Abstract
Background
Acute pancreatitis (AP) is a globally significant disease.
Aims
The purpose of this study is to perform a systematic review of population-based cohort studies that explore the changing global and temporal incidence of AP.
Methods
We performed a systematic literature search of MEDLINE (1946 onward) and EMBASE (1974 onward) up to 2018, to identify population-based studies reporting the incidence of AP with at least five temporal values. Studies reporting the incidence of the first occurrence of AP were examined separately from studies reporting incidence of first and recurrent occurrence of AP. Two teams of authors independently assessed abstracts to identify applicable papers for full-text review and data extraction. Temporal incidence data were summarized in a choropleth map to illustrate global differences in the incidence of AP over time.
Results
We identified 38 studies reporting the temporal incidence of AP (Table 1). The incidence of AP is increasing over time in most countries in North America (e.g., USA: 43.3 to 85.6 per 100,000; 1985–2012), Europe (Norway: 5.5 to 15.9 per 100,000; 1996–2006), and Oceania (New Zealand: 41.3 to 76.8 per 100,000; 2006–2014). In contrast, the incidence of AP varied in Asia with increasing incidence in China (30.5 to 39.2 per 100,000; 2009–2014) and stable incidence in Vietnam (36.2 to 34.3 per 100,000; 2000–2009).
Conclusions
This systematic review provides a comprehensive overview of the global incidence of AP over the last 60 years. The incidence of AP is increasing over time in most countries. However, the reason for rising incidence is likely multifactorial relating to the changing standards of diagnosis, geographic variation in risk factors for AP, and differences in the surveillance systems for AP. Nonetheless, the overall trend of increasing incidence of AP highlights the increasing burden of AP on global health systems.
Acute Pancreatitis Incidence
| First Occurrence AP (per 100,000 person-years) | First and Repeat Occurrence AP (per 100,000 person-years) | |||
|---|---|---|---|---|
| Country | Earliest Incidence (Year) | Latest Incidence (Year) | Earliest Incidence (Year) | Latest Incidence (Year) |
| Albania | 3.95 (2005) | 5.64 (2012) | ||
| Australia | 44.66 (1994) | 129.1 (1999) | ||
| China | 30.5 (2009) | 39.2 (2014) | ||
| Croatia | 25.75 (2000) | 34.51 (2009) | 35 (1997) | 38.25 (2012) |
| Denmark | 17.56 (1981) | 32.39 (2000) | 18.93 (1980) | 27.13 (2012) |
| Finalnd | 10.11 (1972) | 22.51 (1990) | 48.77 (1970) | 74.83 (1989) |
| Germany | 13.57 (1987) | 11.96 (2006) | ||
| Ireland | 17.5 (1997) | 23.6 (2004) | ||
| New Zealand | 41.25 (2006) | 76.83 (2014) | ||
| Netherlands | 12.39 (1985) | 18.46 (2004) | ||
| Norway | 5.49 (1996) | 15.86 (2006) | ||
| Spain | 59.01 (2001) | 59.94 (2011) | ||
| Sweden | 22.13 (1985) | 14.78 (2012) | ||
| United Kingdom | 51.7 (1961) | 91 (1979) | ||
| United States | 42.65 (1983–1986) | 85.56 (2007–2010) | 43.27 (1985–1987) | 87.79 (2012) |
| Vietnam | 36.18 (2000) | 34.25 (2009) | ||
Funding Agencies
None