Pancreatic disease burden varies globally

Acute pancreatitis is the most common pancreatic disease in the world and pancreatic cancer is the most deadly, but the incidence and mortality of major pancreatic diseases varies significantly throughout different geographical regions, according to the results of a meta-analysis published in the Lancet Gastroenterology and Hepatology.

“The aim of this study was to do a systematic review of population-based cohort studies to provide reliable incidence and mortality estimates of major pancreatic diseases around the world, as well as to investigate the effect of covariates,” researchers wrote.

They searched relevant data published through 2014 and ultimately included 48 population-based studies in their analysis, including 35 on pancreatic cancer, 10 on acute pancreatitis and three on chronic pancreatitis (median follow-up, 10 years). These studies involved nearly 296 million individuals in total, more than 119,000 of whom had pancreatic diseases. No studies on pancreatic cysts met inclusion criteria.

“The global incidence of acute pancreatitis in the general population was nearly double that of chronic pancreatitis and pancreatic cancer combined,” the researcher wrote. “Global mortality from pancreatic cancer was nearly four times greater than that from acute chronic pancreatitis combined.”

The global incidence of pancreatic cancer was estimated to be 8.14 cases (95% CI, 6.63-9.98) per 100,000 person-years with 6.92 deaths (95% CI, 3.72-12.89) per 100,000 person-years.

The global incidence of acute pancreatitis was estimated to be 33.74 cases (95% CI, 23.33-48.81) per 100,000 person-years with 1.6 deaths (95% CI, 0.85-1.58) per 100,000 person-years.

The global incidence of chronic pancreatitis was estimated to be 9.62 cases (95% CI, 7.86-11.78) per 100,000 person-years with 0.09 deaths (95% CI, 0.02-0.47) per 100,000 person-years.

“Significant disparities were found in the reported incidence of pancreatic diseases between the WHO regions, with the highest incidences of pancreatic cancer and acute pancreatitis reported from North America and the lowest from the Eastern Mediterranean region and Southeast Asia,” the researchers wrote.

Pancreatic cancer incidence and mortality and acute pancreatitis incidence were significantly higher in the WHO-defined American region compared with the European and Western Pacific regions. Moreover, chronic pancreatitis incidence was significantly higher in the European region compared with the American region, and pancreatic cancer deaths were lowest in the Southeast Asian region.

Incidence and mortality estimates for pancreatic cancer and acute pancreatitis were comparable between men and women, but chronic pancreatitis incidence was twice as high in men.

While this study represents “an important contribution to the literature on the epidemiology of pancreatic disease,” its rigorous inclusion criteria resulted in the representation of largely developed nations, according to a related editorial by John G. Williams, MD, and Stephen E. Roberts, MD, from Swansea University Medical School in the U.K. Moreover, the study “focused on nationwide or nationally representative studies, and excludes reports from single centers or hospitals, which tend to provide data in more depth,” they wrote.

Thus, “more timely and nationally comparable information is needed to make progress in this digital age,” they concluded, suggesting that global standards for reporting electronic patient data could revolutionize population research. – by Adam Leitenberger

Disclosures: The researchers and editorial authors report no relevant financial disclosures.

Acute pancreatitis is the most common pancreatic disease in the world and pancreatic cancer is the most deadly, but the incidence and mortality of major pancreatic diseases varies significantly throughout different geographical regions, according to the results of a meta-analysis published in the Lancet Gastroenterology and Hepatology.

“The aim of this study was to do a systematic review of population-based cohort studies to provide reliable incidence and mortality estimates of major pancreatic diseases around the world, as well as to investigate the effect of covariates,” researchers wrote.

They searched relevant data published through 2014 and ultimately included 48 population-based studies in their analysis, including 35 on pancreatic cancer, 10 on acute pancreatitis and three on chronic pancreatitis (median follow-up, 10 years). These studies involved nearly 296 million individuals in total, more than 119,000 of whom had pancreatic diseases. No studies on pancreatic cysts met inclusion criteria.

“The global incidence of acute pancreatitis in the general population was nearly double that of chronic pancreatitis and pancreatic cancer combined,” the researcher wrote. “Global mortality from pancreatic cancer was nearly four times greater than that from acute chronic pancreatitis combined.”

The global incidence of pancreatic cancer was estimated to be 8.14 cases (95% CI, 6.63-9.98) per 100,000 person-years with 6.92 deaths (95% CI, 3.72-12.89) per 100,000 person-years.

The global incidence of acute pancreatitis was estimated to be 33.74 cases (95% CI, 23.33-48.81) per 100,000 person-years with 1.6 deaths (95% CI, 0.85-1.58) per 100,000 person-years.

The global incidence of chronic pancreatitis was estimated to be 9.62 cases (95% CI, 7.86-11.78) per 100,000 person-years with 0.09 deaths (95% CI, 0.02-0.47) per 100,000 person-years.

“Significant disparities were found in the reported incidence of pancreatic diseases between the WHO regions, with the highest incidences of pancreatic cancer and acute pancreatitis reported from North America and the lowest from the Eastern Mediterranean region and Southeast Asia,” the researchers wrote.

Pancreatic cancer incidence and mortality and acute pancreatitis incidence were significantly higher in the WHO-defined American region compared with the European and Western Pacific regions. Moreover, chronic pancreatitis incidence was significantly higher in the European region compared with the American region, and pancreatic cancer deaths were lowest in the Southeast Asian region.

Incidence and mortality estimates for pancreatic cancer and acute pancreatitis were comparable between men and women, but chronic pancreatitis incidence was twice as high in men.

While this study represents “an important contribution to the literature on the epidemiology of pancreatic disease,” its rigorous inclusion criteria resulted in the representation of largely developed nations, according to a related editorial by John G. Williams, MD, and Stephen E. Roberts, MD, from Swansea University Medical School in the U.K. Moreover, the study “focused on nationwide or nationally representative studies, and excludes reports from single centers or hospitals, which tend to provide data in more depth,” they wrote.

Thus, “more timely and nationally comparable information is needed to make progress in this digital age,” they concluded, suggesting that global standards for reporting electronic patient data could revolutionize population research. – by Adam Leitenberger

Disclosures: The researchers and editorial authors report no relevant financial disclosures.