. After excluding studies that reported incidence of zero or close to zero (≤0.2 per 100,000), mean annual increases in incidence were calculated for the remaining reports.…”

“…The highest incidence was reported among people aged 30-39 years across The Netherlands, 21 in those aged 15-19 and 35-44 across Sweden, 19 and among 40-64 year olds across Denmark. 14 Of the patient co-morbidities that were documented in at least three studies, the most frequent in adults was rhinitis (average = 44.6% of cases), followed by asthma (…”

Eosinophilic Esophagitis in a 75-Year-Old Saudi Man: A Case Report

“…First described as a distinct esophageal disease in the mid-1990s, emerging evidence suggests that EoE is more widespread than originally believed [4]. A recent study conducted in the Danish general population reported the prevalence of EoE as 69.7 per 100,000 people [5]. Traditionally, EoE has been considered predominately to affect males, children, and young adults [3,6].…”

Editorial: Eosinophilic oesophagitis coming of age—Increasing frequency and wider age range

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Once considered a rare disease, eosinophilic oesophagitis (EoE) has seen a surge in prevalence over the past 20 years in Europe and North and South America, reaching 118 per 100,000 persons in a recent Swedish study. [1][2][3][4] Rising prevalence of eosinophilic oesophagitis When the first accounts of EoE emerged in the early 1990s, they referenced patients diagnosed in the late 1980s. 5,6 It seems unlikely that the disease existed much before this time.

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