Together, these cancers were responsible for an estimated 55 percent of all digestive system cancers diagnosed in 2004. Pancreatitis, liver disease, diverticular disease, and gallstones were the most significant causes of lost wages during hospital stays. Table 2.3. We estimate that foodborne illness causes 5,020 deaths annually (1,810 deaths due to known pathogens and 3,210 deaths due to unknown agents), a total that is slightly more than half the 9,000 deaths estimated by Bennett et al. In 2005, according to the World Health Organization (WHO) using the International Statistical Classification of Diseases and Related Health Problems (ICD), about 58 million people died. Emergency ID NET: an emergency department-based emerging infections sentinel network. All Viral Hepatitis: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004, Table 8. Therefore, any individual record could be counted for more than one digestive disease. Table 1. All Digestive Cancers: Age-Adjusted Incidence Rates and 5-Year Survival Rates, 1979–2004 1–53. Mortality from hepatitis A was rare, with fewer than 100 deaths per year (Table 2). Household data on medical conditions are by self-report. Digestive diseases in the United States: epidemiology and impact. The World Health Organization attributes an estimated 700,000 deaths to the hepatitis C Virus (HCV). The occurrence of calicivirus in infants with acute gastroenteritis. Death rates were higher for blacks than whites and for males than females, reflecting the incidence rates. The 10 most significant digestive diseases in terms of direct costs in 2004 were (in descending order) GERD, gallstones, AWH, colorectal cancer, diverticular disease, peptic ulcer disease, pancreatitis, liver disease, appendicitis, and chronic constipation. Chronic Constipation: Number and Age-Adjusted Rates of Deaths and Years of Potential Life Lost (to Age 75) by Age, Race, and Sex in the United States, 2004 Trends in annual deaths. Medications are not shown for the individual malignancies in the following chapters. For these pathogens, we have assumed that if diagnosed sporadic cases were reported, the total number would be 10 times the number of outbreak-related cases. MPC data files are not available for public release; information from these files is incorporated into the HC data files. 94–1447 pp. In 2004, there were an estimated 2.8 million prescriptions at a cost of $100 million filled at retail pharmacies for diagnosis of diverticular disease (Table 3), according to the Verispan database (Appendix 2). Of the 101 sites providing data to NED during 2001–2005, 36 did so throughout the 5-year period. All 10 costliest medications were for either antimicrobial agents (ciprofloxacin being the costliest and most common) or pain-relievers, led by morphine. data). Reported cases: Cases not routinely reported. Table 2. 503-494-7401 (local telephone) HC data files are available for public use. All Digestive Diseases: Costliest Prescriptions Included in this figure are 193,084 cases of gastroenteritis with an identified pathogen and an additional 423,293 cases of gastroenteritis of unknown etiology (Table 5). Figure 2. § Numbers reported in each category may not add up to the total number of reported cases in a year due to cases with missing data or, in the case of race/ethnicity, cases categorized as “Other”. Hepatitis C: Number and Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With First-Listed and All-Listed Diagnoses by Age, Race, and Sex in the United States, 2004, Figure 5. It is not clear how much of the increase can be attributed to the consequences of disease burden due to longstanding infection. As noted previously, 163,153 of these hospitalizations can be attributed to known causes of acute gastroenteritis, yielding an estimated 773,573 hospitalizations for acute gastroenteritis caused by unknown agents. The YPLL prior to age 75 years is the addition of the number of years prior to age 75 at which deaths occur. Longitudinal study of rotavirus infection and gastroenteritis in families served by a pediatric medical practice: clinical and epidemiologic observations. Rates of reported hepatitis A, by sex — United States, 2002–2017. Established in 1996, FoodNet is a collaborative effort by the Centers for Disease Control and Prevention, the U.S. Department of Agriculture, the U.S. Food and Drug Administration, and selected state health departments. Liver Disease: Costliest Prescriptions, Table 1. This conclusion is supported by well-documented foodborne outbreaks of distinctive illness for which the causative agent remains unknown (e.g., Brainerd diarrhea) (26), by the large percentage of foodborne outbreaks reported to CDC for which no pathogen is identified (25), and by the large number of new foodborne