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Published in: European Journal of Epidemiology 2/2016

01-02-2016 | METHODS

Registers of the Swedish total population and their use in medical research

Authors: Jonas F. Ludvigsson, Catarina Almqvist, Anna-Karin Edstedt Bonamy, Rickard Ljung, Karl Michaëlsson, Martin Neovius, Olof Stephansson, Weimin Ye

Published in: European Journal of Epidemiology | Issue 2/2016

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Abstract

The primary aim of the Swedish national population registration system is to obtain data that (1) reflect the composition, relationship and identities of the Swedish population and (2) can be used as the basis for correct decisions and measures by government and other regulatory authorities. For this purpose, Sweden has established two population registers: (1) The Population Register, maintained by the Swedish National Tax Agency (“Folkbokföringsregistret”); and (2) The Total Population Register (TPR) maintained by the government agency Statistics Sweden (“Registret över totalbefolkningen”). The registers contain data on life events including birth, death, name change, marital status, family relationships and migration within Sweden as well as to and from other countries. Updates are transmitted daily from the Tax Agency to the TPR. In this paper we describe the two population registers and analyse their strengths and weaknesses. Virtually 100 % of births and deaths, 95 % of immigrations and 91 % of emigrations are reported to the Population Registers within 30 days and with a higher proportion over time. The over-coverage of the TPR, which is primarily due to underreported emigration data, has been estimated at up to 0.5 % of the Swedish population. Through the personal identity number, assigned to all residents staying at least 1 year in Sweden, data from the TPR can be used for medical research purposes, including family design studies since each individual can be linked to his or her parents, siblings and offspring. The TPR also allows for identification of general population controls, participants in cohort studies, as well as calculation of follow-up time.
Literature
1.
go back to reference Ludvigsson JF, Otterblad-Olausson P, Pettersson BU, Ekbom A. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research. Eur J Epidemiol. 2009;24(11):659–67.CrossRefPubMedPubMedCentral Ludvigsson JF, Otterblad-Olausson P, Pettersson BU, Ekbom A. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research. Eur J Epidemiol. 2009;24(11):659–67.CrossRefPubMedPubMedCentral
2.
go back to reference Swedish_National_Tax_Agency. Den svenska folkbokföringens historia under tre sekler [English: The Swedish national population registration - history of the last 300 years], 2015. Swedish_National_Tax_Agency. Den svenska folkbokföringens historia under tre sekler [English: The Swedish national population registration - history of the last 300 years], 2015.
3.
go back to reference Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Olika familjer lever på olika sätt - om barns boende och försörjning efter en separation. Demogragfiska rapporter 2014:01 [English: Different families have different ways of living—about children’s living and support after a separation], 2014. Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Olika familjer lever på olika sätt - om barns boende och försörjning efter en separation. Demogragfiska rapporter 2014:01 [English: Different families have different ways of living—about children’s living and support after a separation], 2014.
5.
go back to reference Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Overcoverage in the Total Population Register—a register study. Background facts. Population and Welfare 2015;1. Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Overcoverage in the Total Population Register—a register study. Background facts. Population and Welfare 2015;1.
6.
go back to reference Eriksson JK, Neovius M, Ernestam S, Lindblad S, Simard JF, Askling J. Incidence of rheumatoid arthritis in Sweden: a nationwide population-based assessment of incidence, its determinants, and treatment penetration. Arthritis Care Res (Hoboken). 2013;65(6):870–8.CrossRef Eriksson JK, Neovius M, Ernestam S, Lindblad S, Simard JF, Askling J. Incidence of rheumatoid arthritis in Sweden: a nationwide population-based assessment of incidence, its determinants, and treatment penetration. Arthritis Care Res (Hoboken). 2013;65(6):870–8.CrossRef
7.
go back to reference Busch K, Ludvigsson JF, Ekstrom-Smedby K, Ekbom A, Askling J, Neovius M. Nationwide prevalence of inflammatory bowel disease in Sweden: a population-based register study. Aliment Pharmacol Ther. 2014;39(1):57–68.CrossRefPubMed Busch K, Ludvigsson JF, Ekstrom-Smedby K, Ekbom A, Askling J, Neovius M. Nationwide prevalence of inflammatory bowel disease in Sweden: a population-based register study. Aliment Pharmacol Ther. 2014;39(1):57–68.CrossRefPubMed
8.
