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. 2022 Apr 28;12(1):6966.
doi: 10.1038/s41598-022-11017-x.

Increasing incidence and spatial hotspots of hospitalized endometriosis in France from 2011 to 2017

Joëlle Le Moal #  1 , Sarah Goria #  2 , Julie Chesneau  2 , Arnaud Fauconnier  3   4 , Marina Kvaskoff  5 , Perrine De Crouy-Chanel  2 , Vanessa Kahn  6 , Emile Daraï  7 , Michel Canis  8
Affiliations

Increasing incidence and spatial hotspots of hospitalized endometriosis in France from 2011 to 2017

Joëlle Le Moal et al. Sci Rep. .

Abstract

Endometriosis is a female hormone-dependent disease, possibly related to endocrine disruptor exposure. We aimed to monitor this disease nationwide in France and analyze spatial trends at a fine scale to explore possible environmental contributing risk factors. We conducted a retrospective national descriptive study from 2011 to 2017 in females aged 10 years old and over, using comprehensive hospital discharge data. Cases were identified using ICD-10 N80 codes and were localized at their municipality of residence. We defined incident cases as the first hospital stay of patients, without a stay in at least the previous 5 years. We performed statistical analyses according to age and type of endometriosis, and we modeled the temporal, spatial and spatiotemporal trends. We identified 207,462 incident cases of all-type hospitalized endometriosis (83,112 for non-adenomyosis cases). The crude incidence rate for the study period was 9.85/10,000 person-years (3.95/10,000 for non-adenomyosis cases). From 2011 to 2017, the risk of all-type endometriosis increased by 8.5% (95% CI: 3.9; 13.4) (by 3.6% (95% CI: 0.6; 6.8) for non-adenomyosis cases). The risk was geographically heterogeneous, with 20 high-risk hotspots, showing similar results for non-adenomyosis cases. Shifting practice patterns, improved awareness and healthcare disparities interlinked with environmental risk factors could explain these trends.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Relative risk of age, with 95% confidence interval compared to a reference case at 25 years (red line), (a) as regard all-type endometriosis cases, and (b) as regards non-adenomyosis cases.
Figure 2
Figure 2
Temporal trend of the risk of all-type hospitalized cases in the whole of France in females aged 10 years and above: relative risk and its 95% confidence interval (Knorr-Held model).
Figure 3
Figure 3
Estimated temporal trends (colored) for all-type cases compared to the national trend (black) (a) in some departments of metropolitan France and (b) in overseas departments.
Figure 4
Figure 4
Relative risks (RR) of all-type hospitalized cases coded endometriosis in females aged 10 years and above at the municipal scale.
See this image and copyright information in PMC

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