In the past decade, the incidence of idiopathic pulmonary fibrosis nearly tripled and prevalence more than doubled among U.S. veterans, according to an analysis published in the Annals of the American Thoracic Society.

“In 2017, approximately 91% of veterans were male and the mean age was 65 years. The mean age among the non-veteran population was 42 years old, and less than half were male,” Bhavika Kaul, MD, pulmonary/critical care physician and health services researcher in the department of medicine at the University of California, San Francisco, and the Measurement Science Quality Enhancement Research Initiative at the San Francisco Veterans Affairs Healthcare System, and colleagues wrote. “Because IPF is a disease most frequently seen in older males and because observational data has implicated exposures in the pathogenesis of disease, we hypothesized that the prevalence of IPF among veterans may be higher than what has been reported in the general population.”

This comprehensive epidemiologic analysis utilized data from 10.7 million veterans enrolled in the Veterans Health Administration electronic health record system and identified the incidence, prevalence and geographic distribution of IPF from 2010 to 2019. Researchers assessed patient characteristics associated with IPF, including age, race, ethnicity, smoking history and rural residence.

A total of 139,116 veterans had an IPF diagnosis, with IPF prevalence increasing from 276 cases per 100,000 in 2010 to 725 cases per 100,000 in 2019. In addition, the annual incidence for IPF increased from 73 cases per 100,000 person-years in 2010 to 210 cases per 100,000 person-years in 2019. Researchers observed higher absolute incidence and prevalence rates for IPF when using a broader case definition of the disease.

IPF risk factors included older age, white race, tobacco use and rural residency. Researchers noted that the average marginal difference in prevalence of IPF between men and women was small, with a significantly geographic heterogeneity of disease across the U.S.

“In this study, we used the strength of the VA learning health care system to establish a population-based cohort that can serve as the foundation for future work that uses data generated from patient-health care system interactions to more efficiently answer questions related to epidemiology, comparative effectiveness and predictive analytics in IPF with the ultimate goal of improving care for veterans with interstitial lung disease,” the researchers wrote.