go back to reference Johansson B, Helgesson M, Lundberg I, Nordquist T, Leijon O, Lindberg P, Vingard E. Work and health among immigrants and native Swedes 1990–2008: a register-based study on hospitalization for common potentially work-related disorders, disability pension and mortality. BMC Public Health. 2012;12:845.CrossRefPubMedPubMedCentral Johansson B, Helgesson M, Lundberg I, Nordquist T, Leijon O, Lindberg P, Vingard E. Work and health among immigrants and native Swedes 1990–2008: a register-based study on hospitalization for common potentially work-related disorders, disability pension and mortality. BMC Public Health. 2012;12:845.CrossRefPubMedPubMedCentral
9.
go back to reference Ji J, Ludvigsson JF, Sundquist K, Sundquist J, Hemminki K. Incidence of celiac disease among second-generation immigrants and adoptees from abroad in Sweden: evidence for ethnic differences in susceptibility. Scand J Gastroenterol. 2011;46(7–8):844–8.CrossRefPubMed Ji J, Ludvigsson JF, Sundquist K, Sundquist J, Hemminki K. Incidence of celiac disease among second-generation immigrants and adoptees from abroad in Sweden: evidence for ethnic differences in susceptibility. Scand J Gastroenterol. 2011;46(7–8):844–8.CrossRefPubMed
10.
go back to reference Lindblad F, Weitoft GR, Hjern A. ADHD in international adoptees: a national cohort study. Eur Child Adolesc Psychiatry. 2010;19(1):37–44.CrossRefPubMed Lindblad F, Weitoft GR, Hjern A. ADHD in international adoptees: a national cohort study. Eur Child Adolesc Psychiatry. 2010;19(1):37–44.CrossRefPubMed
11.
go back to reference Wicks S, Hjern A, Dalman C. Social risk or genetic liability for psychosis? A study of children born in Sweden and reared by adoptive parents. Am J Psychiatry. 2010;167(10):1240–6.CrossRefPubMed Wicks S, Hjern A, Dalman C. Social risk or genetic liability for psychosis? A study of children born in Sweden and reared by adoptive parents. Am J Psychiatry. 2010;167(10):1240–6.CrossRefPubMed
12.
go back to reference Bjorkenstam E, Hallqvist J, Dalman C, Ljung R. Risk of new psychiatric episodes in the year following divorce in midlife: cause or selection? A nationwide register-based study of 703,960 individuals. Int J Soc Psychiatry. 2013;59(8):801–4.CrossRefPubMed Bjorkenstam E, Hallqvist J, Dalman C, Ljung R. Risk of new psychiatric episodes in the year following divorce in midlife: cause or selection? A nationwide register-based study of 703,960 individuals. Int J Soc Psychiatry. 2013;59(8):801–4.CrossRefPubMed
13.
go back to reference Wallby T, Modin B, Hjern A. Child health care utilisation in families with young or single mothers in a Swedish county. J Child Health Care. 2013;17:17–29.PubMed Wallby T, Modin B, Hjern A. Child health care utilisation in families with young or single mothers in a Swedish county. J Child Health Care. 2013;17:17–29.PubMed
14.
go back to reference Frisell T, Lichtenstein P, Langstrom N. Violent crime runs in families: a total population study of 12.5 million individuals. Psychol Med. 2011;41(1):97–105.CrossRefPubMed Frisell T, Lichtenstein P, Langstrom N. Violent crime runs in families: a total population study of 12.5 million individuals. Psychol Med. 2011;41(1):97–105.CrossRefPubMed
15.
go back to reference Laszlo KD, Svensson T, Li J, Obel C, Vestergaard M, Olsen J, Cnattingius S. Maternal bereavement during pregnancy and the risk of stillbirth: a nationwide cohort study in Sweden. Am J Epidemiol. 2013;177(3):219–27.CrossRefPubMed Laszlo KD, Svensson T, Li J, Obel C, Vestergaard M, Olsen J, Cnattingius S. Maternal bereavement during pregnancy and the risk of stillbirth: a nationwide cohort study in Sweden. Am J Epidemiol. 2013;177(3):219–27.CrossRefPubMed
16.
