The standardized incidence of RA decreased during the study period (Table 2 and Fig. 3). On average, the incidence of RA decreased by 1.6% (95% CI 0.8, 2.5) per year from 1990 to 2014. However, there were two significant joinpoints at 1994 and 2002 (supplementary Fig. S1, available at Rheumatology Online). The incidence of RA decreased by 15.7% (95% CI 8.4, 22.4) per year between 1990 and 1994, plateaued between 1994 and 2002 with an annual change in incidence of 3.0% (95% CI − 0.5, 6.7) and again decreased by 3.8% (95% CI 1.3, 4.3) per year between 2002 and 2014. As the incidence of RA was significantly higher in 1990 and 1991, we reanalysed the data on temporal trends in the incidence of RA after excluding data from these 2 years. Even after this, there was a statistically significant reduction in the annual incidence of RA of −0.9% (95% CI − 0.1, −1.6%) per year between 1992 and 2014, and the incidence of RA decreased significantly between 2003 and 2014, with an average reduction of 2.6% (95% CI 0.6, 4.6%) per year. These findings did not change when the analysis was restricted to participants with a 3 year period of registration prior to 1 January of each year (supplementary Fig. S2, available at Rheumatology Online).
Table 2
Incidence of RA from 1990 to 2014
| Year | Person-years | Incidence rate (95% CI) per 10 000 person-years | ||
|---|---|---|---|---|
| Crude | Age—sex standardizeda | Age—sex duration of data contributed standardizeda | ||
| 1990 | 402 627 | 7.67 (6.86, 8.58) | 7.81 (6.93, 8.68) | 7.46 (6.22, 8.70) |
| 1991 | 772 376 | 5.44 (4.94, 5.98) | 5.73 (5.17, 6.29) | 6.46 (4.55, 8.37) |
| 1992 | 950 289 | 4.76 (4.34, 5.22) | 5.01 (4.54, 5.48) | 4.93 (4.12, 5.75) |
| 1993 | 1 090 675 | 4.69 (4.30, 5.11) | 4.83 (4.41, 5.25) | 4.36 (3.75, 4.97) |
| 1994 | 1 189 540 | 3.94 (3.60, 4.32) | 4.02 (3.66, 4.39) | 3.85 (3.21, 4.49) |
| 1995 | 1 303 325 | 4.12 (3.79, 4.48) | 4.38 (4.00, 4.75) | 3.93 (2.89, 4.97) |
| 1996 | 1 398 690 | 3.85 (3.53, 4.19) | 4.02 (3.68, 4.36) | 3.58 (3.08, 4.08) |
| 1997 | 1 624 108 | 4.54 (4.23, 4.88) | 4.62 (4.28, 4.95) | 4.67 (4.11, 5.24) |
| 1998 | 1 877 971 | 3.98 (3.71, 4.28) | 4.01 (3.72, 4.30) | 4.22 (3.47, 4.96) |
| 1999 | 2 210 469 | 4.11 (3.85, 4.38) | 4.23 (3.95, 4.51) | 3.94 (3.52, 4.35) |
| 2000 | 2 737 196 | 4.42 (4.18, 4.68) | 4.61 (4.35, 4.87) | 4.76 (4.20, 5.32) |
| 2001 | 3 146 122 | 4.48 (4.26, 4.73) | 4.61 (4.36, 4.85) | 4.71 (4.22, 5.21) |
| 2002 | 3 493 910 | 4.64 (4.42, 4.87) | 4.76 (4.53, 5.00) | 4.64 (4.24, 5.04) |
| 2003 | 3 751 801 | 4.41 (4.20, 4.62) | 4.60 (4.37, 4.82) | 4.94 (4.40, 5.48) |
| 2004 | 3 953 837 | 4.62 (4.41, 4.84) | 4.80 (4.57, 5.02) | 5.20 (4.68, 5.72) |
| 2005 | 4 112 549 | 4.04 (3.85, 4.24) | 4.13 (3.94, 4.33) | 4.25 (3.86, 4.65) |
| 2006 | 4 172 806 | 3.92 (3.74, 4.12) | 3.99 (3.79, 4.18) | 4.18 (3.77, 4.58) |
