Ther Adv Gastroenterol. 2026 Aug 27;19:17562848261483780. doi: 10.1177/17562848261483780. eCollection 2026.
ABSTRACT
BACKGROUND: Chronic pancreatitis (CP) is a progressive fibroinflammatory disease associated with substantial long-term morbidity. Synthesized evidence on mortality remains limited.
OBJECTIVES: To systematically review all-cause and cause-specific mortality in adults with CP compared with individuals without CP.
DESIGN: This systematic review of observational studies adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines.
DATA SOURCES AND METHODS: We searched PubMed, Web of Science, Embase, Scopus, and Cochrane Central Register of Controlled Trials from database inception to May 29, 2025. Reference list screening, citation tracking, and targeted author- and consortium-based searches were also conducted. Eligible studies included adults with CP that reported mortality outcomes with a non-CP comparator. Data extraction was conducted by one reviewer while another confirmed accuracy. Quality assessment was done by two independent reviewers and conflicts resolved by a third reviewer. Narrative synthesis was done due to high heterogeneity across studies.
RESULTS: Of 11,957 records screened through title and abstract, 347 underwent full-text review, and 12 met inclusion criteria. Four additional studies were found through reference list, citation tracking, and targeted searches, yielding a total of 16 included studies with cohort design. Across seven comparative studies, CP was consistently associated with higher all-cause mortality, with standardized mortality ratios ranging from 1.20 to 5.50 and hazard ratios ranging from 1.25 to 5.00. Malignancy was the most frequently reported cause of death. Other causes included cardiovascular, suicide, infectious, liver-related, gastrointestinal, endocrine, renal, respiratory, and accidental.
CONCLUSION: CP is associated with excess all-cause mortality and a broad cause-specific mortality burden extending beyond pancreas-related complications alone. These findings support recognizing CP as a systemic, high-risk chronic disease and highlight the need for more consistent mortality reporting and better-designed studies to clarify which patients are at highest risk.
REGISTRATION PROSPERO: CRD420251041174.
PMID:42668722 | PMC:PMC13525319 | DOI:10.1177/17562848261483780