go back to reference Sariaslan A, Larsson H, D’Onofrio B, Langstrom N, Fazel S, Lichtenstein P. Does population density and neighborhood deprivation predict schizophrenia? A nationwide Swedish family-based study of 2.4 million individuals. Schizophr Bull. 2015;41(2):494–502.CrossRefPubMedPubMedCentral Sariaslan A, Larsson H, D’Onofrio B, Langstrom N, Fazel S, Lichtenstein P. Does population density and neighborhood deprivation predict schizophrenia? A nationwide Swedish family-based study of 2.4 million individuals. Schizophr Bull. 2015;41(2):494–502.CrossRefPubMedPubMedCentral
17.
go back to reference Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO. External review and validation of the Swedish national inpatient register. BMC Public Health. 2011;11(1):450.CrossRefPubMedPubMedCentral Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO. External review and validation of the Swedish national inpatient register. BMC Public Health. 2011;11(1):450.CrossRefPubMedPubMedCentral
18.
go back to reference Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009;302(11):1171–8.CrossRefPubMed Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009;302(11):1171–8.CrossRefPubMed
19.
go back to reference Herweijer E, Leval A, Ploner A, Eloranta S, Simard JF, Dillner J, Netterlid E, Sparen P, Arnheim-Dahlstrom L. Association of varying number of doses of quadrivalent human papillomavirus vaccine with incidence of condyloma. JAMA. 2014;311(6):597–603.CrossRefPubMed Herweijer E, Leval A, Ploner A, Eloranta S, Simard JF, Dillner J, Netterlid E, Sparen P, Arnheim-Dahlstrom L. Association of varying number of doses of quadrivalent human papillomavirus vaccine with incidence of condyloma. JAMA. 2014;311(6):597–603.CrossRefPubMed
20.
go back to reference Melander O, Maisel AS, Almgren P, Manjer J, Belting M, Hedblad B, Engstrom G, Kilger U, Nilsson P, Bergmann A, Orho-Melander M. Plasma proneurotensin and incidence of diabetes, cardiovascular disease, breast cancer, and mortality. JAMA. 2012;308(14):1469–75.CrossRefPubMed Melander O, Maisel AS, Almgren P, Manjer J, Belting M, Hedblad B, Engstrom G, Kilger U, Nilsson P, Bergmann A, Orho-Melander M. Plasma proneurotensin and incidence of diabetes, cardiovascular disease, breast cancer, and mortality. JAMA. 2012;308(14):1469–75.CrossRefPubMed
21.
go back to reference Melander O, Newton-Cheh C, Almgren P, Hedblad B, Berglund G, Engstrom G, Persson M, Smith JG, Magnusson M, Christensson A, Struck J, Morgenthaler NG, Bergmann A, Pencina MJ, Wang TJ. Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. JAMA. 2009;302(1):49–57.CrossRefPubMedPubMedCentral Melander O, Newton-Cheh C, Almgren P, Hedblad B, Berglund G, Engstrom G, Persson M, Smith JG, Magnusson M, Christensson A, Struck J, Morgenthaler NG, Bergmann A, Pencina MJ, Wang TJ. Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. JAMA. 2009;302(1):49–57.CrossRefPubMedPubMedCentral
22.
go back to reference Ludvigsson JF, Welander A, Lassila R, Ekbom A, Montgomery SM. Risk of thromboembolism in 14,000 individuals with coeliac disease. Br J Haematol. 2007;139(1):121–7.CrossRefPubMed Ludvigsson JF, Welander A, Lassila R, Ekbom A, Montgomery SM. Risk of thromboembolism in 14,000 individuals with coeliac disease. Br J Haematol. 2007;139(1):121–7.CrossRefPubMed
23.
go back to reference Ludvigsson JF, Olsson T, Ekbom A, Montgomery SM. A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther. 2007;25(11):1317–27.CrossRefPubMed Ludvigsson JF, Olsson T, Ekbom A, Montgomery SM. A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther. 2007;25(11):1317–27.CrossRefPubMed
24.
go back to reference Song H, Ekheden IG, Zheng Z, Ericsson J, Nyren O, Ye W. Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population. BMJ. 2015;351:h3867.CrossRefPubMedPubMedCentral Song H, Ekheden IG, Zheng Z, Ericsson J, Nyren O, Ye W. Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population. BMJ. 2015;351:h3867.CrossRefPubMedPubMedCentral
25.
