Rheumatoid arthritis in Canada

Highlights from the Canadian Chronic Disease Surveillance System

Rheumatoid arthritis is the most common chronic inflammatory joint disease and is a leading cause of disability worldwide.^{Footnote 1} People with rheumatoid arthritis are at a higher risk of mortality than the general population due to the associated comorbidities that present with this disease.^{Footnote 2Footnote 3} There is no cure for rheumatoid arthritis, however, early diagnosis and treatment can reduce associated joint pain and symptoms, helping individuals to live active lives.

The Public Health Agency of Canada (PHAC), in collaboration with all Canadian provinces and territories, conducts national surveillance of rheumatoid arthritis to support public health action. This fact sheet presents an overview of diagnosed rheumatoid arthritis data from the Canadian Chronic Disease Surveillance System (CCDSS). For further information, refer to What's in the Data?

What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease resulting from the body's immune system mistakenly attacking the lining of the joints and other tissues.^{Footnote 2} Inflammation in the joints causes swelling, pain, and stiffness, which left untreated, can lead to joint damage. Rheumatoid arthritis can affect multiple joints in the body and most commonly the joints of the hands, wrists, and feet. The inflammation may also affect other organs, such as the eyes, skin, lungs, or heart.

How many Canadians live with rheumatoid arthritis (prevalence) and how many are newly diagnosed each year (incidence)?

Approximately 374,000 (1.2%) Canadians aged 16 years and older live with diagnosed rheumatoid arthritis and 23,000 (0.8 per 1,000 persons per year) were newly diagnosed in 2016–2017. The prevalence and incidence of diagnosed rheumatoid arthritis generally increase with age and are higher among females (1.7% and 1.0 per 1,000 persons per year, respectively) compared to males (0.8% and 0.5 per 1,000 persons per year, respectively) (Figures 1 and 2).

Footnote a

Data from SK were not available for fiscal year 2016–2017. Data from NL were excluded.

Return to footnote a referrer

Notes: The 95% confidence interval shows an estimated range of values which is likely to include the true prevalence 19 times out of 20.

Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, August 2019.

Text description

Age Group (years)	Prevalence among females for fiscal year 2016-2017	Prevalence among males for fiscal year 2016-2017	Total prevalence for fiscal year 2016-2017
16-19	0.1	0.0	0.0
20-24	0.2	0.1	0.1
25-29	0.2	0.1	0.2
30-34	0.4	0.1	0.2
35-39	0.6	0.2	0.4
40-44	0.8	0.3	0.6
45-49	1.1	0.5	0.8
50-54	1.5	0.7	1.1
55-59	2.1	0.9	1.5
60-64	2.7	1.3	2.0
65-69	3.3	1.6	2.5
70-74	4.0	2.0	3.0
75-79	4.5	2.5	3.6
80-84	5.0	2.9	4.1
85-89	5.2	3.3	4.4
90+	4.9	3.4	4.5
Overall (16+)	1.7	0.8	1.2

Footnote b

Data from SK were not available for fiscal year 2016–2017. Data from NL were excluded.

Return to footnote b referrer

Notes: The 95% confidence interval shows an estimated range of values which is likely to include the true incidence 19 times out of 20.

Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, August 2019.

Text description

Age Group (years)	Incidence among females for fiscal year 2016-2017	Incidence among males for fiscal year 2016-2017	Total incidence for fiscal year 2016-2017
16-19	0.3	0.2	0.3
20-24	0.2	0.1	0.2
25-29	0.3	0.1	0.2
30-34	0.4	0.1	0.2
35-39	0.6	0.2	0.4
40-44	0.7	0.3	0.5
45-49	0.9	0.4	0.6
50-54	1.2	0.5	0.8
55-59	1.4	0.7	1.1
60-64	1.5	0.9	1.2
65-69	1.7	1.0	1.3
70-74	1.8	1.2	1.5
75-79	2.0	1.4	1.7
80-84	2.2	1.5	1.9
85-89	2.1	1.5	1.8
90+	1.7	1.2	1.5
Overall (16+)	1.0	0.5	0.8

What are the trends over time?

Between 2007–2008 and 2016–2017, the age-standardized prevalence of diagnosed rheumatoid arthritis increased among females (from 1.3% to 1.5%) and remained around 0.7% among males (Figure 3).

During the same time period, the age-standardized incidence of diagnosed rheumatoid arthritis decreased from 1.2 to 0.9 per 1,000 persons per year in females and from 0.6 to 0.5 per 1,000 persons per year in males.

Footnote c

Rates were age-standardized to the 2011 final postcensal Canada population released in 2013.

Return to footnote c referrer

Footnote d

Data from SK were not available for fiscal year 2016–2017. Data from YT were excluded before fiscal year 2010–2011. Data from NL were excluded.

Return to footnote d referrer

Notes: The 95% confidence interval shows an estimated range of values which is likely to include the true value 19 times out of 20.

Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, August 2019.

