Trends in childhood asthma in Denmark, Finland, Norway and Sweden

Aim: Estimate the incidence of asthma among children aged 0 to 15 years in Denmark, Finland, Norway and Sweden during 2000–2017. Methods: Cases of preschool asthma (up to 6 years) and school-age asthma (from 6 years) were identified through national registers using an algorithm including hospital diagnoses and prescription medicines. The respective cumulative incidence (CI) was estimated in 1-year age intervals for each country and birth year. Results: The CI of algorithm-based preschool asthma peaked for the birth cohorts 2008 or 2009 at 14.8% in Denmark, 11.0% in Finland, 15.1% in Norway and 13.7% in Sweden. For later birth cohorts, a slight decrease was observed. The CI of school-age asthma was 7.1% in Denmark, 10.5% in Finland, 9.7% in Norway and 10.2% in Sweden (children born in 2002). A slight decline over time was seen in Denmark and Norway, and a slight increase in Sweden and Finland. Conclusion: Finland had a markedly lower CI of preschool asthma and Denmark lower CI of school-age asthma as estimated by prescriptions and hospital diagnoses. Preschool asthma may have plateaued in the Nordic countries. For school-age asthma trends over time varied by country. Differences in diagnostic and prescription practices may have influenced the results.