Epidemiology Of Chronic Pancreatitis Research Articles

Epidemiology of chronic pancreatitis: burden of the disease and consequences.

The epidemiology of chronic pancreatitis (CP) is incompletely understood. A number of difficulties exist in estimating the prevalence and incidence of CP. Long-term follow-up is often problematic, especially in chronic alcoholics, and obtaining a formal and standardised diagnosis can take years. The available studies are reasonably consistent in their estimation of the incidence of CP but few studies have attempted to estimate prevalence. Although life expectancy in CP is diminished compared with control populations, median survival lies in the range of 15-20 years. Such a survival would suggest a prevalence of CP rather higher than that determined from the survey studies. A recent epidemiological study in France found an annual incidence of 7.8 per 100,000. Assuming a survival of 15-20 years, the annual prevalence should be between 120 to 143 per 100,000. Overall, our understanding of the epidemiology of CP is poor compared with other illnesses. We consider that both prevalence and the rate of pancreatic insufficiency and of CP are currently underestimated. There is a distinct need for more studies to remedy this lack of knowledge.

M1374 Epidemiology of Chronic Pancreatitis (CP) at U.S. Referral Centers: Data From the North American Pancreatitis Study 2 (Naps2)

Background: Despite data showing an independent association between smoking and chronic pancreatitis (CP), it is unclear how often physicians consider smoking as a CP risk factor. Aim: Identify how often and in which patients physicians identify smoking as a CP risk factor. Methods: We analyzed data on CP patients (n = 535) prospectively enrolled in the multicenter North American Pancreatitis Study 2 (NAPS2). Patient self-reported smoking status was stratified as never, past, or current, and the amount and duration of smoking was quantified. For each patient, we noted whether the enrolling physician classified alcohol as the diagnostic etiology for CP and whether or not smoking was selected as a risk factor. Results: Among 382 (71.4%) self-reported past or current smokers, physicians cited smoking as a risk factor in only 173 (45.3%) patients, more often when they considered alcohol as CP etiology (54.5 vs. 32.5%, p<0.001). Among patients considered to have alcohol as an etiology, physicians identified smoking as a risk factor equally irrespective of the status (current vs. past) (55.4 vs. 51.1%, p= NS) or the amount of smoking. Among patients not classified as having an alcohol etiology, physicians were more likely to cite smoking as a risk factor in current rather than past smokers (47.4% vs. 19.0%, p<0.001) and in patients who reported higher amount and duration of smoking. Although patient's self-reported smoking status was generally similar across participating centers, a wide variability in physician decision to cite smoking as a risk factor was observed (Figure 1). On multivariable regression analyses however, the association between smoking and CP was independent of physician's decision to cite smoking as a risk factor. Conclusions: Cigarette smoking is common in CP patients. Physicians often underestimate smoking as a CP risk factor. Efforts are needed to increase awareness of the association between smoking and CP.