Epidemiology of sarcoidosis in the United States.

Abstract

This afternoon you have listened to a series of papers on the same general subject, The Epidemiology of Sarcoidosis. Since this is the ninth and final paper in the series, I think it is appropriate to repeat a statement attributed to Dr. R. Keith Cannan: Science does not fear duplication of effort but encourages it until it has been shown that new information has been confirmed to the point of becoming established truth. In the search for a single answer, many avenues must be explored and many explorers are needed. Before mentioning the avenues which we have explored in the Veterans Administration, I should like to acknowledge the contributions of the explorers in our particular study-our Chief Medical Direetor, the .Moderator of today's session, the Chairman and study unit representatives of the Veterans Administration-Army Cooperative Study of Sarcoidosis, and the consultants (several of whom are represented here today). I think it is fair to say that in recent years this group has succeeded in arousing considerable interest in sarcoidosis. Since our experience in the epidemiology of sarcoidosis in the United States has bcen confined mainly to male war veterans, this factor should be borne in mind in interpreting the results of our studies. A. roster has bc(m kept of all veterans discharged from Veterans Administration hospitals with a diagnosis of sarcoidosis during the years 1949 to 1957, inclusive-approximately 2,000 patients. It became evident that, when one is reviewing a disease as ncbulous as sarcoidosis can be, there are going to be differences in diagnoses from one hospital to another. There are bound to be some rather dubious cases included in the statistics. In fact, of almost 300 clinical records selected for review, 10 per cent were not considered to have sarcoidosis. In about 75 per cent of the 300 cases, the diagnosis included a biopsy or examination of material obtained at autopsy. It was interesting to note the high percentage of patients in whom biopsy was performed clue to the difficulty in confirming a clinical diagnosis of sarcoidosis.