title: Incidence of multiple sclerosis among European Economic Area populations, 1985-2009: the framework for monitoring.
abstract: BACKGROUND
  A debate surrounding multiple sclerosis epidemiology has centred on time-related incidence increases and the need of monitoring. The purpose of this study is to reassess multiple sclerosis incidence in the European Economic Area.
  
  
  METHODS
  We conducted a systematic review of literature from 1965 onwards and integrated elements of original research, including requested or completed data by surveys authors and specific analyses.
  
  
  RESULTS
  The review of 5323 documents yielded ten studies for age- and sex-specific analyses, and 21 studies for time-trend analysis of single data sets. After 1985, the incidence of multiple sclerosis ranged from 1.12 to 6.96 per 100,000 population, was higher in females, tripled with latitude, and doubled with study midpoint year. The north registered increasing trends from the 1960s and 1970s, with a historic drop in the Faroe Islands, and fairly stable data in the period 1980-2000; incidence rose in Italian and French populations in the period 1970-2000, in Evros (Greece) in the 1980s, and in the French West Indies in around 2000.
  
  
  CONCLUSIONS
  We conclude that the increase in multiple sclerosis incidence is only apparent, and that it is not specific to women. Monitoring of multiple sclerosis incidence might be appropriate for the European Economic Area.
authors.affiliation: National Centre for Epidemiology, Carlos III Institute of Health, and Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Av Monforte de Lemos 5, Madrid 28029, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Alcalde-Cabero
authors.forename: Javier
authors.initials: J
authors.lastname: Almazán-Isla
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Merino
authors.forename: Joao
authors.initials: J
authors.lastname: de Sá
authors.forename: Jesús
authors.initials: J
authors.lastname: de Pedro-Cuesta
mesh_terms: D000328:Adult; D000367:Age Factors; D016208:Databases, Factual / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors