Prevalence of anal incontinence according to age and gender: a systematic review and meta-regression analysis.
BACKGROUND
Anal incontinence is increasingly being recognised as a significant cause of physical and psychological morbidity with implications for healthcare provision within the community. There is controversy about which population groups are most disadvantaged by this chronic condition.


OBJECTIVE
The aim of this study was to evaluate the prevalence of this condition in the community according to age and gender, a systematic review was performed.


METHODS
Data were from Embase, Medline, bibliographies of known articles and contact with experts.


METHODS
Studies were selected if data on anal incontinence could be extracted for participants over 15 years of age and living in the community.


METHODS
Data were extracted using a piloted form on participants' characteristics, study quality and incontinence rates.


RESULTS
Meta-analysis was used to combine data from multiple studies, and meta-regression evaluated the variation in rates according to age and gender in an analysis adjusted for study quality.


RESULTS
There were 29 studies (69,152 participants), of which 5 met over half of the high quality criteria. The rate of solid and liquid faecal incontinence among people aged 15-60 years was 0.8% [95% confidence interval (CI) 0.3-1.9] in men and 1.6% (95% CI 0.8-3.1) in women. In those aged over 60, this increased to 5.1% (95% CI 3.4-7.6) in men and 6.2% (95% CI 4.9-8.0) in women. Meta-regression showed that age had a significant influence on rates of solid and liquid faecal incontinence (p = 0.007), but not gender (p = 0.368) or study quality (p = 0.085).


CONCLUSIONS
The rate of solid and liquid faecal incontinence in older people is significantly higher than their younger counterparts. Gender differences in rates did not reach statistical significance.
Department of Obstetrics & Gynaecology, Birmingham Women's Hospital, Metchley Park Road, Edgbaston, Birmingham, B15 2TG, UK. sam@pretlove.wanadoo.co.uk
S J
SJ
Pretlove
S
S
Radley
P M
PM
Toozs-Hobson
P J
PJ
Thompson
A
A
Coomarasamy
K S
KS
Khan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000002:abnormalities*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires