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Temporal trends of esophageal disorders by age in the Cerner Health Facts database.

ABSTRACT: PURPOSE:Esophageal adenocarcinoma incidence has increased approximately 600% over the last 4 decades in the United States. Little research has been conducted on the temporal trends of gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE), yet it is important to establish whether these conditions have also increased with time or differ by age. METHODS:The Cerner Health Facts(®) database contains information on 35 million patients between 2001 and 2010. GERD, BE, and esophageal cancer (EC) cases were defined using International Classification of Diseases, ninth edition codes. We calculated age-adjusted rates and 95% confidence intervals for GERD, BE, and EC. RESULTS:In this population, the overall, all-age rate per 100,000 encounters for GERD was 711.9, BE was 21.6, and EC was 6.1. During 2001-2010, GERD rates increased by approximately 50% and EC rates more than doubled, but BE rates declined by approximately 40%. Trends were similar by age, and all rates were higher in Caucasians and males. CONCLUSIONS:These data indirectly support the idea that increased incidence of EC may be partially due to GERD and raise the provocative hypothesis that BE rates may be decreasing possibly as a forerunner of continued stabilization of esophageal adenocarcinoma rates and a possible subsequent decline.

SUBMITTER: Petrick JL

PROVIDER: S-EPMC4844025 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Temporal trends of esophageal disorders by age in the Cerner Health Facts database.

Petrick Jessica L JL Nguyen Tuyet T Cook Michael B MB

Annals of epidemiology 20151211 2

<h4>Purpose</h4>Esophageal adenocarcinoma incidence has increased approximately 600% over the last 4 decades in the United States. Little research has been conducted on the temporal trends of gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE), yet it is important to establish whether these conditions have also increased with time or differ by age.<h4>Methods</h4>The Cerner Health Facts(®) database contains information on 35 million patients between 2001 and 2010. GERD, BE, and e ...[more]

PMID: 26762962

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Project description:Study objectivesSleep disorders are common in the general population. This study aimed to identify direct health care utilization for sleep disorders using big data through the Cerner Health Facts database.MethodsThe Cerner Health Facts database has 68.7 million patients in the data warehouse, documenting approximately 506.9 million encounters from 100 nonaffiliated health care systems. To identify sleep-related health care utilization, we examined the frequency of outpatient encounters related to sleep disorders between the years 2000 and 2017. Sleep disorders were grouped-based on the International Classification of Sleep Disorders-Third Edition.ResultsApproximately 20.5 million patients were identified with a total of 127.4 million outpatient encounters. In pediatric patients (ages 0-18 years), health care utilization for major sleep diagnoses was measured per 100,000 encounters. Sleep-related breathing disorders ranked first among common sleep disorders for pediatric patients followed by parasomnia, insomnia, sleep movement disorders, hypersomnolence, then circadian rhythm disorders (820.1, 258.1, 181.6, 68.3, 48.1, and 16.2 per 100,000 encounters, respectively). However, in adult patients, the ranking was slightly different, with sleep-related breathing disorders ranked first, followed by insomnia, sleep-related movement disorders, hypersomnolence, parasomnia, then circadian rhythm disorders (1352.6, 511.6, 166.3, 79.1, 25.7, and 4.2 per 100,000 encounters, respectively). In general, there was a bimodal pattern with a clear dip in sleep-related health care utilization in young adults age (age 19-29 years), with the exception of insomnia.ConclusionsPatients with sleep disorders show relatively low health care utilization despite a known high prevalence of sleep disorders in the general population. This finding may highlight under-recognition of sleep problems or decreased access to health care for sleep disorders. In addition, this study highlights the effect of age-based variation on different sleep disorders, which may have an impact on allocating resources.

Project description:BACKGROUND:Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined. METHODS:Data from 46?063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age-adjusted incidence and survival were analyzed using joinpoint regression models. RESULTS:The age-adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100?000 person-years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40?years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40-year limited-duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period. CONCLUSION:The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long-term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease. KEY POINTS:Significant findings of the study The incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. What this study adds There has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.

Project description:Studies of head size and brain volume in autism spectrum disorders have suggested that early cortical overgrowth may be followed by prematurely arrested growth. However, the few investigations quantifying cortical thickness have yielded inconsistent results, probably due to variable ages and/or small sample sizes. We assessed differences in cortical thickness between high-functioning adolescent and young adult males with autism spectrum disorders (n = 41) and matched typically developing males (n = 40). We hypothesized thinner cortex, particularly in frontal, parietal and temporal regions, for individuals with autism spectrum disorders in comparison with typically developing controls. Furthermore, we expected to find an age × diagnosis interaction: with increasing age, more pronounced cortical thinning would be observed in autism spectrum disorders than typically developing participants. T(1)-weighted magnetization prepared rapid gradient echo 3 T magnetic resonance imaging scans were acquired from high-functioning males with autism spectrum disorders and from typically developing males matched group-wise on age (range 12-24 years), intelligence quotient (≥ 85) and handedness. Both gyral-level and vertex-based analyses revealed significantly thinner cortex in the autism spectrum disorders group that was located predominantly in left temporal and parietal regions (i.e. the superior temporal sulcus, inferior temporal, postcentral/superior parietal and supramarginal gyri). These findings remained largely unchanged after controlling for intelligence quotient and after accounting for psychotropic medication usage and comorbid psychopathology. Furthermore, a significant age × diagnosis interaction was found in the left fusiform/inferior temporal cortex: participants with autism spectrum disorders had thinner cortex in this region with increasing age to a greater degree than did typically developing participants. Follow-up within group comparisons revealed significant age-related thinning in the autism spectrum disorders group but not in the typically developing group. Both thinner temporal and parietal cortices during adolescence and young adulthood and discrepantly accelerated age-related cortical thinning in autism spectrum disorders suggest that a second period of abnormal cortical growth (i.e. greater thinning) may be characteristic of these disorders.

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Temporal trends of esophageal disorders by age in the Cerner Health Facts database.

Publications

Temporal trends of esophageal disorders by age in the Cerner Health Facts database.

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