go back to reference Holmqvist ME, Neovius M, Eriksson J, Mantel A, Wallberg-Jonsson S, Jacobsson LT, Askling J. Risk of venous thromboembolism in patients with rheumatoid arthritis and association with disease duration and hospitalization. JAMA. 2012;308(13):1350–6.CrossRefPubMed Holmqvist ME, Neovius M, Eriksson J, Mantel A, Wallberg-Jonsson S, Jacobsson LT, Askling J. Risk of venous thromboembolism in patients with rheumatoid arthritis and association with disease duration and hospitalization. JAMA. 2012;308(13):1350–6.CrossRefPubMed
26.
go back to reference Bjorkenstam C, Weitoft GR, Hjern A, Nordstrom P, Hallqvist J, Ljung R. School grades, parental education and suicide—a national register-based cohort study. J Epidemiol Community Health. 2011;65(11):993–8.CrossRefPubMed Bjorkenstam C, Weitoft GR, Hjern A, Nordstrom P, Hallqvist J, Ljung R. School grades, parental education and suicide—a national register-based cohort study. J Epidemiol Community Health. 2011;65(11):993–8.CrossRefPubMed
27.
go back to reference Ljung R, Lagergren J, Bexelius TS, Mattsson F, Lindblad M. Increased risk of acute pancreatitis among tetracycline users in a Swedish population-based case-control study. Gut. 2012;61(6):873–6.CrossRefPubMed Ljung R, Lagergren J, Bexelius TS, Mattsson F, Lindblad M. Increased risk of acute pancreatitis among tetracycline users in a Swedish population-based case-control study. Gut. 2012;61(6):873–6.CrossRefPubMed
28.
go back to reference Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344(11):808–14.CrossRefPubMed Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344(11):808–14.CrossRefPubMed
29.
go back to reference Lind M, Svensson AM, Kosiborod M, Gudbjornsdottir S, Pivodic A, Wedel H, Dahlqvist S, Clements M, Rosengren A. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972–82.CrossRefPubMed Lind M, Svensson AM, Kosiborod M, Gudbjornsdottir S, Pivodic A, Wedel H, Dahlqvist S, Clements M, Rosengren A. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972–82.CrossRefPubMed
30.
go back to reference Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340(11):825–31.CrossRefPubMed Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340(11):825–31.CrossRefPubMed
31.
go back to reference Huang J, Magnusson M, Torner A, Ye W, Duberg AS. Risk of pancreatic cancer among individuals with hepatitis C or hepatitis B virus infection: a nationwide study in Sweden. Br J Cancer. 2013;109(11):2917–23.CrossRefPubMedPubMedCentral Huang J, Magnusson M, Torner A, Ye W, Duberg AS. Risk of pancreatic cancer among individuals with hepatitis C or hepatitis B virus infection: a nationwide study in Sweden. Br J Cancer. 2013;109(11):2917–23.CrossRefPubMedPubMedCentral
32.
go back to reference Eriksson JK, Neovius M, Bratt J, Petersson IF, van Vollenhoven RF, Geborek P, Ernestam S. Biological vs. conventional combination treatment and work loss in early rheumatoid arthritis: a randomized trial. JAMA Intern Med. 2013;173(15):1407–14.CrossRefPubMed Eriksson JK, Neovius M, Bratt J, Petersson IF, van Vollenhoven RF, Geborek P, Ernestam S. Biological vs. conventional combination treatment and work loss in early rheumatoid arthritis: a randomized trial. JAMA Intern Med. 2013;173(15):1407–14.CrossRefPubMed
33.
go back to reference Ludvigsson JF, Haberg SE, Knudsen GP, Lafolie P, Zoega H, Sarkkola C, von Kraemer S, Weiderpass E, Norgaard M. Ethical aspects of registry-based research in the Nordic countries. Clin Epidemiol. 2015;7:491–508.CrossRefPubMedPubMedCentral Ludvigsson JF, Haberg SE, Knudsen GP, Lafolie P, Zoega H, Sarkkola C, von Kraemer S, Weiderpass E, Norgaard M. Ethical aspects of registry-based research in the Nordic countries. Clin Epidemiol. 2015;7:491–508.CrossRefPubMedPubMedCentral
34.
go back to reference Council_of_the_European_Union. Proposal for a Regulation of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data (General Data Protection Regulation), 2015. Council_of_the_European_Union. Proposal for a Regulation of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data (General Data Protection Regulation), 2015.
