The overall global incidence of acute pancreatitis has increased by 3.07% per year since 1961, according to a study in Gastroenterology.
Researchers conducted a systematic review and meta-analysis of population-based studies reporting the incidence of acute pancreatitis by age, sex, and/or cause. They searched MEDLINE from 1946 and EMBASE from 1974 through August 19, 2020. Random effects models were used to pool sex-, age-, and etiology-specific average annual percent change (AAPC) values with 95% confidence intervals.
The investigators identified 44 studies regarding the incidence of pancreatitis, with 4 exclusively conducted in children aged less than 18 years. Pooling all AAPCs showed that the global incidence of acute pancreatitis increased by 3.07% (95% CI, 2.30-3.84; n=34; I2 = 93%) per year from 1961 to 2016.
Pooled incidence values stratified according to geographic region showed that the incidence of acute pancreatitis has been increasing over time in most regions: North America (AAPC, 3.67%; 95% CI, 2.76-4.57; n=4; I2 = 47%) and Europe (AAPC, 2.77%; 95% CI, 1.91-3.63; n=23; I2 = 92%). An exception is Asia, where the incidence of acute pancreatitis has remained stable (AAPC, −0.28%; 95% CI, −5.03 to 4.47; n=4; I2 = 93%).
The increasing incidence of acute pancreatitis was comparable in women (AAPC, 2.80%; 95% CI, 1.19-4.40; n=14; I2 = 95%) and men (AAPC, 2.29%; 95% CI, 1.49-3.09; n=14; I2 = 81%). The incidence of biliary pancreatitis (AAPC, 3.60%; 95% CI, 1.97-5.23; n=8; I2 = 64%) and alcohol-induced pancreatitis (AAPC, 2.96%; 95% CI, 0.72-5.19; n=8; I2 = 89%) had statistically significant increases. For pediatric study populations, incidence of acute pancreatitis has also increased (AAPC, 5.44%; 95% CI, 0.52-10.36; n=4; I2 = 86%).
The researchers noted some limitations to their findings. The incidence rates in the studies had heterogeneity, some of which may be related to differences in study design, populations, diagnostic practices, data collection, and years covered. However, the investigators stated that genuine heterogeneity is also likely involved, and that the epidemiology of acute pancreatitis and its risk factors are truly different among regions. Additionally, researchers a priori excluded studies that had fewer than 5 observational points.
“Our findings confirm that the rate at which acute pancreatitis cases are diagnosed has significantly increased throughout many industrialized countries,” the researchers commented. “The reason for this increase is unknown but likely explained by increased clinical diagnoses, technological innovations, and increased prevalence of biliary disease along with other associated clustering of medical risk factors,” they concluded.
Iannuzzi JP, King JA, Leong JH, et al. Global incidence of acute pancreatitis is increasing over time: a systematic review and meta-analysis. Gastroenterol. Published online September 24, 2021. doi: 10.1053/j.gastro.2021.09.043