title: Rising incidence of celiac disease in the Netherlands; an analysis of temporal trends from 1995 to 2010.
abstract: OBJECTIVE
  According to screening studies, celiac disease (CD) is prevalent in Western Europe. Actual prevalence tends to be much lower. The width of this actual gap is determined by the balance between disease symptoms and the "case-finding" capabilities of the healthcare system. Therefore, we conducted a nationwide study to determine the temporal trends in the incidence in the Netherlands including a focus on demographic aspects.
  
  
  METHODS
  We performed a nationwide search in the Dutch Pathology Registry (PALGA) to identify all biopsy-proven cases of CD in five different years between 1995 and 2010. Furthermore, demographic profiles and socioeconomic status (SES) of patients were studied.
  
  
  RESULTS
  The overall incidence of CD increased from 2.72 (confidence interval [CI] 2.46-2.99) in 1995 to 6.65 (CI 6.27-7.06) per 100,000 inhabitants in 2010. No significant regional differences were noticed. In men, rates increased from 2.28 (CI 1.95-2.65) to 4.71 (CI 4.25-5.20) per 100,000 in 2010. In women, the increase was from 3.27 (CI 2.88-3.70) to 8.66 (CI 8.04-9.31) per 100,000 in 2010. A trend toward leveling of incidence was observed from 2008 to 2010. Patients diagnosed during childhood live in areas with a higher SES compared with patients diagnosed at adult age.
  
  
  CONCLUSIONS
  The incidence of biopsy-proven CD in the Netherlands increased almost threefold between 1995 and 2010. In areas with a higher SES, relatively more children were diagnosed.
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital , Arnhem , The Netherlands.
authors.forename: Jordy P W
authors.initials: JP
authors.lastname: Burger
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Roovers
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Meijer
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wahab
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors
keywords: Netherlands/epidemiology; celiac disease/diagnosis; celiac disease/epidemiology; children; female; incidence; male; prevalence