Burden of pancreatitis and associated risk factors in China, 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Abstract

Background: Pancreatitis is a common disease of the digestive system. Acute pancreatitis is one of the most common reasons for gastrointestinal hospital admission, and chronic pancreatitis significantly reduces quality of life. However, national epidemiological data on pancreatitis in China are lacking. This study aimed to quantify the disease burden of pancreatitis in China from 1990 to 2019.

Methods: This study was based on the Global Burden of Disease Study 2019 dataset. Age-standardized rates of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) were used to describe the disease burden of pancreatitis, and estimated annual percentage change (EAPC) was used to indicate the average change in age-standardized rates. We also described the trend of pancreatitis-related mortality and DALYs, which are attributable to alcohol use by age and sex.

Results: From 1990 to 2019, the ASIR, ASPR, ASMR, and age-standardized DALYs of pancreatitis in China decreased by 10.90, 1.50, 0.49, and 15.54 per 100,000, respectively, with EAPCs of -1.35 (95% uncertainty interval [UI]: -1.67, -1.02) and -0.37 (95% UI: -0.43, -0.31), -2.01 (95% UI: -2.07, -1.94) and -2.32 (95% UI: -2.37, -2.28), respectively. Recently, the numbers of incident and prevalent cases have risen, with estimates of 380,018 (95% UI: 308,669-462,767) and 493,765 (95% UI: 416,705-578,675), respectively, in 2019. Among men, the disease burden of pancreatitis was more severe than among women, and with variances in the distribution among different age groups. Age-standardized DALYs caused by alcohol-related pancreatitis have gradually worsened in the past decade, accounting for 34.09% of the total in 2019.

Conclusions: The disease burden of pancreatitis in China has declined in the past 30 years, but the exacerbation of population aging poses a challenge to prevention and control of pancreatitis. Alcohol use has gradually become an important factor in the disease burden of pancreatitis in recent years.

Figure 1

The age-standardized rates of (A) incidence, (B) prevalence, (C) mortality, and (D) DALYs due to pancreatitis by age and sex, 2019. ASIR: Age-standardized incidence rate; ASMR: Age-standardized mortality rate; ASPR: Age-standardized prevalence rate; DALYs: Disability-adjusted life-years.

Figure 2

Trends in cases and age-standardized rates of (A) incidence, (B) prevalence, (C) mortality, and (D) DALYs of pancreatitis in China, from 1990 to 2019. The bar indicates the cases, and the line indicates the rates. Solid lines denote the estimated values, and shading indicates the upper and lower limits of the 95% UIs. ASIR: Age-standardized incidence rate; ASMR: Age-standardized mortality rate; ASPR: Age-standardized prevalence rate; DALYs: Disability-adjusted life-years; UIs: Uncertainty intervals.

Figure 3

The fractions of pancreatitis ASMR and DALYs attributable to alcohol use, 2019. ASMR: Age-standardized mortality rate; DALYs: Disability-adjusted life-years.

Figure 4

Trends in fractions of pancreatitis ASMR and DALYs attributable to alcohol use, from 1990 to 2019. ASMR: Age-standardized mortality rate; DALYs: Disability-adjusted life-years.