Pancreatitis in Women of Reproductive Age: Global Burden, Rising Incidence in Youth, and Forecasts to 2050

Introduction

Pancreatitis is an important inflammatory disorder of the pancreas that contributes substantially to global morbidity and mortality. In the Global Burden of Diseases (GBD) 2021 study, the annual incidence rates among all ages globally standardized by WHO 2020 standard population (ASIR) for pancreatitis were 3.8 per 100000 population. Among women aged 15–49 years, the ASIR increased from 5.2 to 8.7 per 100,000 between 1990 and 2021, representing a 67.3% rise. Although the age-standardized mortality rate declined slightly over the past three decades, it remained at 1.1 per 100,000 globally in 2021, indicating a persistent and non-negligible disease burden in this population.¹ Approximately 20–30% of patients with acute pancreatitis develop severe complications, including persistent organ failure. Recurrent or chronic pancreatitis may result in long-term sequelae such as exocrine insufficiency and diabetes, substantially impairing quality of life. The damage caused by chronic pain and digestive function not only results in economic loss but also could lead to social issues as suffering from mental disorders as well. Global direct costs involved in the treatment of pancreatitis among those people reached $4.27 billion in 2021; indirect productivity costs accounted for 0.08% of total GDP suffered from this in countries where the disease took place, including many low-income countries and low-middle income countries.²

Epidemiological data suggest that women aged 15–49 years have a higher incidence of pancreatitis than men of the same age group (approximately 1.3:1). This difference may partly relate to sex-specific risk factors. First, estrogen fluctuation promotes occurrence of gallstones (women are 2–3 times more likely than men to develop gallstones), and gallstones are the leading cause of acute pancreatitis, accounting for 40%~60% of cases.³ Second, shifts in hormones of pregnancy and raised biliary pressure could cause pregnancy-accompanying pancreatitis which endangers 3%~5% reproductive-age women of world population.⁴ Besides, common social behaviors such as alcohol promoting incidence [globally, 28.7% of women aged 15–49 years consumed alcohol in 2021], or obesity dominating risk factors, the age-standardized prevalence of overweight among women aged 15–49 years increased from 15.2% in 1990 to 24.5% in 2021, potentially contributing to increased pancreatitis incidence.^1,5 But previously relevant investigation of ours targeted total population or ages group but less aiming on this exact population where dynamic change can emerge. Thus, results were not specialized in clinical intervention program, long time forward vision on disease burdens poor.

However, existing global analyses have primarily focused on the overall population, with limited attention to women aged 15–49, a group with distinct biological and social risk profiles. The lack of age- and sex-specific long-term trend analyses and future projections limits the development of targeted prevention strategies. Therefore, this study used GBD data from 1990 to 2021 to systematically evaluate temporal trends in incidence and DALYs using Joinpoint regression and age-period-cohort analysis and to forecast future incidence trends through 2050 using the Bayesian Age-Period-Cohort model. By specifically addressing this understudied population and integrating trend analysis with predictive modeling, this study aims to provide evidence to inform more precise public health strategies.

Methods

Data Source

The data of this study were from GBD 2021, which could be queried through the Global Health Data Exchange (GHDX). The data consisted of information on 371 diseases across 204 countries and regions (including 811 locations) from 1990 to 2021.^6,7 Diseases were classified according to ICD (Version 9 and 10). Pancreatitis was numbered as ICD-9577-577.9 and ICD-10 K85-K86.9. The standardization tools used in this study mainly included the DisMod-MR tool and the Cause-of-Death Set Model (CODEm). DisMod-MR is a Bayesian meta-regression tool assesses all available information regarding disease prevalence, incidence, remission rates and mortality and improves the consistency between epidemiological estimates.⁸ CODEm is an extremely effective software for analyzing cause-of-deaths and assessing the out-of-sample predictive value of each statistical model and arrangement of covariates, and provides specific estimates of deaths from each cause based on the prediction result of these.⁸ The GBD study was approved by The First Affiliated Hospital of Guangxi Medical University and University of Washington. This study employed publicly available data that did not include confidential or personally identifiable patient information.

Description Analysis

This study screened global data from the Global Burden of Disease (GBD) database for pancreaticitis incidence, disability-adjusted life years (DALYs), and corresponding age-standardized incidence (ASIR) and age-standardized DALY rates, providing foundational data for subsequent research. To clarify temporal trends in disease burden, the annual percentage change (EAPC) was calculated using Joinpoint software (National Cancer Institute, Rockville, MD, USA), with trend direction determined by the 95% confidence interval (CI) of EAPC estimates: a 95% CI >0 indicates an upward trend in age-standardized indicators; a 95% CI <0 suggests a downward trend; and a 95% CI containing 0 indicates a stable trend.⁹ All statistical analysis and visualization were performed using R statistical software (version 4.3) and Joinpoint software (version 4.9.1.0), with P <0.05 as the criterion for statistical significance.

