African-Americans and Indigenous Peoples Have Increased Burden of Diseases of the Exocrine Pancreas: A Systematic Review and Meta-Analysis
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Ethnic health disparity is a well-acknowledged issue in many disease settings, but not diseases of the exocrine pancreas. A systematic review and meta-analysis was conducted to explore the race- and ethnicity-specific burden of diseases of the exocrine pancreas. Studies that compared health-related endpoints between two or more ethnicities were eligible for inclusion. Proportion meta-analyses were conducted to compare burden between groups. A total of 42 studies (24 on pancreatic cancer, 17 on pancreatitis, and one on pancreatic cyst) were included in the systematic review, of which 19 studies were suitable for meta-analyses. The incidence of pancreatic cancer was 1.4-fold higher among African–Americans, while the incidence of acute pancreatitis was 4.8-fold higher among an indigenous population (New Zealand Māori) compared with Caucasians. The prevalence of post-pancreatitis diabetes mellitus was up to 3.0-fold higher among certain ethnicities, including Asians, Pacific Islanders, and indigenous populations compared with Caucasians. The burden of diseases of the exocrine pancreas differs between ethnicities, with African-Americans and certain indigenous populations being at the greatest risk of developing these diseases. Development of race- and ethnicity-specific screening as well as protocols for lifestyle modifications may need to be considered with a view to reducing the disparities in burden of diseases of the exocrine pancreas.
KeywordsHealth disparity Pancreatic cancer Pancreatitis Post-pancreatitis diabetes mellitus
This study was part of the Clinical and epidemiological inveStigations in Metabolism, nutrition, and pancreatic diseaseS (COSMOS) program. COSMOS is supported in part by the Auckland Medical Research Foundation (Grant 1116021 to Associate Professor Max Petrov), which played no role in the study design; collection, analysis, or interpretation of data; or writing of the manuscript.
MSP and AC were involved in conception and design. AC and EKW were involved in study identification, screening, and assessment for inclusion. AC was involved in statistical analysis. AC, EKW, and MSP were involved in drafting of the article and critical revision of content.
Compliance with ethical standards
Conflict of interest
The authors declares that they have no conflict of interest.
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