Kido Masamitsu, Arita Tomohiro, Shoda Katsutoshi, Inoue Ken, Okimura Hiroyuki, Shimizu Hiroki, Kiuchi Jun, Nanishi Kenji, Shiozaki Atsushi
Department of Orthopedic Surgery Inage Hospital Chiba Japan.
Division of Digestive Surgery, Department of Surgery, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan.
Ann Gastroenterol Surg. 2025 Mar 25;9(5):987-996. doi: 10.1002/ags3.70018. eCollection 2025 Sep.
The epidemiology of hemorrhoids is challenging because of variability in sampling methodologies and diagnostic criteria across different studies. This study indirectly clarified the epidemiology of hemorrhoids by investigating the number of invasive treatments for hemorrhoids (ITH) using a nationwide healthcare claims database.
The annual number and rate of ITH procedures per 100 000 people during 2018-2022 were examined. ITH covered by the Japanese healthcare insurance includes sclerotherapy, rubber band ligation, infrared coagulation, thrombectomy, hemorrhoidectomy, and stapled hemorrhoidopexy. The demographic peak patterns in the sex- and age-stratified data were analyzed. Annual trends were evaluated using the Jonckheere-Terpstra trend test or Poisson regression model.
Over the 5-year period, the total number of ITH was 697 838, with a rate of 110.5 per 100 000 person-years. The male-to-female ratio was 1.2:1, indicating slight male predominance. Demographic peak analysis revealed bimodal peaks in males aged 40-44 and 75-79 years, and in females aged 35-39 and 75-79 years. No significant changes were observed in all ITH procedures. The age-adjusted number across all age groups per 100 000 person-years demonstrated annual decreasing trends for males but increasing trends for females ( < 0.0167). Subgroup analysis indicated a decrease among older cohorts in both males and females, in contrast to an increase among young and middle-aged females ( < 0.00088).
Distinct bimodal ITH peaks were observed in males and females in their 30s-40s and 70s. These findings provide valuable insights into the epidemiology of hemorrhoids.
由于不同研究的抽样方法和诊断标准存在差异，痔疮的流行病学研究具有挑战性。本研究通过使用全国医疗保健索赔数据库调查痔疮的侵入性治疗数量（ITH），间接阐明了痔疮的流行病学。
研究了2018 - 2022年期间每年每10万人的ITH手术数量和发生率。日本医疗保险涵盖的ITH包括硬化疗法、橡皮圈套扎术、红外线凝固术、血栓切除术、痔切除术和吻合器痔上黏膜环切术。分析了性别和年龄分层数据中的人口统计学高峰模式。使用Jonckheere - Terpstra趋势检验或泊松回归模型评估年度趋势。
在5年期间，ITH总数为697838例，每10万人年发生率为110.5例。男女比例为1.2:1，表明男性略占优势。人口统计学高峰分析显示，男性在40 - 44岁和75 - 79岁出现双峰，女性在35 - 39岁和75 - 79岁出现双峰。所有ITH手术均未观察到显著变化。每10万人年所有年龄组的年龄调整后数量显示，男性呈年度下降趋势，而女性呈上升趋势（<0.0167）。亚组分析表明，老年男性和女性队列数量减少，而年轻和中年女性队列数量增加（<0.00088）。
在30多岁至40多岁和70多岁的男性和女性中观察到明显的双峰ITH高峰。这些发现为痔疮的流行病学提供了有价值的见解。
