The epidemiology of microscopic colitis: a population based study in Olmsted County, Minnesota
- Darrell S Pardi1,
- Edward V Loftus Jr1,
- Thomas C Smyrk2,
- Patricia P Kammer1,
- William J Tremaine1,
- Cathy D Schleck3,
- W Scott Harmsen3,
- Alan R Zinsmeister3,
- L Joseph Melton III4,
- William J Sandborn1
- 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- 2Division of Anatomic Pathology, Department of Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- 3Divisions of Biostatistics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- 4Divisions of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Correspondence to:
Dr Darrell S Pardi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota 55905, USA;
- Accepted 27 September 2006
- Revised 15 September 2006
- Published Online First 29 November 2006
Objective: Although the epidemiology of microscopic colitis has been described in Europe, no such data exist from North America. We studied the incidence, prevalence and temporal trends of microscopic colitis in a geographically defined US population.
Design and setting: In this population based cohort study, residents of Olmsted County, Minnesota, with a new diagnosis of microscopic colitis, and all who had colon biopsies for evaluation of diarrhoea, between 1 January 1985 and 31 December 2001 were identified. Biopsies were reviewed for confirmation (cases) and to identify missed cases (diarrhoea biopsies).
Main outcome measures: Incidence rates, age and sex adjusted to the 2000 US white population. Poisson regression assessed the association of calendar period, age and sex with incidence.
Results: We identified 130 incident cases for an overall rate of 8.6 cases per 100 000 person-years. There was a significant secular trend, with incidence increasing from 1.1 per 100 000 early in the study to 19.6 per 100 000 by the end (p<0.001). Rates increased with age (p<0.001). By subtype, the incidence was 3.1 per 100 000 for collagenous colitis and 5.5 per 100 000 for lymphocytic colitis. Collagenous colitis was associated with female sex (p<0.001) but lymphocytic colitis was not. Prevalence (per 100 000 persons) on 31 December 2001 was 103.0 (39.3 for collagenous colitis and 63.7 for lymphocytic colitis).
Conclusions: The incidence of microscopic colitis has increased significantly over time, and by the end of the study, the incidence and prevalence were significantly higher than reported previously. Microscopic colitis is associated with older age, and collagenous colitis is associated with female sex.
Published Online First 28 November 2006
Funding: Funded in part by an American College of Gastroenterology Clinical Research grant and a career development grant from the Miles and Shirley Fiterman Foundation. The Rochester Epidemiology Project is supported by grant AR 30582 from the National Institutes of Health, US Public Health Service.
Competing interests: None.