Age-Period-Cohort (APC) Analysis

Results are expressed as the 2021 GBD database, including incidence and DALYs data of female pancreatitis in each year from the age-group defined as women of reproductive age (15–19 years, ...,45–49 years), period (1992–1996,1997-2001, ...,2017–2021) and birth cohort (1943–1953,1948-1958, ...,1998–2008). It uses a log-linear Poisson regression APC model to fit the disease’s prevalence over time by age group, period and birth cohort in the world and shows relative changes across three dimensions in the relative risk. APC is a standard method for studying epidemiological diseases. In the model: “age effect” refers to the trend of incidence change with age. The effects of period and cohort in different periods were adjusted by controlling their trends to the age-specific incidence and DALYs change. “Period effect” indicates that the changes from different periods in relative risk (RR) compared to the reference period; “cohort effect” indicates that the changes from different birth cohorts in relative risk compared to the reference cohort. According to the fitting model, the net drift and local drift were calculated. Net drift reflects the average annual change rate of incidence and DALYs of all population; and the local drift indicated that in different age groups, incidence and DALYs could display annual variation trend within the same group. All data management and model fitting were performed by R software version 4.3. The R scripts obtained from “APC Web Tool” of National Cancer Institute (NCI) were used to calculate net drift, local drift, age, period effect and the influence of the birth cohort.

BAPC Prediction Model

The Bayesian Age-Period-Cohort Model (BAPC) is a statistical method for analyzing and predicting age, period, and cohort effects in demographic events such as disease incidence and mortality. Built on a Bayesian framework, it effectively handles data complexity and parameter uncertainties. Using R, this study applied the BAPC model with the Integrated Nested Laplace Approximation (INLA) algorithm to forecast age-standardized incidence rates (ASIR) of pancreatitis from 2022 to 2050, assessing future trends and epidemiological impacts.⁸

Results

Global Trends

From 1990 to 2021, both the DALY burden and prevalence of pancreatitis among women aged 15–49 increased globally. The DALY burden rose from 325,376.51 to 417,564.75, and prevalence increased from 351,301.92 to 505,011.92. However, the age-standardized DALY rate decreased from 26.12 to 20.89, and the age-standardized incidence rate (ASIR) dropped from 27.84 to 25.48. Both standardized rates demonstrated significant annual decreases, with the EAPC (annual percentage change) for age-standardized DALY rate being −0.80 (95% CI: −0.94, −0.66) and for ASIR being −0.37 (95% CI: −0.44, −0.30), indicating a faster decline in the age-standardized DALY rate (Table 1).

Table 1 Age Standardized Rate and EAPC of Pancreatitis in Female Aged 15–49 Years at Global and Regional Level, 1990–2021

SDI Regional Distribution Trends

In 2021, the disease burden of pancreatitis among women aged 15–49 showed significant regional disparities across SDI levels. The age-standardized DALY rate was highest in High-middle SDI regions (28.61) and lowest in High SDI regions (13.45). All SDI regions exhibited a downward trend in DALY rates, with the sharpest decline observed in High SDI regions (EAPC [annual percentage change] = −1.22) and the slowest in Low-middle SDI regions (EAPC [annual percentage change] = −0.53). For ASIR, High SDI regions had the highest value (31.01), followed by Low SDI regions (22.07). ASIR increased in Low-middle SDI and Low SDI regions, with EAPC values of 0.30 and 0.12 respectively, while all other SDI regions saw decreases. High SDI regions experienced the most significant reduction (EAPC = −0.72), followed by Middle SDI regions (EAPC = −0.16) (Table 1 and Figure 1).

Figure 1 ASIR and age-standardized DALY rate of pancreatitis in female aged 15–49 years globally and for 21 GBD regions by SDI from 1990 to 2021. (A) ASIR. (B) Age-standardized DALY rate. Abbreviation: ASIR, age standardized incidence rate.

