Incidence of MS in Europe

Half of the world’s MSers live in Europe. Wow! #MSBlog #MSResearch

“The overall message is that MS is common in Europe and the incidence appears to be increasing. The sex ratio increase is a surrogate of increasing incidence. Why is the incidence increasing? Some claim it is due to increasing vitamin D deficiency in woman driven by social and cultural factors; make-up with added sunblock (marketed as anti-ageing), summer-time sun-block (the dermatologists have won this one via their anti-skin cancer advertising), covering-up (religion and cultural), more indoor activity (facebook generation), pollution (filters UV light), change in diet (less fish and farmed fish that has lower vD levels), obesity (reduced circulating levels of vD), and smoking. Smoking is still a problem in young woman.”

“How will the next generation of MSers judge this generation of MS researchers when they realise that we knew that MS was a preventable disease and we didn’t start the trials to prove it? Not very well. We need to start the trials ASAP.”

Epub: Kingwell et al. Incidence and prevalence of multiple sclerosis in Europe: a systematic review. BMC Neurol. 2013 Sep 26;13(1):128.

BACKGROUND: MS is the most common cause of neurological disability in young adults worldwide and approximately half of those affected are in Europe. The assessment of differential incidence and prevalence across populations can reveal spatial, temporal and demographic patterns which are important for identifying genetic and environmental factors contributing to MS. However, study methodologies vary and the quality of the methods can influence the estimates. This study aimed to systematically review European studies of incidence and prevalence of MS and to provide a quantitative assessment of their methodological quality.

METHODS: A comprehensive literature search was performed to obtain all original population-based studies of MS incidence and prevalence in European populations conducted and published between January 1985 and January 2011. Only peer-reviewed full-text articles published in English or French were included. All abstracts were screened for eligibility and two trained reviewers abstracted the data and graded the quality of each study using a tool specifically designed for this study.

RESULTS: There were 123 studies that met the inclusion criteria. The study estimates were highly heterogeneous, even within regions or countries. Quality was generally higher in the more recent studies, which also tended to use current diagnostic criteria. Prevalence and incidence estimates tended to be higher in the more recent studies and were higher in the Nordic countries and in northern regions of the British Isles. With rare exceptions, prevalence and incidence estimates were higher in women with ratios as high as 3:1. Few studies examined ethnicity. Epidemiological data at the national level was uncommon and there were marked geographical disparities in available data, with large areas of Europe unrepresented and other regions well-represented in the literature. Only 37% of the studies provided standardized estimates.

CONCLUSIONS: Despite the breadth of the literature on the epidemiology of MS in Europe, inter-study comparisons are hampered by the lack of standardization. Further research should focus on regions not yet studied and the evaluation of ethnic differences in MS prevalence and incidence. National-level studies using current diagnostic criteria, validated case definitions and similar age- and sex-standardization would allow better geographical comparisons.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

1 comment

  • Prof G, can you tell me if the occurrence of MS is less common in mixed-race people? I ask because I thought that human cross-pollination creates a more dynamic gene pool, meaning stronger biological characteristics.

    Yet at your ECTRIMs debate, a scientist said that the only case of MS he's seen in a person from the far east was a mixed-race Philippine-French girl. He claimed it was the French component that was responsible for her developing MS.

    Are mixed-race folk more susceptible to MS.

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