スウェーデンにおける顕微鏡的大腸炎の増加を解明(Large rise in microscopic colitis seen in Sweden)

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2026-05-05 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所の研究チームは、顕微鏡的大腸炎の発症率が国内で大幅に増加していることを明らかにした。顕微鏡的大腸炎は慢性的な水様性下痢を特徴とする炎症性腸疾患で、通常の内視鏡検査では異常が見えにくく、組織検査によって診断される。研究では全国規模の患者データを解析し、特に高齢者や女性で患者数が顕著に増加していることを確認した。背景には高齢化に加え、診断技術の向上や特定薬剤の使用増加などが関与している可能性が示唆されている。また、生活の質低下や医療負担の増大につながるため、早期診断と治療体制整備の重要性が指摘された。研究チームは、発症要因や環境・薬剤との関連をさらに解明する必要があるとしている。

スウェーデンにおける顕微鏡的大腸炎の増加を解明(Large rise in microscopic colitis seen in Sweden)
Intermediate magnification micrograph of collagenous colitis. Photo: Nephron, CC BY-SA 3.0

<関連情報>

スウェーデンにおける顕微鏡的大腸炎の発生率と有病率の増加:全国規模の人口ベースのコホート研究。 Increasing incidence and prevalence of Microscopic Colitis in Sweden: A nationwide population-based cohort study.

David Bergman, MD PhD ∙ Soran Rabin Bozorg, MD PhD ∙ Anders Forss, MD PhD ∙ … ∙ Carole A. Marxer, PhD ∙ Darrell S. Pardi, MD ∙ Jonas F. Ludvigsson, MD PhD
Clinical Gastroenterology and Hepatology  Published:May 3, 2026
DOI:https://doi.org/10.1016/j.cgh.2026.03.019

ABSTRACT

Background

There are few population-based studies on the incidence and prevalence of microscopic colitis (MC).

Objective

To assess incidence and prevalence of MC in Sweden.

Design

Nationwide population-based cohort study including all incident cases of biopsy-confirmed MC and all biopsied cases with normal mucosa from 1995 to 2021. Incidence rates (IRs) were age-standardized to the 2021 Swedish population. Age-specific IRs were plotted by sex. Poisson regression estimated trends and female-to-male incidence rate ratios (IRRs). A combined model of MC and normal mucosa evaluated whether changes in MC incidence exceeded background biopsy trends. Point prevalence on 31 December 2021 was derived by dividing MC cases with population denominators. Lifetime risk was computed using a competing-risk cumulative incidence estimator.

Results

We identified 22,519 incident MC cases (71% women) from 1995 to 2021. The mean age-standardized IR across the study period was 8.8 (95% confidence interval(CI)=7.1-10.5) cases per 100,000 person-years and rose steeply from 1995 until 2007 (+17% per year, 95% CI=1.15–1.19), then increased more modestly (+3%, 1.02–1.04). The incidence of MC increased faster than that of normal mucosa, the mean difference was 4.33% per year (95% CI 3.19–5.48). The prevalence of MC was 170 per 100,000 inhabitants in 2021. Lifetime risk was 1 in 54 for women and 1 in 133 for men.

Conclusion

In Sweden, incidence and prevalence of MC continued to rise through 2021. The steeper slope of MC incidence in relation to normal mucosa indicates either a true rise in disease occurrence or an ongoing diagnosis of prevalent cases related to an increased awareness of MC.

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