In Europe and North America, the incidence of idiopathic pulmonary fibrosis (IPF) has been estimated to be between 2.8 and 19 per 100,000 persons per year; incidence in Asia is lower (1.2 to 4.6 per 100,000 persons per year).[6]Hutchinson J, Fogarty A, Hubbard R, et al. Global incidence and mortality of idiopathic pulmonary fibrosis: a systematic review. Eur Respir J. 2015 Sep;46(3):795-806.
https://erj.ersjournals.com/content/46/3/795.long
http://www.ncbi.nlm.nih.gov/pubmed/25976683?tool=bestpractice.com
[7]Caminati A, Madotto F, Cesana G, et al. Epidemiological studies in idiopathic pulmonary fibrosis: pitfalls in methodologies and data interpretation. Eur Respir Rev. 2015 Sep;24(137):436-44.
https://err.ersjournals.com/content/24/137/436.long
http://www.ncbi.nlm.nih.gov/pubmed/26324805?tool=bestpractice.com
[8]Olson AL, Gifford AH, Inase N, et al. The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype. Eur Respir Rev. 2018 Dec 31;27(150):180077.
https://err.ersjournals.com/content/27/150/180077.long
http://www.ncbi.nlm.nih.gov/pubmed/30578336?tool=bestpractice.com
Approximately two-thirds of patients are older than 60 years at diagnosis (mean age at diagnosis is between 60 and 70 years).[1]Raghu G, Remy-Jardin M, Myers JL, et al; American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2018 Sep 1;198(5):e44-68.
https://www.atsjournals.org/doi/full/10.1164/rccm.201807-1255ST
http://www.ncbi.nlm.nih.gov/pubmed/30168753?tool=bestpractice.com
[8]Olson AL, Gifford AH, Inase N, et al. The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype. Eur Respir Rev. 2018 Dec 31;27(150):180077.
https://err.ersjournals.com/content/27/150/180077.long
http://www.ncbi.nlm.nih.gov/pubmed/30578336?tool=bestpractice.com
Among people ages ≥65 years in the US Medicare population, an IPF incidence of 93.7 per 100,000 persons per year has been reported.[9]Raghu G, Chen SY, Yeh WS, et al. Idiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: incidence, prevalence, and survival, 2001-11. Lancet Respir Med. 2014 Jul;2(7):566-72.
http://www.ncbi.nlm.nih.gov/pubmed/24875841?tool=bestpractice.com
Prevalence in this population was 494.5 cases per 100,000 persons.[9]Raghu G, Chen SY, Yeh WS, et al. Idiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: incidence, prevalence, and survival, 2001-11. Lancet Respir Med. 2014 Jul;2(7):566-72.
http://www.ncbi.nlm.nih.gov/pubmed/24875841?tool=bestpractice.com
A higher proportion of males than females develop IPF.[8]Olson AL, Gifford AH, Inase N, et al. The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype. Eur Respir Rev. 2018 Dec 31;27(150):180077.
https://err.ersjournals.com/content/27/150/180077.long
http://www.ncbi.nlm.nih.gov/pubmed/30578336?tool=bestpractice.com
There is no known ethnic or racial predilection for the development of IPF. The disease is very rare in children.[10]Nathan N, Sileo C, Thouvenin G, et al. Pulmonary fibrosis in children. J Clin Med. 2019 Aug 26;8(9):1312.
https://www.mdpi.com/2077-0383/8/9/1312
http://www.ncbi.nlm.nih.gov/pubmed/31455000?tool=bestpractice.com
IPF incidence appears to be increasing with time, even when allowing for aging populations and improved diagnostic sensitivity.[11]Navaratnam V, Fleming KM, West J, et al. The rising incidence of idiopathic pulmonary fibrosis in the U.K. Thorax. 2011 Jun;66(6):462-7.
http://www.ncbi.nlm.nih.gov/pubmed/21525528?tool=bestpractice.com
[12]Gupta R, Morgan AD, George PM, et al. Incidence, prevalence and mortality of idiopathic pulmonary fibrosis in England from 2008 to 2018: a cohort study. Thorax. 2024 Jun 14;79(7):624-31.
http://www.ncbi.nlm.nih.gov/pubmed/38688708?tool=bestpractice.com
This may be related, in part, to a growing awareness of IPF, particularly among general practitioners, as well as increased CT utilization in older patients.[13]Harari S, Davì M, Biffi A, et al. Epidemiology of idiopathic pulmonary fibrosis: a population-based study in primary care. Intern Emerg Med. 2020 Apr;15(3):437-45.
http://www.ncbi.nlm.nih.gov/pubmed/31541394?tool=bestpractice.com
[14]Smith-Bindman R, Kwan ML, Marlow EC, et al. Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016. JAMA. 2019 Sep 3;322(9):843-56.
https://jamanetwork.com/journals/jama/fullarticle/2749213
http://www.ncbi.nlm.nih.gov/pubmed/31479136?tool=bestpractice.com
Acute exacerbations
The annual incidence of acute exacerbations without an identifiable cause is estimated to range from 4 to 20 per 100 patient-years.[15]Collard HR, Ryerson CJ, Corte TJ, et al. Acute exacerbation of idiopathic pulmonary fibrosis. an international working group report. Am J Respir Crit Care Med. 2016 Aug 1;194(3):265-75.
https://www.atsjournals.org/doi/10.1164/rccm.201604-0801CI?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
http://www.ncbi.nlm.nih.gov/pubmed/27299520?tool=bestpractice.com
Acute exacerbations are more common in patients with physiologically and functionally advanced disease. One retrospective review found that 35% of IPF patients had at least one episode of rapid deterioration, of whom 55% were considered to have had an acute exacerbation.
Familial pulmonary fibrosis
Present in a subset of patients with IPF. Familial linkage is suggested by an increased prevalence of 10% in first-degree relatives.[16]Borie R, Kannengiesser C, Antoniou K, et al. European Respiratory Society statement on familial pulmonary fibrosis. Eur Respir J. 2023 Mar;61(3):2201383.
https://erj.ersjournals.com/content/61/3/2201383.long
http://www.ncbi.nlm.nih.gov/pubmed/36549714?tool=bestpractice.com
Although this condition is indistinguishable from the sporadic form, it typically afflicts patients at a younger age (mean age at diagnosis is 55-60 years).[17]Marshall RP, Puddicombe A, Cookson WO, et al. Adult familial cryptogenic fibrosing alveolitis in the United Kingdom. Thorax. 2000 Feb;55(2):143-6.
http://www.ncbi.nlm.nih.gov/pubmed/10639533?tool=bestpractice.com
[18]Lee HL, Ryu JH, Wittmer MH, et al. Familial idiopathic pulmonary fibrosis: clinical features and outcome. Chest. 2005 Jun;127(6):2034-41.
http://www.ncbi.nlm.nih.gov/pubmed/15947317?tool=bestpractice.com