Chronic pancreatitis: a case ascertainment study

• Published in: Frontline gastroenterology 2025-01, p.flgastro-2024-102786
• Main Authors: Quammie, Shauntelle, Rashid, Adil, Munyal, Rahul, Nicholson, Edward S, Clarke, Christopher, Venkatachalapathy, Suresh V, Crooks, Colin J, Aithal, Guruprasad P, Aravinthan, Aloysious D, Thorley, Andrew, Duckworth, Anna, Mohammadi-Nejad, Ali-Reza, Harbottle, Anthony, Villalon, Armando Mendez, Scotton, Chris, Denton, Christopher, Lea, Daniel, Auer, Dorothee, Joof, Ebrima, Cox, Eleanor, Eves, Elizabeth, Robertson, Elizabeth, Blamont, Emma, Khan, Fasihul, Massen, Georgie, Parcesepe, Gina, Jenkins, Gisli, Moran, Gordon, Aithal, Guruprasad, Longhurst, Hilary, Stewart, Iain, Paxton, Jane, Quint, Jennifer, Hanley, Karen Piper, Frost, Kate, Casmino, Leo, Chakrabarti, Lisa, Wain, Louise, Roeth, Margot, Kaisar, Maria, Craig, Martin, Nation, Michael, Kisomi, Mohammad Alireza, Zeybel, Mujdat, Guha, Neil, Selby, Nicholas, Oliver, Nick, Selby, Nick, Leavy, Olivia C., Gowland, Penny, Quinlan, Philip, Chambers, Rachel, Allen, Richard, Hubbard, Richard, Slack, Rob, Ploeg, Rutger, Moss, Sam, Fawaz, Sara, Turner, Scott, Johnson, Simon, Sotiropoulos, Stamatios N, Astbury, Stuart, Francis, Susan, Giles, Tom, Quinn, Valerie, Adams, Wendy, Chen, Xin, Gong, Zhendi
• Format: Article
• Language: English
• Subjects: Abdomen; Calcification; CHRONIC PANCREATITIS; Comorbidity; Cysts; Endoscopy; Hepatopancreatobiliary; Pancreatitis; Patients; Ultrasonic imaging
• ISSN: 2041-4137; 2041-4145
• DOI: 10.1136/flgastro-2024-102786

BackgroundChronic pancreatitis (CP) is a debilitating condition, characterised by chronic inflammation and fibrosis of the pancreas. The population frequency of CP is poorly understood. Therefore, we used a broad pragmatic approach to estimate the frequency of CP among a patient population undergoing investigations at a UK tertiary university hospital.MethodAll adult patients who, during 2006–2014, underwent abdominal CT MRI, abdominal X-ray, endoscopic ultrasonography (EUS), faecal elastase testing, received a pancreatin prescription or a recorded primary/comorbid ICD diagnosis of CP were screened (screening cohort) for inclusion. By applying the well-recognised CT, MRI and EUS criteria to the screening cohort, patients with CP were identified (study cohort). The incidence and point prevalence of CP were calculated, and changes in incidence were modelled using Poisson regression.ResultsScreening cohort included 24 271 cases, and 1003 patients who met the diagnostic criteria for CP were included in the study cohort. The median age of diagnosis was 65 (IQR 50–76); the majority were males (n=656, 65.4%) and of European ancestry (n=884, 88.1%). The annual incidence of diagnosis increased by a mean of 4.1% per year (95% CI 0.5% to 7.8%; p=0.03) over the study period ranging from 8.5 to 13.8 per 100 000 general population. The point prevalence also increased reaching 53.6 (95% CI 48.3 to 59.4) per 100 000 population at the end of the study period.ConclusionThis study provides a clear method of pragmatically identifying patients with CP in a clinical setting. The incidence of CP diagnosis in patients undergoing investigations in hospital increased gradually in Greater Nottingham.