Regional and Sex-Specific Trends in the Burden of Pancreatitis in Asia, 1990-2021: A Global Burden of Disease Study 2021 Analysis.

PURPOSE: Long-term patterns of pancreatitis burden across Asian subregions, sexes, and age groups remain incompletely characterized. We assessed temporal changes and identified populations with divergent trends.

PATIENTS AND

METHODS

We analyzed Global Burden of Disease Study 2021 estimates for pancreatitis from 1990 to 2021. Outcomes included incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) globally, in Asia, and across three Asian subregions, namely East Asia, South Asia, and Southeast Asia. Joinpoint regression was used to estimate average annual percentage changes (AAPCs) and 95% confidence intervals for temporal trends, stratified by location, sex, and 5-year age group. Subgroup findings were interpreted descriptively because of the ecological design and multiple stratified comparisons. We also examined the burden attributable to alcohol use and the relative contributions of years lived with disability (YLDs) and years of life lost (YLLs) to DALYs among Asian females aged 15-24 years.

RESULTS

Absolute numbers of incident cases, prevalent cases, deaths and DALYs increased globally and across Asia, whereas most age-standardised rates declined. In Asia, AAPCs for age-standardised incidence, prevalence, mortality and DALY rates were -0.33%, -0.45%, -1.00% and -0.94%, respectively. Alcohol-attributable fractions were substantially lower among females than males in Asia (1.6% vs 16.1% for deaths and 1.6% vs 17.0% for DALYs), suggesting that non-alcohol-related hypotheses require further individual-level evaluation. All four rates declined markedly in East Asia. Incidence and prevalence increased annually by 0.33% and 0.13% in South Asia. Prevalence increased annually by 0.25% in Southeast Asia. Overall burden and alcohol-attributable fractions were higher among males. Incidence increased among females aged 15-19 and 20-24 years, with AAPCs of 0.80% and 0.71%, respectively. Among women aged 15-24 years, the YLD share increased from 8.51% to 10.62%. The YLL share declined from 91.49% to 89.38%.

CONCLUSION

Regional and demographic disparities persisted despite declining age-standardized rates. Rising incidence among young Asian females warrants further surveillance and etiological research. Biliary, metabolic, and other explanations require individual-level evaluation; these ecological findings cannot establish causation.