Socioeconomic variation in the incidence of childhood coeliac disease in the UK

BACKGROUND: Serological studies indicate that evidence of coeliac disease (CD) exists in about 1% of all children, but we lack estimates of current diagnostic patterns among children and how they vary by socioeconomic group. METHODS: We identified all children aged 0–18 years between 1993 and 20...

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Main Authors: Zingone, Fabiana, West, Joe, Crooks, Colin J., Fleming, Kate M., Card, Timothy R., Ciacci,, Carolina, Tata, Laila J.
Format: Article
Published: BMJ Publishing Group 2015
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Online Access:https://eprints.nottingham.ac.uk/32327/
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author Zingone, Fabiana
West, Joe
Crooks, Colin J.
Fleming, Kate M.
Card, Timothy R.
Ciacci,, Carolina
Tata, Laila J.
author_facet Zingone, Fabiana
West, Joe
Crooks, Colin J.
Fleming, Kate M.
Card, Timothy R.
Ciacci,, Carolina
Tata, Laila J.
author_sort Zingone, Fabiana
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: Serological studies indicate that evidence of coeliac disease (CD) exists in about 1% of all children, but we lack estimates of current diagnostic patterns among children and how they vary by socioeconomic group. METHODS: We identified all children aged 0–18 years between 1993 and 2012 who were registered with general practices across the UK that contribute to a large population-based general practice database. The incidence of CD was evaluated in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year. RESULTS: Among 2 063 421 children, we identified 1247 CD diagnoses, corresponding to an overall CD incidence of 11.9 per 100 000 person-years, which was similar across the UK countries and higher in girls than in boys. We found a gradient of CD diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages. Across all four countries of the UK, we found similar associations between CD and socioeconomic status. While CD incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years. CONCLUSIONS: Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with CD. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas.
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spelling nottingham-323272020-05-04T20:09:01Z https://eprints.nottingham.ac.uk/32327/ Socioeconomic variation in the incidence of childhood coeliac disease in the UK Zingone, Fabiana West, Joe Crooks, Colin J. Fleming, Kate M. Card, Timothy R. Ciacci,, Carolina Tata, Laila J. BACKGROUND: Serological studies indicate that evidence of coeliac disease (CD) exists in about 1% of all children, but we lack estimates of current diagnostic patterns among children and how they vary by socioeconomic group. METHODS: We identified all children aged 0–18 years between 1993 and 2012 who were registered with general practices across the UK that contribute to a large population-based general practice database. The incidence of CD was evaluated in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year. RESULTS: Among 2 063 421 children, we identified 1247 CD diagnoses, corresponding to an overall CD incidence of 11.9 per 100 000 person-years, which was similar across the UK countries and higher in girls than in boys. We found a gradient of CD diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages. Across all four countries of the UK, we found similar associations between CD and socioeconomic status. While CD incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years. CONCLUSIONS: Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with CD. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas. BMJ Publishing Group 2015-05 Article PeerReviewed Zingone, Fabiana, West, Joe, Crooks, Colin J., Fleming, Kate M., Card, Timothy R., Ciacci,, Carolina and Tata, Laila J. (2015) Socioeconomic variation in the incidence of childhood coeliac disease in the UK. Archives of Disease in Childhood, 100 (5). pp. 466-473. ISSN 1468-2044 Coeliac disease Children Incidence Socioeconomic status http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413865/ doi:10.1136/archdischild-2014-307105 doi:10.1136/archdischild-2014-307105
spellingShingle Coeliac disease
Children
Incidence
Socioeconomic status
Zingone, Fabiana
West, Joe
Crooks, Colin J.
Fleming, Kate M.
Card, Timothy R.
Ciacci,, Carolina
Tata, Laila J.
Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title_full Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title_fullStr Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title_full_unstemmed Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title_short Socioeconomic variation in the incidence of childhood coeliac disease in the UK
title_sort socioeconomic variation in the incidence of childhood coeliac disease in the uk
topic Coeliac disease
Children
Incidence
Socioeconomic status
url https://eprints.nottingham.ac.uk/32327/
https://eprints.nottingham.ac.uk/32327/
https://eprints.nottingham.ac.uk/32327/