Kohring Claudia, Akmatov Manas K, Holstiege Jakob, Brandes Iris, Mechsner Sylvia
Central Research Institute of Ambulatory Health Care in Germany, Department of Epidemiology and Health Care Atlas, Berlin, Germany; Charité-Universitätsmedizin Berlin, Berlin, Germany; Hannover Medical School, Institute of Epidemiology, Social Medicine and Health System Research, Hannover, Germany; Charité-Universitätsmedizin Berlin, Department of Gynecology, Endometriosis Center, Berlin, Germany.
Dtsch Arztebl Int. 2024 Sep 20;121(19):619-626. doi: 10.3238/arztebl.m2024.0160.
The epidemiological characterization of endometri - osis, particularly with regard to its incidence, has been inadequate to date both in Germany and other countries. The goal of this study was to determine trends in the incidence of diagnosed endometri - osis and changes in age structure at the time of first diagnosis over the period 2014-2022.
Nationwide claims data from physicians in private practice, obtained according to relevant German law (§ 295 SGB V), were used to identify the population at risk for a first assured diagnosis of endometriosis (ICD-10-GM: N80) during each year of the study period, consisting of women and girls aged 10-52 who were insured by the statutory health insurance system and for whom at least two years of prior observation were possible. Patients were defined as incident if they were documented as having received a first confirmed diagnosis of endometriosis, according to the case definition, during the study year. The case definition comprised multiple options for validating the diagnosis.
The incidence of diagnosed endometriosis rose over the period of the study from 2.8 per 1000 persons at risk in 2014 to 4.1 per 1000 in 2022, corresponding to a 44% relative increase. There was also a marked shift in agespecific incidence toward higher values at younger ages: the median age at diagnosis fell from 37 years (2014) to 34 (2022).
This is the first study providing nationwide population-based data on the incidence of endometriosis in Germany. The observed rise in newly diagnosed cases is presumably mainly due to an increased awareness of endometriosis and to the growing recognition of the disease.
子宫内膜异位症的流行病学特征,尤其是其发病率,在德国和其他国家至今仍不充分。本研究的目的是确定2014年至2022年期间确诊子宫内膜异位症的发病率趋势以及首次诊断时年龄结构的变化。
根据德国相关法律(《社会法典》第五卷第295条)获取的全国私人执业医生索赔数据,用于确定研究期间每年首次确诊子宫内膜异位症(国际疾病分类第十版德国修订本:N80)的高危人群,包括年龄在10至52岁之间、由法定健康保险系统承保且至少有两年观察期的女性和女孩。根据病例定义,如果患者在研究年度内被记录为首次确诊子宫内膜异位症,则定义为发病病例。病例定义包括多种诊断验证选项。
在研究期间,确诊子宫内膜异位症的发病率从2014年每1000名高危人群中的2.8例上升到2022年的每1000名中的4.1例,相对增加了44%。年龄别发病率也有明显向年轻年龄组更高值的转变:诊断时的中位年龄从2014年的37岁降至2022年的34岁。
这是第一项提供德国全国基于人群的子宫内膜异位症发病率数据的研究。新诊断病例的上升可能主要归因于对子宫内膜异位症认识的提高和对该疾病认识的增加。