Age Distribution Trends

In 2021, the total DALY and cases of pancreatitis in women aged 15–49 increased with age, peaking at 45–49 years (DALYs: 106,583.20; cases: 94,774.39) and lowest at 15–19 years (DALYs: 24,943.57; cases: 41,802.94). All ASIR values show significant EAPC trend in varied ages for incidence rate. With regard to ASIR, only 15–19 and 20–24 had EAPC greater than 0 (0.45 and 0.26 respectively), which indicated a rising trend; all others experienced downward trends on average with ASIR dropping with aging groups, and the rate was larger than those with younger ages. ASIRs of both age groups of 40–44 and 45–49 were at the highest level, −0.78, which was the great decrease amount; concern about age-standardized DALY rate, all ages possessed the EAPCs below 0 with downward trend, while the decrease magnitude was the largest at the age group 40–44 (EAPC = −1.09), and the decrease was the least (the smallest decrease value) at the age of 25–29 (EAPC = −0.59). Both burden (ASIR) and disease (DALY) were highest at 45–49 years (40.22 and 45.23) and lowest at 15–19 years (ASIR: 13.77; DALY: 8.21), showing higher burdens in older age groups (Table 1 and Figures S1–S2).

Region and Distribution Trends

In 2021, the disease burden of pancreatitis in women aged 15–49 varied significantly across the 21 GBD regions. Eastern Europe had the highest DALY (116.37), far above Tropical Latin America (39.17) and Andean Latin America (38.71), while Central Sub-Saharan Africa had the lowest (6.00). Regarding the All-Region Disability-Adjusted Life Year (ASIR), Eastern Europe (74.44) also led, followed by High-Income North America (48.31) and Southern Latin America (45.46), while Tropical Latin America (11.13) had the lowest incidence. From 1990 to 2021, Eastern Europe’s ASIR DALYs EAPC (Estimated Annual Percentage Change) was 1.36, the only region with a worsening trend, whereas East Asia improved most (EAPC = −2.73). In terms of incidence trends, South Asia (EAPC = 0.46) and Eastern Europe (EAPC = 0.23) were among the few regions showing an increase, while East Asia (EAPC = −1.60) once again demonstrated the most significant decline (Tables S1−2, Figure 1 and Figure S3).

Country Trends

At the national level, data from 204 countries further revealed more specific distribution patterns. In 2021, the three countries with the heaviest disease burden were all concentrated in Eastern Europe: the Russian Federation (ASR DALYs: 127.16), Ukraine (97.00), and the Republic of Moldova (92.07), while Guam (2.42) had the lightest burden. The countries with the highest incidence rates were the Russian Federation (ASIR: 76.82), Ukraine (73.65), and surprisingly Cameroon (61.37), whereas Singapore (8.58) had the lowest incidence. Between 1990 and 2021, Guyana (EAPC = 2.74), Georgia (EAPC = 2.71), and Kyrgyzstan (EAPC =2.50) experienced the fastest growth in the disease burden of female pancreatitis; conversely, Slovenia (EAPC = −4.01) and Hungary (EAPC = −3.87) achieved the greatest improvement. For incidence, Chad (EAPC = 1.25) increased fastest, while Poland (−2.01) declined most (Tables S2–4, Figure 2 and Figure S4).

Figure 2 Age-standardized rate and EAPC of pancreatitis in female aged 15–49 years in 204 countries, 2021. (A) ASIR. (B) Age-standardized DALY rate. (C) EAPC of ASIR. (D) EAPC of age-standardized DALY rate. Abbreviations: ASIR: age standardized incidence rate; EAPC: estimated annual percentage change.

APC Analysis

From 1990 to 2021, the age-standardized incidence rate (ASIR) for women aged 15–49 with pancreatitis ASIR globally showed a slight decline (net drift = −0.25,95% CI: −0.30 to-0.20), while the age-standardized DALY rate decreased more significantly (−0.84,95% CI: −0.91 to −0.78). When categorized by Sustainable Development Index (SDI) levels, High SDI regions exhibited the most substantial reductions in both ASIR and age-standardized DALY rate (−0.67 and −1.25), Middle SDI regions remained relatively stable, whereas Low-middle and Low SDI regions displayed a paradoxical pattern: ASIR increased (−0.35 to 0.15) while age-standardized DALY rate decreased (−0.65 and −1.26). Local drift analysis showed ASIR peaking at 0.31 for women aged 15–19 globally, then declining with age and turning negative in middle age, especially in Middle, Low-middle, and Low SDI regions. The age effect reveals that both ASIR and age-standardized DALY rate increase with age (ASIR: 12.68 for 15–19 years to 39.72 for 45–49 years; age-standardized DALY rate: 11.01 to 45.47). High SDI regions show the steepest gradient, while Low SDI regions reach their peak age-standardized DALY rate in middle age (71.11). Period effects demonstrate a global decline in women’s ASIR from 1.04 (1992–1996) to 0.97 (2017–2021), with age-standardized DALY rate dropping from 1.03 to 0.82. High SDI regions experienced rapid decline after early peaks, whereas Middle SDI regions showed mild recovery in recent years. Birth cohort effects show the highest risk in early cohorts (1943–1953; ASIR RR = 1.23, DALY RR = 1.24), followed by gradual decline (1963–1973 cohort: RR = 1.01 and 1.00). Later-born cohorts (1998–2008) saw ASIR risk rebound (RR = 1.08) while DALY rate continued to decline. Further SDI analysis revealed that High SDI regions exhibited the highest early cohort risk, followed by a decline and sustained low levels. Middle SDI regions stabilized after the 1960s but showed recent recovery. Low-middle and Low SDI regions showed an “early high, decline, and rebound” pattern, while the age-standardized DALY rate remained downward (Tables S5−8, Figure 3 and Figures S5−7).