pathogens identified in recent years. All Inflammatory Bowel Disease: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004, Table 8. Gallstones: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004 In: Everhart JE, editor. Pancreatitis: Costliest Prescriptions, 24. This continued at least a century of decline in peptic ulcer mortality.9 Much of the decline in the medical significance of peptic ulcer has been attributed to the decline of Helicobacter pylori, which is a causative agent. U.S. Department of Health and Human Services All Digestive Diseases: Age-Adjusted Rates of Death in the United States, 1979–2004, Table 3. Hepatitis B: Age-Adjusted Rates of Death in the United States, 1979–2004 A limitation of this approach is an underestimate of indirect costs related to work loss from digestive diseases not related to medical care (discussion follows). Most of these deaths are due to chronic liver disease and primary liver cancer. National Endoscopy Database (NED)/Clinical Outcomes Research Initiative (CORI), Clinical Outcomes Research Initiative Age-adjusted rates were 18 percent higher among whites than blacks and 49 percent higher among women than men. The nature of food and foodborne illness has changed dramatically in the United States over the last century. Pancreatitis: Number and Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With First-Listed and All-Listed Diagnoses by Age, Race, and Sex in the United States, 2004 All Digestive Cancers: Age-Adjusted Rates of Death in the United States, 1979–2004, Table 4. Figure 4. Prevalence of chronic conditions by primary diagnosis, medications taken, functional status, receipt of services (medical, nursing, and therapeutic), discharge health status and length of stay by diagnosis, cost of providing care by diagnosed condition, and sources of payment are available. The proportion of newly diagnosed patients who survived for at least 5 years has climbed steadily since 1979. ICD codes are used for diagnoses. Given these data, we assume that 11% of all episodes of acute primary gastroenteritis are due to NLVs (using the data from the best of the studies) (92).Hospitalizations: NLV assumed to account for 11% of 452,000 annual hospitalizations for viral gastroenteritis (100).Case-fatality rate: Low. Staphylococcal food poisoning caused by imported canned mushrooms. Table 1. First, the sampling frame changed over time as more States made their data available to HCUP. 94–1447 pp. Hepatitis A. Death from hemorrhoids has always been exceedingly rare (Table 2 and Figure 2). Pancreatitis: Number and Age-Adjusted Rates of Deaths and Years of Potential Life Lost (to Age 75) by Age, Race, and Sex in the United States, 2004 Because of low survival, bile duct cancer mortality was similar to incidence. Hepatitis A: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004 (Ambulatory Care Visit Data Unavailable), Table 2. Mortality rates were slightly higher among whites than blacks, and were nearly twice as high among males. SEER data are verified for quality and completeness. Table 8. Crohn’s Disease: Number and Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With First-Listed and All-Listed Diagnoses by Age, Race, and Sex in the United States, 2004, Figure 1. The median number of deaths was 28 per year (range = 23-40). Figure 1. Rates of both ambulatory care visits and hospitalizations with hepatitis B were higher among blacks than whites and among males than females. The study design is described in: National Center for Health Statistics, Dennison CF, Pokras R. Design and operation of the National Hospital Discharge Survey: 1988 redesign. Table 5. Figure 3. In spite of a century of progress, the burden of digestive diseases in numerical terms remains staggering in the United States; the numbers, however, convey in only a limited way the suffering of and impact on the millions of individuals affected. Where information from both active and passive reporting was available, we used the figure from active surveillance when estimating the total number of cases. Included in this chapter are separate entries on chronic constipation and irritable bowel syndrome (IBS). Prevalence of Hepatitis C in the United States. The figures showing mortality data for the period 1979–2004 used the multiple cause-of-death data for each year. Nevertheless, the patterns of endoscopy in NED have been shown to be quite similar to that of a national sample of the Medicare population and may well be applicable to the United States as a whole.27 There is no independent confirmation of the indications and diagnoses reported by the endoscopist on the endoscopy record, although the report is frequently included in the medical record and used for billing. In 2004, there were an estimated 1.8 million