35.
go back to reference Swedish_National_Tax_Agency. Kvarskrivning. Swedish_National_Tax_Agency. Kvarskrivning.
36.
go back to reference Lichtenstein P, Holm NV, Verkasalo PK, Iliadou A, Kaprio J, Koskenvuo M, Pukkala E, Skytthe A, Hemminki K. Environmental and heritable factors in the causation of cancer–analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med. 2000;343(2):78–85.CrossRefPubMed Lichtenstein P, Holm NV, Verkasalo PK, Iliadou A, Kaprio J, Koskenvuo M, Pukkala E, Skytthe A, Hemminki K. Environmental and heritable factors in the causation of cancer–analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med. 2000;343(2):78–85.CrossRefPubMed
37.
go back to reference Furu K, Kieler H, Haglund B, Engeland A, Selmer R, Stephansson O, Valdimarsdottir UA, Zoega H, Artama M, Gissler M, Malm H, Norgaard M. Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ. 2015;350:h1798.CrossRefPubMedPubMedCentral Furu K, Kieler H, Haglund B, Engeland A, Selmer R, Stephansson O, Valdimarsdottir UA, Zoega H, Artama M, Gissler M, Malm H, Norgaard M. Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ. 2015;350:h1798.CrossRefPubMedPubMedCentral
38.
go back to reference Stephansson O, Kieler H, Haglund B, Artama M, Engeland A, Furu K, Gissler M, Norgaard M, Nielsen RB, Zoega H, Valdimarsdottir U. Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA. 2013;309(1):48–54.CrossRefPubMed Stephansson O, Kieler H, Haglund B, Artama M, Engeland A, Furu K, Gissler M, Norgaard M, Nielsen RB, Zoega H, Valdimarsdottir U. Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA. 2013;309(1):48–54.CrossRefPubMed
39.
go back to reference Sandin S, Schendel D, Magnusson P, Hultman C, Suren P, Susser E, Gronborg T, Gissler M, Gunnes N, Gross R, Henning M, Bresnahan M, Sourander A, Hornig M, Carter K, Francis R, Parner E, Leonard H, Rosanoff M, Stoltenberg C, Reichenberg A. Autism risk associated with parental age and with increasing difference in age between the parents. Mol Psychiatry. 2015. doi:10.1038/mp.2015.70.PubMed Sandin S, Schendel D, Magnusson P, Hultman C, Suren P, Susser E, Gronborg T, Gissler M, Gunnes N, Gross R, Henning M, Bresnahan M, Sourander A, Hornig M, Carter K, Francis R, Parner E, Leonard H, Rosanoff M, Stoltenberg C, Reichenberg A. Autism risk associated with parental age and with increasing difference in age between the parents. Mol Psychiatry. 2015. doi:10.​1038/​mp.​2015.​70.PubMed
40.
go back to reference Fletcher RH, Fletcher SW, Fletcher GS. Clinical epidemiology. The Essentials, 5th edn. Baltimore: Lippincott, Williams & Wilkins; 2012. Fletcher RH, Fletcher SW, Fletcher GS. Clinical epidemiology. The Essentials, 5th edn. Baltimore: Lippincott, Williams & Wilkins; 2012.
41.
go back to reference Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Different families live in different ways—a survey on residence and support of children after a separation. BE51BR1401., 2014. Statistics_Sweden (Swedish: Statistiska Centralbyrån S. Different families live in different ways—a survey on residence and support of children after a separation. BE51BR1401., 2014.
42.
go back to reference Bellis MA, Hughes K, Hughes S, Ashton JR. Measuring paternal discrepancy and its public health consequences. J Epidemiol Community Health. 2005;59(9):749–54.CrossRefPubMedPubMedCentral Bellis MA, Hughes K, Hughes S, Ashton JR. Measuring paternal discrepancy and its public health consequences. J Epidemiol Community Health. 2005;59(9):749–54.CrossRefPubMedPubMedCentral
Metadata
Title
Registers of the Swedish total population and their use in medical research
Authors
Jonas F. Ludvigsson
Catarina Almqvist
Anna-Karin Edstedt Bonamy
Rickard Ljung
Karl Michaëlsson
Martin Neovius
Olof Stephansson
Weimin Ye
Publication date
01-02-2016
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 2/2016
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-016-0117-y

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