Diverticular disease in Scandinavia

In radiological contrasts undertaken by Kohler (1963) on a Finnish and southern Swedish population, he found that the contrast enema rarely showed diverticular disease in the Finnish population, yet using the same radiological medium diverticular disease appears to be more common among the southern Swedish population. Although diverticular disease can be demonstrated by radiological studies with barium enemas and by double contrast, much of the statistical evidence is dominated by the UK and America.

As far back as 1925 there were studies indicating that there may be a racial difference that predisposes to diverticular disease and Larimore (1925) suggests that it is higher among the white than the black population. Hilden (1933) suggested that European racial variations were a contributing factor to the disease. The Nordic race, from which the Swedes descend, is a different race from the one from which the Finnish people descend. The Finnish people descend from the east Baltic race. Diverticulosis was seen in 5.2% of 3125 Finnish patients, whereas in the Swedish group diverticulosis was seen in 15.8% of 3563 patients. In both groups the incidence increased with age. In the Swedish series the diverticulosis was seen in the sigmoid colon, but in the Finnish series diverticulosis was seen in other segments of the colon. Eighty-six per cent of diverticulosis cases in Swedish patients occurred in the sigmoid or descending areas whereas only 66% occurred in the same bowel area in the Finnish patients. The Swedish figures correlate to the UK and US statistics.

A comparison on the same level as the Scandinavian study was undertaken in Utah, USA by Smith and Christensen in 1959, and the results were similar to the Swedish arm of Kohler's study (1963).

Although the incidence of diverticulosis in the colon appears to be three times higher in southern Sweden than in southern Finland, it is difficult to ascertain the reasons why. Although complex and not defined precisely, racial and genetic differences may be inherent, along with diet, mobility, socioeconomic factors and general way of life.

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