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We aimed to examine the effects of the birth cohort on gout incidence using an age-period-cohort (APC) model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Nationwide data from the UK primary care database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Individuals between 30 and 89 years of age were included. We excluded individuals who had gout history when entering the database and individuals with less than 1 year of continuous follow-up between 1 January 1999 and 31 December 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Gout was identified using READ codes assigned by general practitioners. The incidence of gout between 1999\u20132013 and 2011\u20132019 was analysed with APC model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of gout between 1999 and 2013 increased with birth cohorts. Compared with those born in 1949\u20131953 (reference), the age-adjusted and period-adjusted rate ratios (RRs) of incident gout increased from 0.39 (95% CI 0.34 to 0.46) in participants born in 1910\u20131914 to 2.36 (95% CI 2.09 to 2.66) in participants born in 1979\u20131983 (p for trend &lt;0.001). In contrast, the incidence of gout between 2011 and 2019 decreased with birth cohorts. Compared with those born in 1949\u20131953 (reference), the age-adjusted and period-adjusted RRs of incident gout declined from 2.75 (95% CI 2.30 to 3.28) in participants born in 1922\u20131926 to 0.75 (95% CI 0.65 to 0.87) in participants born in 1976\u20131980 but then increased slightly to 0.95 (95% CI 0.77 to 1.17) in participants born in 1985\u20131989.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The gout incidence between 1999 and 2013 in the UK increased with the birth cohorts and then decreased between 2011 and 2019 except for those born after 1980. Future monitoring is needed to help identify aetiological factors and guide preventive and treatment strategies for gout.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079665","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T03:17:33Z","timestamp":1706584653000},"page":"e079665","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Secular trend of gout incidence in the UK: an age-period-cohort analysis"],"prefix":"10.1136","volume":"14","author":[{"given":"Jing","family":"Ye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiya","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Doherty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2987-138X","authenticated-orcid":false,"given":"Guanghua","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4484-936X","authenticated-orcid":false,"given":"Xiang","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2024012919152325000_14.1.e079665.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00569-9"},{"key":"2024012919152325000_14.1.e079665.2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41572-019-0115-y","article-title":"Gout","volume":"5","author":"Dalbeth","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2024012919152325000_14.1.e079665.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210146"},{"key":"2024012919152325000_14.1.e079665.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206410"},{"key":"2024012919152325000_14.1.e079665.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.02.004"},{"key":"2024012919152325000_14.1.e079665.6","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem150"},{"key":"2024012919152325000_14.1.e079665.7","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1002\/art.41008","article-title":"Cause-specific mortality in gout: novel findings of elevated risk of non-cardiovascular-related deaths","volume":"71","author":"Vargas-Santos","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"2024012919152325000_14.1.e079665.8","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1002\/art.41404","article-title":"Prevalence, incidence, and years lived with disability due to gout and its attributable risk factors for 195 countries and territories 1990-2017: a systematic analysis of the global burden of disease study 2017","volume":"72","author":"Safiri","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2024012919152325000_14.1.e079665.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0441-1"},{"key":"2024012919152325000_14.1.e079665.10","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221989"},{"key":"2024012919152325000_14.1.e079665.11","doi-asserted-by":"crossref","first-page":"697","DOI":"10.7326\/0003-4819-152-11-201006010-00002","article-title":"Sex, age, and birth cohort effects in colorectal Neoplasms: a cohort analysis","volume":"152","author":"Brenner","year":"2010","journal-title":"Ann Intern Med"},{"key":"2024012919152325000_14.1.e079665.12","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)90557-W"},{"key":"2024012919152325000_14.1.e079665.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1715907"},{"key":"2024012919152325000_14.1.e079665.14","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1161\/CIRCULATIONAHA.119.042864","article-title":"Time trends in cardiovascular disease mortality across the BRICS: an age-period-cohort analysis of key nations with emerging economies using the global burden of disease study 2017","volume":"141","author":"Zou","year":"2020","journal-title":"Circulation"},{"key":"2024012919152325000_14.1.e079665.15","doi-asserted-by":"crossref","unstructured":"Su Z , Zou Z , Hay SI , et al . 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