Nationwide epidemiological survey of chronic pancreatitis in Japan: introduction and validation of the new Japanese diag
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ORIGINAL ARTICLE–LIVER, PANCREAS, AND BILIARY TRACT
Nationwide epidemiological survey of chronic pancreatitis in Japan: introduction and validation of the new Japanese diagnostic criteria 2019 Atsushi Masamune1 • Kazuhiro Kikuta1 • Kiyoshi Kume1 • Shin Hamada1 • Ichiro Tsuji2 • Yoshifumi Takeyama3 • Tooru Shimosegawa1 • Kazuichi Okazaki4 for the Japan Pancreas Society
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Received: 4 June 2020 / Accepted: 25 June 2020 Ó Japanese Society of Gastroenterology 2020
Abstract Objectives To provide updated clinico-epidemiological information on chronic pancreatitis (CP) in Japan. Methods We conducted a two-stage nationwide epidemiological survey; the number of CP patients was estimated in the first-stage survey, and their clinical features were examined in the second-stage survey. We surveyed patients with CP who had visited hospitals in 2016 and were diagnosed according to the Japanese diagnostic criteria 2009 (DC2009). Furthermore, we validated the new Japanese diagnostic criteria (DC2019) in patients with early CP diagnosed according to DC2009. Results The number of patients with definite/probable CP in 2016 was 56,520 (prevalence, 44.5 per 100,000 persons), and that of early CP was 4470 (prevalence, 3.5 per 100,000 persons). We obtained detailed clinical information of 2150 patients with definite/probable CP and 249 patients with
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00535-020-01704-9) contains supplementary material, which is available to authorized users. & Atsushi Masamune [email protected] 1
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
2
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
3
Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan
4
Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Japan
early CP. Compared with the early CP cases, the definite/ probable CP cases had higher proportions of male (4.8 vs. 1.3), alcohol-related etiology (72.0% vs. 45.8%), smoking history (69.6% vs. 41.0%), diabetes mellitus (42.3% vs. 19.3%), and past history of acute pancreatitis (AP) (50.4% vs. 22.1%). Among the patients with early CP diagnosed according to DC2009, 93 (37.3%) were diagnosed with early CP according to DC2019, but the diagnosis of the remaining 156 (62.7%) patients was downgraded. Alcoholrelated etiology, smoking history, early disease onset, and past history of AP were associated with the maintenance of early CP diagnosis in DC2019. Conclusion We clarified the current status of CP in Japan. Further validation studies are warranted to clarify the diagnostic utility of DC2019. Keywords Alcohol Early chronic pancreatitis Endoscopic ultrasonography MRCP Smoking Abbreviations AP Acute pancreatitis BTN-benzoyl-l-tyrosyl-p-aminobenzoic acid PABA CI Confidence interval CP Chronic pancreatitis DC Japanese clini
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