title: Dramatic decline of acute appendicitis in Greece over 30 years: index of improvement of socioeconomic conditions or diagnostic aids?
abstract: OBJECTIVE
  There are several reports showing a continuing fall in the incidence of acute appendicitis in the western countries. Our aim was to study the trend of the incidence of acute appendicitis in the Greek population over 30 years.
  
  
  METHODS
  We analyzed the data referring to the years 1970-1999 on the incidence and mortality of acute appendicitis for the entire Greek population. Data were retrieved from the Annual Bulletin for the Social Welfare and Health Statistics of the National Statistics Service of Greece. In this database, acute appendicitis was a hospital discharge diagnosis.
  
  
  RESULTS
  Over the study period, there was a 75% decrease of the age-standardized incidence of acute appendicitis from 652/100,000 to 164/100,000. The median female-to-male ratio of hospitalized patients for appendicitis of the study period (1970-1999) fell progressively from 1.27 in the year 1970 to 0.93 in the year 1999. The case fatality rates remained constant, ranging below 0.09 deaths per 100 appendicitis cases.
  
  
  CONCLUSIONS
  There is a significant decline of the incidence of acute appendicitis in the Greek population over the years 1970-1999. This time trend is probably related to the improvement of the socioeconomic conditions over the same period and not to the introduction of new diagnostic aids.
authors.affiliation: Hepatogastroenterology Unit, 2nd Department of Internal Medicine - Propaedeutic, Attikon University Hospital, Medical School, Athens University, Athens, Greece.
authors.forename: A A
authors.initials: AA
authors.lastname: Papadopoulos
authors.forename: D
authors.initials: D
authors.lastname: Polymeros
authors.forename: M
authors.initials: M
authors.lastname: Kateri
authors.forename: C
authors.initials: C
authors.lastname: Tzathas
authors.forename: M
authors.initials: M
authors.lastname: Koutras
authors.forename: S D
authors.initials: SD
authors.lastname: Ladas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006115:Greece / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors