Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review

Pancreas. 2006 Nov;33(4):323-30. doi: 10.1097/01.mpa.0000236733.31617.52.


Objective: To systematically review trends in the epidemiology of the first attack of acute pancreatitis (AP) based on reported population-based studies.

Methods: From Medline, we retrieved 18 full-length English language peer-reviewed original articles published from 1966 to June 2005 with population-based information on the epidemiology of first-attack AP. Trends over time were analyzed based on study- and country-specific data and the study site (UK vs non-UK).

Results: Eight studies were from the UK and 10 from other European centers. An increase in the annual incidence per 100,000 for first-attack AP was reported in 10 of 12 studies with longitudinal data from 4 countries (UK, Sweden, Denmark, and Netherlands). The overall AP incidence seems to be higher in non-UK studies compared with that of UK, partly explained by a higher incidence of alcoholic pancreatitis in non-UK studies. A linear trend for increase in gallstone pancreatitis incidence over time was observed irrespective of the study site (UK or non-UK). The AP incidence and mortality increased with age. Gallstone pancreatitis was more common in female subjects, and alcoholic pancreatitis was more common in middle-aged male subjects. The AP case fatality (%) has decreased over time, but the overall population mortality rate per 100,000 has remained unchanged. Recurrence after the first attack is milder with a substantially lower mortality.

Conclusions: The incidence of AP seems to be increasing. Differences in the incidence and etiology between and within countries reflect differences in the risk factor prevalence. Case-fatality rate, but not the population-based mortality rate, decreased over time.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Acute Disease
  • Age Distribution
  • Age Factors
  • Epidemiology / trends
  • Europe / epidemiology
  • Female
  • Gallstones / complications
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Pancreatitis / epidemiology*
  • Pancreatitis / etiology
  • Pancreatitis / mortality
  • Pancreatitis, Alcoholic / epidemiology
  • Recurrence
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • United Kingdom / epidemiology