Sex differences in peptic ulcer disease

Area of Science:

• Gastroenterology
• Epidemiology
• Public Health

Background:

• Historically, peptic ulcer disease (PUD) disproportionately affected men, with a 2:1 male-to-female ratio reported in the US in 1968.
• This historical disparity suggested underlying biological or lifestyle factors influencing PUD incidence.

Purpose of the Study:

• To investigate the contemporary prevalence and sex-specific trends of peptic ulcer disease in the United States.
• To analyze shifts in PUD incidence, hospitalization, and mortality rates between men and women.

Main Methods:

• Utilized data from the National Center for Health Statistics to examine current patterns of PUD frequency.
• Analyzed self-reported period prevalence, hospitalization records, and mortality data stratified by sex.

Main Results:

• The male predominance in PUD has diminished, with current male-to-female ratios of 1.0 for prevalence and 1.3 for hospitalization/mortality.
• Ulcer prevalence rates have increased in women while decreasing in men.
• Changes in hospitalization and mortality ratios are largely attributed to a faster decline in duodenal ulcer rates among men.
• Gastric ulcer hospitalizations show a marked increase in women aged over 65.

Conclusions:

• The epidemiology of peptic ulcer disease has evolved, with a near-equal prevalence between men and women.
• Increasing PUD rates in older women, particularly for gastric ulcers, warrant further investigation.
• The declining rates in men, especially for duodenal ulcers, suggest successful interventions or changing risk factors.