Saskatchewan is often cited as having one of the highest rates of multiple sclerosis (MS) in Canada, but until now, the actual number of people with the disease in our province was unknown. With funding from a Saskatchewan Health Research Foundation (SHRF) Establishment grant, Dr. Charity Evans and her PhD student, Lina Al-Sakran, have confirmed that Saskatchewan does have one of the highest rates of MS in Canada, and worldwide, by establishing the incidence and prevalence of the disease in the province.
Incidence – how many people are being diagnosed with MS every year
Prevalence – how many people currently live with MS in Saskatchewan
The Saskatchewan government maintains several databases that record health services delivered to the majority of residents who are entitled to publicly funded provincial health care benefits. By looking at physician claims, hospital visits, prescription drugs, vital statistics and population registry information, Evans and Al-Sakran began to identify the number of individuals with MS based on their use of health care for reasons that are likely related to MS. To ensure correct identification of individuals with MS, they tested a number of definitions and found two that were most accurate for Saskatchewan data (Marrie definition and the Canadian Chronic Disease Surveillance System (CCDSS) definition).
Using the more sensitive case definition of MS (Marrie definition), there were 2,226 incident cases of MS identified between 2001 and 2013. Approximately 70 per cent of these cases were women with an average age of 43 during the year of symptom onset. Using this same definition, as of July 1, 2013, there were 3,456 individuals living with MS in Saskatchewan. Prevalence was higher in females, with a female to male ratio of 2.42. Similar to other regions in Canada, it was found that incidence has remained stable while prevalence has gradually increased. In 2013, 314 individuals per 100,000 in Saskatchewan were identified as living with MS.
The causes of MS remain elusive, but some evidence suggests that geographic and environmental factors play a role. Evans’ work to establish the incidence and prevalence of MS in Saskatchewan will contribute toward a better understanding of geographic and environmental factors, while helping to inform decision making when it comes to future health care planning and resource allocation.
Evans’ next step will be to determine the actual distribution of MS throughout the province, a project supported by the Saskatchewan Centre for Patient-Oriented Research (SCPOR). This will help identify any possible geographical patterns of MS, which may prove useful in trying to unravel the cause of MS.
“Knowing not just the incidence and prevalence of MS in Saskatchewan, but also where these individuals are located throughout the province is extremely important, as this will help inform decisions related to treatment, health care delivery, policy development and resource planning,” says Evans. “Ultimately, this information will provide benefit to the Saskatchewan health care system, the MS research community, and most importantly, the individuals who are affected by MS.”