| 2007 | 4 185 156 | 3.86 (3.68, 4.05) | 3.97 (3.78, 4.17) | 3.66 (3.32, 4.01) |
| 2008 | 4 226 454 | 3.67 (3.49, 3.86) | 3.78 (3.59, 3.97) | 3.52 (3.16, 3.87) |
| 2009 | 4 237 654 | 3.92 (3.73, 4.11) | 3.95 (3.76, 4.14) | 3.72 (3.39, 4.06) |
| 2010 | 4 165 240 | 3.72 (3.54, 3.91) | 3.75 (3.56, 3.93) | 3.52 (3.17, 3.87) |
| 2011 | 4 076 348 | 3.66 (3.48, 3.85) | 3.73 (3.54, 3.92) | 3.62 (3.28, 3.96) |
| 2012 | 4 016 632 | 3.67 (3.49, 3.87) | 3.76 (3.57, 3.96) | 3.55 (3.20, 3.90) |
| 2013 | 3 773 084 | 4.04 (3.84, 4.24) | 4.06 (3.85, 4.26) | 3.73 (3.38, 4.09) |
| 2014 | 3 413 043 | 3.81 (3.61, 4.02) | — | — |
| Year | Person-years | Incidence rate (95% CI) per 10 000 person-years | ||
|---|---|---|---|---|
| Crude | Age—sex standardizeda | Age—sex duration of data contributed standardizeda | ||
| 1990 | 402 627 | 7.67 (6.86, 8.58) | 7.81 (6.93, 8.68) | 7.46 (6.22, 8.70) |
| 1991 | 772 376 | 5.44 (4.94, 5.98) | 5.73 (5.17, 6.29) | 6.46 (4.55, 8.37) |
| 1992 | 950 289 | 4.76 (4.34, 5.22) | 5.01 (4.54, 5.48) | 4.93 (4.12, 5.75) |
| 1993 | 1 090 675 | 4.69 (4.30, 5.11) | 4.83 (4.41, 5.25) | 4.36 (3.75, 4.97) |
| 1994 | 1 189 540 | 3.94 (3.60, 4.32) | 4.02 (3.66, 4.39) | 3.85 (3.21, 4.49) |
| 1995 | 1 303 325 | 4.12 (3.79, 4.48) | 4.38 (4.00, 4.75) | 3.93 (2.89, 4.97) |
| 1996 | 1 398 690 | 3.85 (3.53, 4.19) | 4.02 (3.68, 4.36) | 3.58 (3.08, 4.08) |
| 1997 | 1 624 108 | 4.54 (4.23, 4.88) | 4.62 (4.28, 4.95) | 4.67 (4.11, 5.24) |
| 1998 | 1 877 971 | 3.98 (3.71, 4.28) | 4.01 (3.72, 4.30) | 4.22 (3.47, 4.96) |
| 1999 | 2 210 469 | 4.11 (3.85, 4.38) | 4.23 (3.95, 4.51) | 3.94 (3.52, 4.35) |
| 2000 | 2 737 196 | 4.42 (4.18, 4.68) | 4.61 (4.35, 4.87) | 4.76 (4.20, 5.32) |
| 2001 | 3 146 122 | 4.48 (4.26, 4.73) | 4.61 (4.36, 4.85) | 4.71 (4.22, 5.21) |
| 2002 | 3 493 910 | 4.64 (4.42, 4.87) | 4.76 (4.53, 5.00) | 4.64 (4.24, 5.04) |
| 2003 | 3 751 801 | 4.41 (4.20, 4.62) | 4.60 (4.37, 4.82) | 4.94 (4.40, 5.48) |
| 2004 | 3 953 837 | 4.62 (4.41, 4.84) | 4.80 (4.57, 5.02) | 5.20 (4.68, 5.72) |
| 2005 | 4 112 549 | 4.04 (3.85, 4.24) | 4.13 (3.94, 4.33) | 4.25 (3.86, 4.65) |
| 2006 | 4 172 806 | 3.92 (3.74, 4.12) | 3.99 (3.79, 4.18) | 4.18 (3.77, 4.58) |
| 2007 | 4 185 156 | 3.86 (3.68, 4.05) | 3.97 (3.78, 4.17) | 3.66 (3.32, 4.01) |
| 2008 | 4 226 454 | 3.67 (3.49, 3.86) | 3.78 (3.59, 3.97) | 3.52 (3.16, 3.87) |
| 2009 | 4 237 654 | 3.92 (3.73, 4.11) | 3.95 (3.76, 4.14) | 3.72 (3.39, 4.06) |
| 2010 | 4 165 240 | 3.72 (3.54, 3.91) | 3.75 (3.56, 3.93) | 3.52 (3.17, 3.87) |
| 2011 | 4 076 348 | 3.66 (3.48, 3.85) | 3.73 (3.54, 3.92) | 3.62 (3.28, 3.96) |
| 2012 | 4 016 632 | 3.67 (3.49, 3.87) | 3.76 (3.57, 3.96) | 3.55 (3.20, 3.90) |
| 2013 | 3 773 084 | 4.04 (3.84, 4.24) | 4.06 (3.85, 4.26) | 3.73 (3.38, 4.09) |
| 2014 | 3 413 043 | 3.81 (3.61, 4.02) | — | — |
a
To the 2014 population.
