Epidemiology of Haemorrhoids and Publicly-Funded Excisional Haemorrhoidectomiesin New Zealand (2007 - 2016): A Population-Based Cross-Sectional Study.

AIM Haemorrhoids are frequently encountered by the general or colorectal surgeon. Although a benign disease, those with symptomatic, advanced grades frequently require excisional haemorrhoidectomy for definitive management. Despite their wide-spread nature, the epidemiological burden of haemorrhoids and haemorrhoidectomies on populations is not well described. This study seeks to establish the incidence of both haemorrhoids diagnosed and haemorrhoidectomies performed in New Zealand. METHOD This is a population-based cross-sectional study examining the incidence of all patients who were newly diagnosed with haemorrhoids in New Zealand public hospital outpatient clinicsand those who received excisional haemorrhoidectomy in New Zealand public hospitals from 2007 to 2016. Data were extracted and linked using the New Zealand National Minimum Dataset and the National Non-Admitted Patient Collection. Variables collected included age group, sex, ethnicity and geographical location. RESULTS A total of 46,095 recorded diagnoses of haemorrhoids were made, with a total of 18,739 haemorrhoidectomies in the 10-year period recorded. The incidence rate of diagnosis increased from 84.6 to 120.5 per 100,000 and the incidence rate of haemorrhoidectomies performed from 30.4 to 51.1 per 100,000, a significantly increased annual incidence. There was a unimodal peak prevalence in the 5th decade of life with females more affected. Europeans formed the largest group affected, with Asians showing the highest rate of increased incidence. CONCLUSION There is an increasing incidence of patients with symptomatic haemorrhoidspresenting to the New Zealand public healthcare system, with a preponderance in working age adults, especially females.