Epidemiology of Sarcoidosis in a Prospective Cohort Study of U.S. Women.
BACKGROUND
Sarcoidosis is a systemic granulomatous and inflammatory disorder that most often involves the lungs but also affects many other organs. Data on sarcoidosis from large epidemiological studies remain scarce.


OBJECTIVE
To evaluate the baseline prevalence and 22-year incidence of sarcoidosis and their associations with demographic and geographic characteristics in a large cohort of U.S. women.


METHODS
The Nurses' Health Study II is a prospective cohort study of U.S. female nurses enrolled in 1989 (aged 25-44 yr, n = 116,430). Data on major illnesses were collected through biennial questionnaires (1989-2011). Cases were identified by the nurses' self-report of physician-diagnosed sarcoidosis. Associations of demographic and geographic characteristics with sarcoidosis were evaluated by logistic regression and Cox models.


RESULTS
A total of 377 sarcoidosis cases were identified. The baseline prevalence was 100/100,000 women. The average annual incidence rate was 11/100,000 during 2,275,028 person-years of follow up. Incidence rate increased with age (P = 0.003), from 9 to 15/100,000 in women aged less than 35 to 55 or more years, respectively. Black women had a higher prevalence (odds ratio, 5.24; 95% confidence interval, 2.87-9.55) and incidence (hazard ratio, 3.80; 95% confidence interval, 2.31-6.24) than white women. Across U.S. regions, more than twofold differences were observed in sarcoidosis prevalence and incidence, with consistently higher rates in the Northeast.


CONCLUSIONS
We provide recent national data on the epidemiology of sarcoidosis among U.S. women. Important differences in prevalence and incidence were observed across U.S. regions. Large epidemiological studies are needed to better understand the causes of the observed demographic and geographic differences in sarcoidosis.
1 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.|2 Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and.
Orianne
O
Dumas
1 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Lisa
L
Abramovitz
1 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Aleta S
AS
Wiley
3 Slone Epidemiology Center, Boston University, Boston, Massachusetts.
Yvette C
YC
Cozier
1 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.|2 Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and.
Carlos A
CA
Camargo
D000328:Adult; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015399:Nursing Research / Q000706:statistics & numerical data; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012507:Sarcoidosis / Q000175:diagnosis / Q000453:epidemiology; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
epidemiology; incidence; lung diseases; prevalence