Table 2
Incidence of RA from 1990 to 2014
| Year | Person-years | Incidence rate (95% CI) per 10 000 person-years | ||
|---|---|---|---|---|
| Crude | Age—sex standardizeda | Age—sex duration of data contributed standardizeda | ||
| 1990 | 402 627 | 7.67 (6.86, 8.58) | 7.81 (6.93, 8.68) | 7.46 (6.22, 8.70) |
| 1991 | 772 376 | 5.44 (4.94, 5.98) | 5.73 (5.17, 6.29) | 6.46 (4.55, 8.37) |
| 1992 | 950 289 | 4.76 (4.34, 5.22) | 5.01 (4.54, 5.48) | 4.93 (4.12, 5.75) |
| 1993 | 1 090 675 | 4.69 (4.30, 5.11) | 4.83 (4.41, 5.25) | 4.36 (3.75, 4.97) |
| 1994 | 1 189 540 | 3.94 (3.60, 4.32) | 4.02 (3.66, 4.39) | 3.85 (3.21, 4.49) |
| 1995 | 1 303 325 | 4.12 (3.79, 4.48) | 4.38 (4.00, 4.75) | 3.93 (2.89, 4.97) |
| 1996 | 1 398 690 | 3.85 (3.53, 4.19) | 4.02 (3.68, 4.36) | 3.58 (3.08, 4.08) |
| 1997 | 1 624 108 | 4.54 (4.23, 4.88) | 4.62 (4.28, 4.95) | 4.67 (4.11, 5.24) |
| 1998 | 1 877 971 | 3.98 (3.71, 4.28) | 4.01 (3.72, 4.30) | 4.22 (3.47, 4.96) |
| 1999 | 2 210 469 | 4.11 (3.85, 4.38) | 4.23 (3.95, 4.51) | 3.94 (3.52, 4.35) |
| 2000 | 2 737 196 | 4.42 (4.18, 4.68) | 4.61 (4.35, 4.87) | 4.76 (4.20, 5.32) |
| 2001 | 3 146 122 | 4.48 (4.26, 4.73) | 4.61 (4.36, 4.85) | 4.71 (4.22, 5.21) |
| 2002 | 3 493 910 | 4.64 (4.42, 4.87) | 4.76 (4.53, 5.00) | 4.64 (4.24, 5.04) |
| 2003 | 3 751 801 | 4.41 (4.20, 4.62) | 4.60 (4.37, 4.82) | 4.94 (4.40, 5.48) |
| 2004 | 3 953 837 | 4.62 (4.41, 4.84) | 4.80 (4.57, 5.02) | 5.20 (4.68, 5.72) |
| 2005 | 4 112 549 | 4.04 (3.85, 4.24) | 4.13 (3.94, 4.33) | 4.25 (3.86, 4.65) |
| 2006 | 4 172 806 | 3.92 (3.74, 4.12) | 3.99 (3.79, 4.18) | 4.18 (3.77, 4.58) |
| 2007 | 4 185 156 | 3.86 (3.68, 4.05) | 3.97 (3.78, 4.17) | 3.66 (3.32, 4.01) |
| 2008 | 4 226 454 | 3.67 (3.49, 3.86) | 3.78 (3.59, 3.97) | 3.52 (3.16, 3.87) |
| 2009 | 4 237 654 | 3.92 (3.73, 4.11) | 3.95 (3.76, 4.14) | 3.72 (3.39, 4.06) |
| 2010 | 4 165 240 | 3.72 (3.54, 3.91) | 3.75 (3.56, 3.93) | 3.52 (3.17, 3.87) |
| 2011 | 4 076 348 | 3.66 (3.48, 3.85) | 3.73 (3.54, 3.92) | 3.62 (3.28, 3.96) |
| 2012 | 4 016 632 | 3.67 (3.49, 3.87) | 3.76 (3.57, 3.96) | 3.55 (3.20, 3.90) |
| 2013 | 3 773 084 | 4.04 (3.84, 4.24) | 4.06 (3.85, 4.26) | 3.73 (3.38, 4.09) |
| 2014 | 3 413 043 | 3.81 (3.61, 4.02) | — | — |
| Year | Person-years | Incidence rate (95% CI) per 10 000 person-years | ||
