Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017

Dolores Catelan, Manuela Giangreco, Annibale Biggeri, Fabio Barbone, Lorenzo Monasta, Giuseppe Ricci, Federico Romano, Valentina Rosolen, Gabriella Zito and Luca Ronfani
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Dolores Catelan: Unit of Biostatistics, Epidemiology and Public Health Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy
Manuela Giangreco: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Annibale Biggeri: Department of Statistics, Computer Science, Applications ‘G. Parenti’ (DiSIA), University of Florence, 50134 Firenze, Italy
Fabio Barbone: Department of Medical Area, University of Udine, 33100 Udine, Italy
Lorenzo Monasta: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Giuseppe Ricci: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Federico Romano: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Valentina Rosolen: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Gabriella Zito: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
Luca Ronfani: Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy

IJERPH, 2021, vol. 18, issue 13, 1-14

Abstract: Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: We retrieved incident cases of endometriosis in women aged 15–50 years using hospital discharge records and pathology databases of the Friuli Venezia Giulia region in the calendar period 2004–2017. We studied the spatial pattern of endometriosis incidence applying Bayesian approaches to Disease Mapping, and profiled municipalities at higher risk controlling for multiple comparisons using both q-values and a fully Bayesian approach. Results: 4125 new cases of endometriosis were identified in the age range 15 to 50 years in the period 2004–2017. The incidence rate (x100 000) is 111 (95% CI 110–112), with a maximum of 160 in the age group 31–35 years. The geographical distribution of endometriosis incidence showed a very strong north-south spatial gradient. We consistently identified a group of five neighboring municipalities at higher risk (RR 1.31 95% CI 1.13; 1.52), even accounting for ascertainment bias. Conclusions: The cluster of 5 municipalities in the industrialized and polluted south-east part of the region is suggestive. However, due to the ecologic nature of the present study, information on the patients’ characteristics and exposure histories are limited. Individual studies, including biomonitoring, and life-course studies are necessary to better evaluate our findings.

Keywords: endometriosis; Incidence; Epidemiological surveillance; disease mapping; hierarchical Bayesian models; High Risk Areas Profiling (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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