title: Trends in incidence of acute pancreatitis in a Swedish population: is there really an increase?
abstract: OBJECTIVE
  Recent reports have suggested an increasing incidence of acute pancreatitis, and changing patterns of risk factors, over the past decades. The aim of this study was to investigate trends in the incidence of acute pancreatitis, and risk factors related to the disease, in a general population over a 15-year period.
  
  
  METHODS
  Clinical, autopsy, and forensic records for all patients with a first attack of acute pancreatitis in Malmö, Sweden, from 1985 to 1999, were validated retrospectively. Evidence for diagnosis was reconsidered and plausible cause was assessed. The incidence of gallstone disease, lung cancer, and alcohol-related conditions in the background population were retrieved from hospital diagnosis records and cancer and cause-of-death registries.
  
  
  RESULTS
  A total of 929 first attacks of acute pancreatitis were identified. The total incidence of acute pancreatitis increased by 3.9% per year (95% confidence interval [CI], 2.1-5.8). The incidence of gallstone-related pancreatitis increased by 7.6% per year (95% CI, 4.0-11.4), and this correlated with an increase in the incidence of other gallstone-related conditions ( r = 0.68; P = 0.005). Alcohol-related pancreatitis decreased by -5.1% per year (95% CI, -7.4 to -2.8), and this correlated with a decrease in the incidence of delirium tremens ( r = 0.75; P = 0.001), mortality from cirrhosis ( r = 0.81; P < 0.001), and incidence of lung cancer ( r = 0.57; P = 0.026).
  
  
  CONCLUSIONS
  There was a statistically significant increase in the incidence of acute pancreatitis. Gallstone-related pancreatitis increased, and alcohol-related pancreatitis decreased. Both of these trends were statistically significant and correlated with trends in the incidence of other conditions associated with either gallstone disease or alcohol abuse.
authors.affiliation: Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden. Bjorn.Lindkvist@kir.mas.lu.se
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.forename: Stefan
authors.initials: S
authors.lastname: Appelros
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Anders
authors.initials: A
authors.lastname: Borgström
mesh_terms: D000208:Acute Disease; D000368:Aged; D000437:Alcoholism / Q000150:complications; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology