Epidemiology of Sarcoidosis in a Prospective Cohort Study of U.S. Women

Abstract

Rationale: Sarcoidosis is a systemic granulomatous and inflammatory disorder that most often involves the lungs but also affects many other organs. Data on sarcoidosis from large epidemiological studies remain scarce.Objectives: To evaluate the baseline prevalence and 22-year incidence of sarcoidosis and their associations with demographic and geographic characteristics in a large cohort of U.S. women. Methods:The Nurses' Health Study II is a prospective cohort study of U.S. female nurses enrolled in 1989 (aged 25-44 yr, n = 116,430). Data on major illnesses were collected through biennial questionnaires . Cases were identified by the nurses' self-report of physician-diagnosed sarcoidosis. Associations of demographic and geographic characteristics with sarcoidosis were evaluated by logistic regression and Cox models. Measurements and Main Results:A total of 377 sarcoidosis cases were identified. The baseline prevalence was 100/100,000 women. The average annual incidence rate was 11/100,000 during 2,275,028 person-years of follow up. Incidence rate increased with age (P = 0.003), from 9 to 15/100,000 in women aged less than 35 to 55 or more years, respectively. Black women had a higher prevalence (odds ratio, 5.24; 95% confidence interval, 2.87-9.55) and incidence (hazard ratio, 3.80; 95% confidence interval, 2.31-6.24) than white women. Across U.S. regions, more than twofold differences were observed in sarcoidosis prevalence and incidence, with consistently higher rates in the Northeast. Conclusions:We provide recent national data on the epidemiology of sarcoidosis among U.S. women. Important differences in prevalence and incidence were observed across U.S. regions. Large epidemiological studies are needed to better understand the causes of the observed demographic and geographic differences in sarcoidosis.

Joint SNMMI–ASNC expert consensus document on the role of 18F-FDG PET/CT in cardiac sarcoid detection and therapy monitoring

“…A recent prospective cohort study estimated a baseline prevalence of 100 in 100,000 women aged 25-44 y. 2 Other data suggest a higher prevalence, at 330 cases per 100,000, in certain regions of the United States. 3 A variegated disease prevalence defined by ethnicity, sex, and geographic region identifies an important interaction between genetic and environmental factors influencing the risk for developing sarcoidosis.…”

Clinical Characteristics and Outcome of Hepatic Sarcoidosis: A Population-Based Study 1976–2013

“…The characteristic histological finding of sarcoid granuloma consists of epithelioid cells and multinucleated cells without area of necrosis, unlike caseating granuloma of tuberculosis (1). It has been estimated that 70,000 – 80,000 new cases of sarcoidosis are diagnosed in the United States annually with a significant variation across regions and ethnic groups (2, 3). …”

Prospective study of body mass index and risk of sarcoidosis in US women

“…Geographical variations in sarcoidosis occurrence support the existence of environmental risk factors [3–5]. Research into the potential causes of sarcoidosis has focused on occupational and environmental exposures [6, 7], but lifestyle-related risk factors are less well examined.…”

“…The Nurses’ Health Study II (NHSII) began in 1989 when 116,430 female registered nurses from 14 U.S. states, aged 25 to 44 years, completed a mailed questionnaire on their medical history and lifestyle characteristics [3]. Follow-up questionnaires have been sent every two years since.…”