ambulatory care visits with a diagnosis of gallstones, most of which were for gallstones as a first-listed diagnosis (Table 1). Division of Health Care Statistics Gastrointestinal Infections: Costliest Prescriptions, Table 1. HCUP NIS data are weighted to represent the annual discharges from non-Federal hospitals in the United States. Counts for 2004 for deaths from digestive disease were derived from the Multiple Cause-of-Death data files from the Division of Vital Statistics, CDC. Gastroesophageal Reflux Disease: Number and Age-Adjusted Rates of Deaths and Years of Potential Life Lost (to Age 75) by Age, Race, and Sex in the United States, 2004 A new sample of households is included in the survey each year. The recent increase in overnight hospital stays with a diagnosis of digestive disease is surprising for two reasons. That number is comparable to HIV, tuberculosis, and malaria. The weighted total may underestimate or overestimate the number of patients enrolled in a given year due to the rolling nature of the survey and the length of stay of patients. 540 Gaither Road, Suite 2000 * Includes case reports indicating the presence of at least one of the following risks 2–6 weeks prior to onset of symptomatic hepatitis A: 1) traveled to hepatitis A-endemic regions of Mexico, South/Central America, Africa, Asia/South Pacific, or the Middle East; 2) sexual/household or other contact with suspected/confirmed hepatitis A patient; 3) a child/employee in day-care center/nursery/preschool or having had contact with such persons; 4) involved in a foodborne/waterborne outbreak; 5) being a man who has sex with men; and 6) injection drug use. † Cause of death is defined as one of the multiple causes of death and is based on the International Classification of Diseases, 10th Revision (ICD-10) codes B15 (hepatitis A). Number of prescriptions written by physicians may not be equivalent to number of prescriptions filled. The diverse patterns of hepatitis A epidemiology in the United States. As a result of the large number of deaths occurring at an early age, the YPLL prior to age 75 years was higher than for any other digestive disease. The main demographic difference between ambulatory care diagnoses and hospital diagnoses was that blacks had a higher age-adjusted rate of hospital diagnoses. Colorectal Cancer: Number and Age-Adjusted Rates of Deaths and Years of Potential Life Lost (to Age 75) by Age, Race, and Sex in the United States, 2004 Unlike recently stable rates of hospitalizations, the death rate from viral hepatitis A was halved between 1999 and 2004 (Figure 2). The Altmetric Attention Score for a research output provides an indicator of the amount of attention that it has received. SEER statistics used in this report are number of cases and incidence in 2004, and the time trends for incidence and 5-year survival following diagnosis between 1979 and 2004. Published data are found in: National Center for Health Statistics. In this visual representation, the sum of reported and estimated not reported total the estimated number of acute cases. Different World . Because hospitalizations in Federal facilities are not included, hospitalization rates based on the U.S. population are underestimates. Table 2.3. All rates were age-adjusted. U.S. Department of Health and Human Services Because ICD-10 does not separate acute from chronic liver disease, ICD-9 codes for acute and chronic liver disease were combined to achieve consistency for time trend data (Appendix 1). Number of Flexible Sigmoidoscopies at Stable Sites (N=36) by Age and Year, 2001–2005 Quality is dependent on the accuracy of death certificates, which may vary, according to condition. Hepatitis A (Hep A) 203,339,060 8 6 47 61 36 97 Hepatitis B (Hep B) 216,772,259 12 12 73 97 94 191 . In contrast, the number of sigmoidoscopies at stable sites declined appreciably among persons ages 40–79 years, but most among those ages 50–79 (Figure 4). 3 GERD = reflux symptoms, excluding dysphagia and surveillance of Barrett’s esophagus. Because no national estimates were available for the average price charged by physicians per procedure, Medicare reimbursement rates were used. The methodology used to derive cost estimates for digestive diseases is briefly described here. Primary Liver Cancer: Number and Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With First-Listed and All-Listed Diagnoses by Age, Race, and Sex in the United States, 2004, Figure 2. As with incidence, mortality rate increased, although not as quickly. Hepatitis B: Number and Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With First-Listed and All-Listed Diagnoses by Age, Race, and Sex in the United States, 2004 Figure 7. Stephen P. James, M.D. Figure 2. Appendicitis: Age-Adjusted Rates of Death in the United