Observations on the European Incidence of Chronic Ulcerative Colitis

Although chronic ulcerative colitis has long been regarded as being a widespread, though uncommon, disease of temperate zones, the concept that its incidence and behaviour may vary in different countries, or even within different areas of the same country, is not widely recognized. Kírsner and Palmer (1954) believe that the disease is less common in South America than in the United States, and in the United States itself Bockus (1943-46) considers that ulcerative colitis is more common in the northern than in the southern states. It has also been possible to demonstrate variations in the geographic incidence of the disease in Britain (Melrose, 1955). The incidence rate showed a tendency to decrease from south to north, the disease being significantly less frequent in the northern British towns. The results were derived from an analysis of grouped hospital returns collected from fifteen major British cities. Since the incidence of the disease cannot be judged from the usual sources of health statistics, hospital records were employed as a source of information, but the limitations and possible imperfections of so doing were noted. Since the original British investigation described above was completed, the author has attempted to extend the study to the Continent of Europe. Many countries have been unable to supply information, and the attempt has not been wholly successful. However, with the aid of certain European colleagues to whom I am indebted, some data of interest have been collected. Hospital records from major towns have again been utilized in each case. In table 1 the countries have been arbitrarily arranged in increasing order of incidence from above downwards. The Island of Fyn was the only Danish area from which data could be obtained. Switzerland occupies a special position in having the lowest incidence. England has the TABLE 1 Ulcerative Colitis – Rates of Incidence in Europe (derived from grouped hospital returns)