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Epidemiological survey of the Dutch Coeliac Disease Society: an update 1992

Objective To update epidemiological data of coeliac disease on a national level in The Netherlands. Design Analysis of the records of the members of the Dutch Coeliac Disease Society up to 1st January 1992. Results The Society consisted of 2479 patient members, of whom 1983 (80.0%) were at least single-biopsy confirmed. From 1982, 1038 new single-biopsy proven members have been registered. Manifestation occurred most frequently in the first (36%) and in the fourth and fifth decades (32%) of life. Most cases were diagnosed when the patients were adults (age <20 years): 64%. Prevalence rates (per 100000 inhabitants) varied according to geographical area in The Netherlands, with an overall prevalence rate of single-biopsy proven cases of 8.1 in 1990 and 13.1 in 1992; prevalence rates were lower in the 16 largest cities (<100000 inhabitants) than in a selected group of prosperous, smaller cities (> 60000 inhabitants); respective prevalence rates (mean ± SD) 12.2 ± 3.4 versus 24.7 ± 11.2; P > 0.01. Incidence rates (per 100000 inhabitants/year) increased from +0.49 in 1975 to +1.03 in 1992. This increase in diagnoses of coeliac disease is greater than the mean increase in the Dutch population over the last 15 years ( + 0.63 ± 0.17%/year). Conclusions The number of known coeliacs in The Netherlands is low compared with neighbouring countries, although this number is rising enormously. Incidence rates and geographically varying prevalence rates suggest that factors other than increasing population numbers must play a part in this phenomenon. This study suggests an association between the high prevalence of coeliac disease and high socioeconomic status. It may be hypothesized that medical attention and/or dietary gluten content may explain this phenomenon. Further analysis is needed to substantiate the causes of this phenomenon.