Study by IDOR Analyzed 11 Years of Data on Hospitalizations and Mortality from Chronic Pancreatitis in Brazil 

A new study led by the D’Or Institute for Research and Education (IDOR) and the Federal University of Rio de Janeiro (UFRJ), published in the journal Digestive Diseases and Sciences, analyzed trends and the geographic distribution of chronic pancreatitis across Brazil over the past 11 years. This disease, which is associated with an increased risk of pancreatic cancer, has shown a sharp decline in hospitalizations over the years, yet mortality rates have remained steady, especially among the elderly, smokers, and residents of the Southern and Southeastern regions. 

Chronic Pancreatitis in Brazil

Chronic pancreatitis is an inflammatory condition of the pancreas that causes progressive damage, leading to serious complications such as pancreatic insufficiency, diabetes, and an increased risk of developing pancreatic cancer. For those affected, the debilitating symptoms significantly impact their quality of life, while the healthcare system faces the high cost of hospitalizations and long-term treatments. The situation is even more concerning in developing countries like Brazil, where access to specialized healthcare is limited, and regional inequalities can worsen the problem. 

Given the lack of comprehensive data on chronic pancreatitis in the country, researchers from IDOR and UFRJ conducted an extensive study to better understand the disease’s epidemiology in Brazil over the 11 years leading up to the COVID-19 pandemic. 

SUS Data Fuels Health Research in Brazil

The analysis considered factors such as geographic distribution, age groups, and potential links to alcohol and tobacco use—well-documented risk factors for the disease. The study examined data from more than 64,000 hospitalizations between January 2009 and December 2019, highlighting trends and challenges that demand attention from public health authorities. 

Researchers gathered this retrospective data from DATASUS, the Ministry of Health’s database, and incorporated information from VIGITEL, a surveillance system that tracks alcohol and tobacco use in Brazil. This approach allowed the team to explore whether the prevalence of chronic pancreatitis is linked to population behaviors over time, as well as regional disparities in access to healthcare. 

Chronic Pancreatitis: Fewer Hospitalizations, Same Mortality Rate

The number of hospitalizations for chronic pancreatitis in Brazil saw a significant reduction over the study period. From 2009 to 2019, hospital admission rates dropped by 54.68%, from 6.4 to 2.9 per 100,000 inhabitants. However, mortality rates remained steady at around 5% to 6%, indicating that despite fewer hospitalizations, the severity of the disease has not diminished. 

Demographically, men were more affected by chronic pancreatitis, accounting for 63.54% of hospitalizations, with the highest mortality rates among patients aged 70 and older. This group experienced mortality rates between 12% and 17%. According to researchers, the high mortality is due to the lack of a cure, the presence of comorbidities, and the fragility of elderly patients, placing increasing pressure on the healthcare system given Brazil’s aging population. 

Regions with Higher Smoking Rates Show More Cases of Chronic Pancreatitis

The geographic distribution of chronic pancreatitis in Brazil revealed significant regional disparities. The Southeastern and Southern regions, which are more economically developed, showed the highest adjusted hospitalization rates. In contrast, the Northern and Northeastern regions had the lowest rates. 

The authors argue that these differences appear to be linked to levels of economic development and access to more complex healthcare services, as well as population behaviors concerning tobacco and alcohol use. Smoking was identified as a particularly important risk factor, with a sharp decrease in chronic pancreatitis hospitalizations associated with a reduction in tobacco consumption, especially among women, whose rates dropped by 38.40%. However, in the Southern region, home to much of Brazil’s tobacco production, the decline in cigarette consumption was more modest, potentially explaining the observed increase in mortality rates in that area. 

Reducing Smoking and Strengthening Primary Care to Combat Chronic Pancreatitis

Chronic pancreatitis continues to pose a significant challenge to Brazil’s healthcare system, particularly due to its high mortality rate among the elderly and the lack of a cure. The study showed that while hospitalizations have decreased, the disease still imposes a considerable socioeconomic burden, with stark regional disparities. 

Researchers emphasize that public policies aimed at reducing alcohol and tobacco consumption, along with strengthening primary healthcare, are essential to mitigating the impact of chronic pancreatitis, particularly in Brazil’s more vulnerable regions. These actions could also reduce the number of pancreatic cancer cases and other diseases that affect the population’s quality of life and strain public healthcare resources. 

Written by Maria Eduarda Ledo de Abreu.