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Article

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

1
Unit of Biostatistics, Epidemiology and Public Health Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy
2
Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
3
Department of Statistics, Computer Science, Applications ‘G. Parenti’ (DiSIA), University of Florence, 50134 Firenze, Italy
4
Department of Medical Area, University of Udine, 33100 Udine, Italy
5
Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Milan Terzic, Antonio Simone Laganà and Antonio Sarria-Santamera
Int. J. Environ. Res. Public Health 2021, 18(13), 7175; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137175
Received: 11 May 2021 / Revised: 28 June 2021 / Accepted: 29 June 2021 / Published: 5 July 2021
(This article belongs to the Special Issue Women Health and Gynecology)
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. View Full-Text
Keywords: endometriosis; Incidence; Epidemiological surveillance; disease mapping; hierarchical Bayesian models; High Risk Areas Profiling endometriosis; Incidence; Epidemiological surveillance; disease mapping; hierarchical Bayesian models; High Risk Areas Profiling
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MDPI and ACS Style

Catelan, D.; Giangreco, M.; Biggeri, A.; Barbone, F.; Monasta, L.; Ricci, G.; Romano, F.; Rosolen, V.; Zito, G.; Ronfani, L. Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017. Int. J. Environ. Res. Public Health 2021, 18, 7175. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137175

AMA Style

Catelan D, Giangreco M, Biggeri A, Barbone F, Monasta L, Ricci G, Romano F, Rosolen V, Zito G, Ronfani L. Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017. International Journal of Environmental Research and Public Health. 2021; 18(13):7175. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137175

Chicago/Turabian Style

Catelan, Dolores, Manuela Giangreco, Annibale Biggeri, Fabio Barbone, Lorenzo Monasta, Giuseppe Ricci, Federico Romano, Valentina Rosolen, Gabriella Zito, and Luca Ronfani. 2021. "Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017" International Journal of Environmental Research and Public Health 18, no. 13: 7175. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137175

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