Epidemiological trends in pancreatitis in China and the United States, 1990–2023

Objective: This study aims to systematically compare the epidemiological patterns and long-term trends of pancreatitis burden between China and the United States. Methods: Using the Global Burden of Disease (GBD) 1990–2023 data, we analyzed the burden of pancreatitis in China and the United States, including prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Temporal trends were assessed using Joinpoint regression and age–period–cohort (APC) analysis. Socioeconomic inequality was evaluated using the slope index of inequality (SII) and concentration index (CIX) based on socio-demographic index (SDI), while alcohol-attributable burden was quantified using the population attributable fraction (PAF) approach. Results: In 2023, China had 515,000 prevalent pancreatitis cases vs . 403,000 in the United States, but lower age-standardized prevalence (24.26 vs . 81.31), incidence (23.70 vs . 51.11), mortality (0.42 vs . 1.05), and DALY rates (13.10 vs . 35.99) per 100,000. From 1990 to 2023, the age-standardized burden declined more rapidly in China, with greater reductions in females, whereas the United States males had higher mortality and DALY rates than females. APC analysis showed pronounced age effects in both countries but declining cohort risks only in China. Pancreatitis burden was higher in high-SDI regions and alcohol-attributable burden remained higher in the United States than in China. Conclusions: China had a higher absolute number of pancreatitis cases but a lower and faster-declining age-standardized burden than the United States. Targeted prevention strategies addressing aging, alcohol-related risks, and socioeconomic disparities are needed.