Text description

Fiscal Year	Age-standardized prevalence among females aged 16 years and older	Age-standardized prevalence among males aged 16 years and older	Age-standardized incidence among females aged 16 years and older	Age-standardized incidence among males aged 16 years and older
2007-2008	1.3	0.7	1.2	0.6
2008-2009	1.4	0.7	1.2	0.6
2009-2010	1.4	0.7	1.1	0.6
2010-2011	1.4	0.7	1.1	0.6
2011-2012	1.4	0.7	1.1	0.6
2012-2013	1.5	0.7	1.1	0.6
2013-2014	1.5	0.7	1.0	0.5
2014-2015	1.5	0.7	1.0	0.5
2015-2016	1.5	0.7	1.0	0.5
2016-2017	1.5	0.7	0.9	0.5

What are the mortality rates (due to any cause of death) among Canadians with or without rheumatoid arthritis?

Between 2007–2008 and 2016–2017, age-standardized all-cause mortality rates (i.e. mortality due to any cause) decreased among females with diagnosed rheumatoid arthritis (11.2 per 1,000 persons per year to 9.7 per 1,000 persons per year) and among males with diagnosed rheumatoid arthritis (16.6 per 1,000 persons per year to 14.2 per 1,000 persons per year) (Figure 4). Mortality rates were consistently higher among males compared to females.

Over the surveillance period, the age-standardized all-cause mortality rate ratios (i.e., comparing individuals with, versus without, diagnosed rheumatoid arthritis) were relatively stable ranging from 1.7 to 1.6 in females and from 1.5 to 1.7 in males. While rate ratios were similar among females and males, they showed an increase in mortality risk among those with diagnosed rheumatoid arthritis.

Footnote e

Rates were age-standardized to the 2011 final postcensal Canada population released in 2013.

Return to footnote e referrer

Footnote f

Data from SK were not available for fiscal year 2016–2017. Data from YT were excluded before fiscal year 2010–2011. Data from NL were excluded.

Return to footnote f referrer

Notes: The 95% confidence interval shows an estimated range of values that is likely to include the true value 19 times out of 20.

Data source: Public Health Agency of Canada, using CCDSS data files contributed by provinces and territories, August 2019.

Text description

Fiscal Year	Age-standardized all-cause mortality among females aged 16 years and older with diagnosed rheumatoid arthritis	Age-standardized all-cause mortality among females aged 16 years and older without diagnosed rheumatoid arthritis	Age-standardized all-cause mortality among males aged 16 years and older with diagnosed diagnosed rheumatoid arthritis	Age-standardized all-cause mortality among males aged 16 years and older without diagnosed diagnosed rheumatoid arthritis	Rate ratio among females aged 16 years and older (females with versus without diagnosed diagnosed rheumatoid arthritis)	Rate ratio among males aged 16 years and older (males with versus without diagnosed diagnosed rheumatoid arthritis)
2007-2008	11.2	6.6	16.5	9.8	1.7	1.7
2008-2009	10.8	6.6	16.2	9.7	1.7	1.7
2009-2010	10.5	6.4	14.9	9.3	1.6	1.6
2010-2011	11.1	6.4	15.3	9.2	1.7	1.7
2011-2012	9.7	6.1	14.9	8.8	1.6	1.7
2012-2013	9.7	6.2	14.3	8.8	1.6	1.7
2013-2014	9.7	6.0	13.8	8.4	1.6	1.6
2014-2015	9.9	6.2	13.3	8.6	1.6	1.5
2015-2016	9.8	5.9	13.6	8.5	1.7	1.6
2016-2017	9.6	6.0	14.2	8.5	1.6	1.7

How can rheumatoid arthritis be managed?

The specific causes of rheumatoid arthritis are unknown, but there are a number of factors associated with an increased risk of developing the disease including family history, smoking, increased age and occupational exposures.^{Footnote 4Footnote 5} While there is no cure for rheumatoid arthritis, there are treatment options which aim to alleviate joint symptoms and improve function. Individuals often work with a rheumatologist to develop a treatment plan to prevent further joint damage. Medication is often prescribed as a first line of therapy and is key to controlling disease and preventing damage. Other ways to manage include physical therapy, occupational therapy and education.^{Footnote 6} Individuals with rheumatoid arthritis who are diagnosed and treated early are less likely to experience long-term joint damage and functional impairments.

What do the national data on rheumatoid arthritis tell us?

• The prevalence and incidence of diagnosed rheumatoid arthritis are more common among females compared to males and increase with age.

Acknowledgements

This work was made possible through collaboration between PHAC and all Canadian provincial and territorial governments and expert contribution from the CCDSS Arthritis Working Group. Results and interpretations reported in this fact sheet are those of the authors. No endorsement by the provinces and territories is intended or should be inferred.

How to learn more

Visit: Canada.ca search "arthritis" or "rheumatoid arthritis"

Get data: Canadian Chronic Disease Surveillance System Data Tool

Follow us: @GovCanHealth

Like us: @HealthyCdns

More: visit the Arthritis Society

References