Achalasia in Iceland, 1952-2002: an epidemiologic study

[Guest guest]

I found this little gem over at PubMed:

http://www.ncbi.nlm.nih.gov/pubmed/17420933

If you know about genetic research and Iceland, you know that the

population of Iceland is genetically very homogeneous - they are all

related. It is like studying one big family. If achalasia is genetic you

would expect the incidence and prevalence rates to higher in a family or

homogeneous gene pool when there are members with achalasia.

In this study they reviewed the demographic and clinical history for

" all patients diagnosed with achalasia in Iceland from 1952 to 2002. "

That gave them a total of " Sixty-two achalasia patients, " 33 males and

29 females.

Here is want they found about the rates. " The mean prevalence was 8.7

cases/100,000 and the overall incidence was 0.55 case/100,000/year. This

is the first national epidemiological study of achalasia in a

genetically homogeneous population, spanning over half a century. The

epidemiology of achalasia in Iceland is similar to that in most other

reported studies. "

If anything these rates are just a little lower than we usually see

stated but if you round them up, 8.7 to 10 (some give it as 5.0) and

0.55 to 1.0 they are the same. There is a little variation from country

to country and even region to region so these numbers can be considered

typical. In others words, no change or increase in risk because the

people are related to each other.

On the subject of epidemiology, here is an interesting, but old, US study.

Epidemiology of hospitalization for achalasia in the United States.

http://www.ncbi.nlm.nih.gov/pubmed/8425436

" To gain insights into possible etiologic risk factors, demographic and

comorbidity data were obtained from Medicare hospital discharge data

files from 1986-1989 on patients aged 65 and older. " ... " Records of

15,000 achalasia discharges were available for analysis. " ... " High

rates were observed in the South and low rates in most states of the

East North Central region around the Great Lakes and in the Pacific

region. " ... " Achalasia was associated with a significantly increased

risk for pulmonary complications, malnutrition, and gastroesophageal

cancer. The concordant occurrence of achalasia in patients with

Parkinson's disease, depressive disorder, and various other myoneural

disorders indicated a possible etiologic relationship. Achalasia appears

to represent the clinical end point of several different pathways.

Besides aging, different neurologic diseases may contribute to a loss in

control of esophageal motility. The geographic pattern could suggest the

influence of environmental factors. "

I find that interesting and wish they would do more of this type of study.

notan