States, 1979–2004, Table 1. Hepatitis B Much of the increase can be attributed to increasing recognition of the disease. The remaining 20 percent was allocated to the secondary diagnoses in proportion to the number of secondary diagnoses. Figure 4. Averaging the totals for all causes from death certificate and National Hospital Discharge Survey data and adjusting to the 1997 U.S. census estimates, we estimated that gastroenteritis contributed to the death of 6,402 persons in the United States in 1997. In addition to these assumptions, our analysis has several limitations. The sample allows estimates for specific physician subspecialties. In addition to LRI, diarrheal diseases, and HIV/AIDS, these groups were hepatitis, meningitis, and tuberculosis. Hepatitis C: Age-Adjusted Rates of Death in the United States, 1979–2004 More than 40 percent of examinations had normal findings (Table 5). However, transmission from a hepatitis These rates are locality-specific; therefore, we used the average of the regional reimbursement rates weighted by the population density of each region. Excluding death due to Listeria, Toxoplasma, and hepatitis A virus, the number of deaths due to pathogens that cause acute gastroenteritis is 1,381, of which 931 (67%) are attributable to foodborne transmission. Data on residents and discharges are collected by interviewing a nurse who obtains the needed information from the medical records and the next of kin. Data utilized in the current report were from the HC and consisted of counts of the number of days of work missed due to illness, injury, or hospitalization. The diagnostic codes traditionally used for digestive diseases primarily code for chronic conditions that are neither infectious nor malignant. In 2004, Crohn’s disease resulted in more than 800,000 first-listed ambulatory care visits and more than 1 million all-listed visits (Table 1). Indirect costs of lost earnings and leisure due to premature death (Table 3, column 4) were estimated using the number of deaths in 2004 and the projected future lifetime earnings, benefits, and leisure for men and women to age 75, based on age at death.36 The expected lifetime value was discounted to the present using a 4 percent annual discount rate; 100 percent of costs were attributed to the underlying cause of death. For digestive cancers (Chapters 4–12), the figures for age-adjusted cancer incidence and 5-year survival were derived from data obtained by the nine registries that SEER used through the entire period 1979–2004. The survey includes all agencies that are licensed or certified (Medicare or Medicaid). Alcohol is a factor in the deaths of thousands of people younger than age 21 in the United States each year. Table 1. Figure 3. Bile Duct Cancer: Age-Adjusted Rates of Death in the United States, 1979–2004, Table 1. Atlanta, GA 30333 If cancer of the gastroesophageal junction were included among gastric cancer, the number of deaths would have increased 5.6 percent to 11,883 in 2004. Based on experience with reported outbreaks, assumed to be 1 in 10,000 cases in the United States.Percent foodborne: Nearly all outbreaks reported to CDC from 1975 through 1997 have been foodborne (CDC, unpub. Households were telephoned weekly to identify incident cases of self-defined diarrhea, vomiting, nausea, or stomach upset. The sample size is approximately 8 million hospital stays each year. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 357–408. Data are obtained directly from hospital records, thus minimizing underreporting. The six most common digestive diseases diagnoses on hospital discharge records were GERD, diverticular disease, liver disease, constipation, gallstones, and peptic ulcer disease. Pancreatitis: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004 The sample is a 100 percent count of deaths in the United States. Data are compiled twice a year. Reported cases: Outbreak-related cases based on reports to CDC, 1983-1992 (10,25). 39.). Primary Liver Cancer: Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All–Listed Diagnoses in the United States, 1979–2004, Table 3. However, this was an underestimate of the actual hospital burden, because most hospitalizations with gallstones were for cholecystectomy, of which a high proportion were performed laparoscopically without overnight stay and, therefore, not included in hospitalization statistics.22 Based on hospitalization rates prior to this shift in hospital care, gallstones would have ranked first among digestive diseases in first-listed diagnoses and second in all-listed (the first being GERD). Age-adjusted ambulatory care visits for hemorrhoids declined slightly between the periods of 1992–1993 and 2003–2005 (Figure 1).
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