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Meta-Analysis
. 2024 Feb;12(1):89-102.
doi: 10.1002/ueg2.12465. Epub 2023 Nov 3.

Incidence and prevalence of eosinophilic oesophagitis across Europe: A systematic review and meta-analysis

Stephen E Roberts  1 , Sian Morrison-Rees  1 , Nikhil Thapar  2   3   4 , John G Williams  1
Affiliations
Meta-Analysis

Incidence and prevalence of eosinophilic oesophagitis across Europe: A systematic review and meta-analysis

Stephen E Roberts et al. United European Gastroenterol J. 2024 Feb.

Abstract

Background: Several studies have reported large increases in the incidence of eosinophilic oesophagitis (EoE) in the last 20 years. We aimed to systematically review the incidence and prevalence of EoE, focused on all European countries.

Methods: Systematic review and meta-analysis up to 31 December 2022, based on PubMed, CINAHL and extensive hand searching of reference lists. Twenty-five eligible studies were identified and included.

Results: For both adults and children, the highest EoE incidence and prevalence have been reported from regional studies in Spain. EoE incidence for both adults and children was significantly lower (p < 0.001) in nationwide studies (meta-analysis = 3.64 per 100,000 person-years overall) compared with regional or centre-based studies (7.16). EoE incidence and prevalence were significantly higher (p < 0.001) in adults than children. All studies that reported on longitudinal trends in EoE incidence showed increases over time, more markedly during more recent years. Larger increases in incidence tend to refer to regional rather than nationwide studies; from Spain, Switzerland and Denmark, both for paediatric and adult age groups. Increases in EoE incidence 100,000 person-years were larger than for incidence per number of diagnostic endoscopies. The most frequently reported co-morbidities in adults were rhinitis, followed by asthma, food allergy and gastroesophageal reflux disease, and in children, erosive oesophagitis, asthma, food allergy and rhinitis.

Conclusions: The incidence of EoE has increased in Europe over the last 30 years, exceeding increases in the volume of oesophago-gastro-duodenoscopies performed. The patchy and low incidence and prevalence of EoE generally in Europe and compared with North America, may reflect a lack of clinical awareness and research focus rather than a genuinely low incidence of EoE. A co-ordinated Europe-wide study that uses standardised methodology is urgently needed to provide a comprehensive picture of EoE incidence and prevalence across Europe.

Keywords: Europe; eosinophilic oesophagitis; incidence; prevalence; trends.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
The incidence of EoE (per 100,000 person‐years) across Europe, grouped into quintiles, for (a) adults or all age groups and (b) paediatric age groups. Circles denote the approximate locations of the studies. Where studies report incidence for both paediatric age groups and for adults/all ages, both are included in this map. Further details of the studies are provided in Figure 1 and Table 2. EoE, eosinophilic oesophagitis.
FIGURE 3
FIGURE 3
Meta‐analysis of the incidence of EoE (per 100,000 person‐years) across Europe for (a) adults or all age groups and (b) paediatric age groups. Horizontal bars represent 95% confidence intervals. EoE, eosinophilic oesophagitis.
FIGURE 4
FIGURE 4
Trends in the incidence of EoE (per 100,000 person‐years) across Europe for (a) adults or all age groups and (b) paediatric age groups. EoE, eosinophilic oesophagitis.
FIGURE 5
FIGURE 5
Meta‐analysis of the prevalence of EoE (per 100,000 population) across Europe for (a) adults or all age groups and (b) paediatric age groups. Horizontal bars represent 95% confidence intervals. EoE, eosinophilic oesophagitis.
See this image and copyright information in PMC

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