|---|---|---|---|---|
| Crude | Age—sex standardizeda | Age—sex duration of data contributed standardizeda | ||
| 1990 | 402 627 | 7.67 (6.86, 8.58) | 7.81 (6.93, 8.68) | 7.46 (6.22, 8.70) |
| 1991 | 772 376 | 5.44 (4.94, 5.98) | 5.73 (5.17, 6.29) | 6.46 (4.55, 8.37) |
| 1992 | 950 289 | 4.76 (4.34, 5.22) | 5.01 (4.54, 5.48) | 4.93 (4.12, 5.75) |
| 1993 | 1 090 675 | 4.69 (4.30, 5.11) | 4.83 (4.41, 5.25) | 4.36 (3.75, 4.97) |
| 1994 | 1 189 540 | 3.94 (3.60, 4.32) | 4.02 (3.66, 4.39) | 3.85 (3.21, 4.49) |
| 1995 | 1 303 325 | 4.12 (3.79, 4.48) | 4.38 (4.00, 4.75) | 3.93 (2.89, 4.97) |
| 1996 | 1 398 690 | 3.85 (3.53, 4.19) | 4.02 (3.68, 4.36) | 3.58 (3.08, 4.08) |
| 1997 | 1 624 108 | 4.54 (4.23, 4.88) | 4.62 (4.28, 4.95) | 4.67 (4.11, 5.24) |
| 1998 | 1 877 971 | 3.98 (3.71, 4.28) | 4.01 (3.72, 4.30) | 4.22 (3.47, 4.96) |
| 1999 | 2 210 469 | 4.11 (3.85, 4.38) | 4.23 (3.95, 4.51) | 3.94 (3.52, 4.35) |
| 2000 | 2 737 196 | 4.42 (4.18, 4.68) | 4.61 (4.35, 4.87) | 4.76 (4.20, 5.32) |
| 2001 | 3 146 122 | 4.48 (4.26, 4.73) | 4.61 (4.36, 4.85) | 4.71 (4.22, 5.21) |
| 2002 | 3 493 910 | 4.64 (4.42, 4.87) | 4.76 (4.53, 5.00) | 4.64 (4.24, 5.04) |
| 2003 | 3 751 801 | 4.41 (4.20, 4.62) | 4.60 (4.37, 4.82) | 4.94 (4.40, 5.48) |
| 2004 | 3 953 837 | 4.62 (4.41, 4.84) | 4.80 (4.57, 5.02) | 5.20 (4.68, 5.72) |
| 2005 | 4 112 549 | 4.04 (3.85, 4.24) | 4.13 (3.94, 4.33) | 4.25 (3.86, 4.65) |
| 2006 | 4 172 806 | 3.92 (3.74, 4.12) | 3.99 (3.79, 4.18) | 4.18 (3.77, 4.58) |
| 2007 | 4 185 156 | 3.86 (3.68, 4.05) | 3.97 (3.78, 4.17) | 3.66 (3.32, 4.01) |
| 2008 | 4 226 454 | 3.67 (3.49, 3.86) | 3.78 (3.59, 3.97) | 3.52 (3.16, 3.87) |
| 2009 | 4 237 654 | 3.92 (3.73, 4.11) | 3.95 (3.76, 4.14) | 3.72 (3.39, 4.06) |
| 2010 | 4 165 240 | 3.72 (3.54, 3.91) | 3.75 (3.56, 3.93) | 3.52 (3.17, 3.87) |
| 2011 | 4 076 348 | 3.66 (3.48, 3.85) | 3.73 (3.54, 3.92) | 3.62 (3.28, 3.96) |
| 2012 | 4 016 632 | 3.67 (3.49, 3.87) | 3.76 (3.57, 3.96) | 3.55 (3.20, 3.90) |
| 2013 | 3 773 084 | 4.04 (3.84, 4.24) | 4.06 (3.85, 4.26) | 3.73 (3.38, 4.09) |
| 2014 | 3 413 043 | 3.81 (3.61, 4.02) | — | — |
a
To the 2014 population.
Fig. 3
Annual incidence of RA in the UK, 1990–2014
Data given as incidence and 95% CI. Black line, prevalence; red line, upper 95% CI estimates; blue line, lower 95% CI estimates.
