Black patients were almost twice as likely as white patients to have alcohol or smoking as a cause of their chronic pancreatitis, according to recent findings published in the American Journal of Gastroenterology.
“We found that when compared with whites, black patients were almost twice as likely to be diagnosed to have [chronic pancreatitis (CP)] due to alcohol or smoking; more likely to have morphologic abnormalities of the pancreas; more likely to have, and describe their pain as constant or severe; have a higher prevalence of endocrine insufficiency; and have a greater degree of disease-related disability,” Charles Mel Wilcox, MD, MSPH, in the division of gastroenterology and hepatology at the University of Alabama at Birmingham, and colleagues wrote. “Some of these racial differences could be explained by the higher prevalence of environmental exposures in black CP patients.”
Charles Mel Wilcox
Although data from some epidemiologic studies of CP suggest racial differences , few studies report the clinical profile, causes and outcome of CP in black patients, according to the researchers.
Wilcox and colleagues assessed data from 1,159 patients with CP who were enrolled in North American Pancreatitis Studies between 2000 and 2014. They administered questionnaires to patients and physicians to obtain information on demographics, etiology, risk factors, disease phenotype, treatment and perceived effectiveness.
They found black patients were more likely to smoke (64.2% vs. 45.9%) or drink alcohol (77% vs. 41.9%). There was no difference in the duration of CP, except for alcoholic CP, for which black patients had a longer duration (8.6 years vs. 6.97 years; P = .02). Black patients were more likely to have advanced changes in pancreatic morphology (63.3% vs. 55.2%), atrophy (43.2% vs. 34.6%), pancreatic ductal stricture or dilatation (72.6% vs. 65.5%) or common bile duct stricture (18.6% vs. 8.2%) and function (endocrine insufficiency, 39.9% vs. 30.2%). Black patients were more likely to experience any pain (94.7% vs. 83%), constant pain (62.6% vs. 51%), severe pain (78.4% vs. 65.8%) and disability (35.1% vs. 21.4%). Further, white patients were more likely to receive prior cholecystectomy (31.1% vs. 19%).
These differences can be partly explained by increased alcohol and tobacco use in black patients, the researchers wrote.
“Interestingly, the intensity of smoking was greater among whites, an observation that has also been noted in the general population,” the researchers wrote. “The difference we detected between blacks and whites regarding heavy smoking also suggests this to be a greater risk factor for CP in blacks.” – by Will Offit
Disclosure: One researcher reports being an inventor of intellectual property licensed to Ambry Genetics and having an ownership interest in Ambry Genetics.