Chronic pancreatitis: a case ascertainment study

Quammie, Shauntelle; Rashid, Adil; Munya, Rahul; Nicholson, Edward S; Clarke, Christopher; Venkatachalapathy, Suresh V; Crooks, Colin J; Aithal, Guruprasad P; Aravinthan, Aloysious D

Abstract

Background Chronic 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.

Method All 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.

Results Screening 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.

Conclusion This 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.

Citation

Quammie, S., Rashid, A., Munya, R., Nicholson, E. S., Clarke, C., Venkatachalapathy, S. V., Crooks, C. J., Aithal, G. P., & Aravinthan, A. D. (2025). Chronic pancreatitis: a case ascertainment study. Frontline Gastroenterology, https://doi.org/10.1136/flgastro-2024-102786

• Journal Article Type: Article
• Acceptance Date: Jan 7, 2025
• Online Publication Date: Jan 23, 2025
• Publication Date: Jan 23, 2025
• Deposit Date: Jan 8, 2025
• Publicly Available Date: Jan 9, 2025
• Journal: Frontline Gastroenterology
• Print ISSN: 2041-4137
• Electronic ISSN: 2041-4145
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/flgastro-2024-102786
• Public URL: https://nottingham-repository.worktribe.com/output/43951963
• Publisher URL: https://fg.bmj.com/content/early/2025/01/23/flgastro-2024-102786