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Original research
Incidence of collagenous colitis in NHS Lothian: a population-based study
  1. Rebecca K Grant1,
  2. William M Brindle1,
  3. Andrew J Robertson2,
  4. Alexander R Robertson1,
  5. Gareth-Rhys Jones1,
  6. Kathryn J Kirkwood3,
  7. Paul W Fineron3,
  8. Ian D R Arnott1
  1. 1 The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
  2. 2 The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3 Department of Pathology, Western General Hospital, Edinburgh, UK
  1. Correspondence to Dr Rebecca K Grant, The Edinburgh IBD Unit, Western General Hospital, Edinburgh EH4 2XU, UK; rebecca.x.grant{at}nhslothian.scot.nhs.uk

Abstract

Objective Increases in incidence of collagenous colitis (CC) have been documented across Europe; however, previous data from NHS Lothian (1998–2003) demonstrated this to be a low-prevalence area. We aimed to assess incidence of CC in NHS Lothian over time by comparing a more recent cohort (2013–2018) with our existing cohort.

Methods All histologically confirmed diagnoses of CC between 2013 and 2018 were obtained from the NHS Lothian colorectal pathology department (Western General Hospital, Edinburgh). Case record review was performed to obtain relevant demographic and clinical data. Data were also collected regarding the availability of colonoscopy in NHS Lothian.

Results 224 cases of CC were diagnosed between 2013 and 2018, compared with 25 between 1998 and 2003. Mean annual incidence rose from 0.5/100 000 population to 4.3/100 000 population. Incidence in females ≥60 years old rose from 2.3/100 000 population to 22.4/100 000 population (p<0.001). The total number of colonoscopies performed increased by 179.1% from 15 262 (1998–2003) to 42 600 (2013–2018), with the number of CC cases per 1000 colonoscopies performed rising from 1.7 to 5.3 (p<0.001).

Conclusion We describe the increasing incidence of CC in Southeast Scotland, with temporal trends comparable to other European countries. The increase is particularly marked in older females and parallels increasing numbers of colonoscopies being performed.

  • microscopic colitis
  • collagenous colitis
  • epidemiology

Data availability statement

Data are available upon reasonable request. The data underlying this article will be shared on reasonable request from the corresponding author.

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Data availability statement

Data are available upon reasonable request. The data underlying this article will be shared on reasonable request from the corresponding author.

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Footnotes

  • Twitter @rebeccakg6, @Alexoscopy, @Gastro_GRJ

  • Contributors RKG contributed to the conception of the work, data collection, analysis and interpretation of the data and drafting of the manuscript. WMB contributed to the conception of the work, data collection and revision of the manuscript. AJR, KJK and PWF contributed to data collection and revision of the manuscript. ARR and G-RJ contributed to the critical revision of the manuscript. IDRA was the senior author and contributed to the conception of the work, interpretation of the data and performed critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests IDRA has received consultancy fees from Vifor and travel support from Takeda and Dr Falk. RKG, WMB, AJR, ARR, G-RJ, KJK and PWF have no personal or financial conflicts of interest to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.