Figure 3 Analysis results of age-period-cohort model for global pancreatitis in women of childbearing age. (A) ASIR in globally. (B) ASIR in the high SDI. (C) ASIR in the high-middle SDI. (D) ASIR in the middle SDI. (E) ASIR in the low-middle SDI. (F) ASIR in the low SDI. (G) Age-standardized DALY rate in globally. (H) Age-standardized DALY rate in the high SDI. (I) Age-standardized DALY rate in the high-middle SDI. (J) Age-standardized DALY rate in the middle SDI. (K) Age-standardized DALY rate in the low-middle SDI. (L) Age-standardized DALY rate in the low SDI. Abbreviations: ASIR: Age standardized incidence rate; SDI: Socio-demographic Index.

ASIR’s BAPC Prediction

Prospective prediction results indicate that the ASIR of pancreatitis among women aged 15–49 worldwide will continue to rise between 2021 and 2050, showing a trend of gradual acceleration. The overall trend is approximately linear with progressive acceleration, increasing by an average of about 0.089 per year (a relative annual growth rate of 0.35%). When observed in phases, the ASIR was 25.51 (95% CI: 25.48–25.53) in 2021; it is projected to rise to 26.31 (95% CI: 25.84–26.77) by 2030, an increase of 0.80 (+3.14%) compared to 2021; further climb to 27.31 (95% CI: 26.08–28.54) by 2040, with a cumulative increase of 1.80 (+7.06%); and reach 28.10 (95% CI: 25.12–31.08) by 2050, representing a total increase of 2.59 (+10.15%) (Table S9 and Figure 4).

Figure 4 ASIR trend of global pancreatitis in women of childbearing age from 2022 to 2050 predicted by the Bayesian Age-Period-Cohort (BAPC) model. Abbreviation: ASIR: age standardized incidence rate.

Discussion

In this study, ASIR represents incidence, while DALY represents disease burden. This consistent terminology is used throughout the text to avoid confusion. From 1990 to 2021, the total number of cases and health loss among women aged 15–49 with pancreatitis increased, while age-standardized DALY rates (burden) declined faster than the age-standardized incidence rate (ASIR, incidence). Across SDI regions, high-middle SDI areas showed the highest age-standardized DALY rates, while low-middle and low SDI regions were the only categories with rising ASIR. In terms of age distribution, the 45–49 age group bore the heaviest disease burden, while the 15–19 and 20–24 age groups experienced increasing ASIR. At the GBD regional and national levels, Eastern Europe had the highest disease burden and was the only region showing worsening trends. Among countries, the Russian Federation had the highest burden, Guyana saw the fastest disease burden growth, and Chad recorded the sharpest increase in incidence. APC analysis revealed the highest local drift in the age-standardized incidence rate (ASIR) for women aged 15–19, with incidence risk rebounding in later-born cohorts. Additionally, the BAPC model projected sustained and accelerating ASIR growth for this population globally from 2021 to 2050.

This trend primarily resulted from population growth and demographic shifts that offset the actual risk reduction: global population expansion and increased reproductive-age women drove up absolute case numbers, while the decline in age-standardized disability-adjusted life years (DALYs) reflected improvements in risk factor control (eg., reduced smoking rates and better gallstone management) and widespread early screening, which significantly lowered age-adjusted disease risk.¹⁰ The faster decline in age-standardized DALYs compared to ASIR indicates that medical interventions (eg., upgraded intensive care and minimally invasive surgeries) substantially reduced mortality. Although the disability burden partially offsets this effect, the overall reduction in health loss was more pronounced.¹¹ High-middle SDI regions showed the highest DALY rates due to high prevalence of obesity, alcohol consumption, and metabolic syndrome.¹² In contrast, low-middle and low SDI regions experienced rising ASIR due to urbanization and Westernized lifestyles, with limited public health resources constraining intervention effectiveness.^13,14 This highlights the need for coordinated public health strategies to prevent further increases in pancreatitis burden.

Older women (45–49 years) bear the highest disease burden, whereas adolescents (15–24 years) show rising ASIR. This pattern reflects age-related risk factors, including gallstone formation, chronic metabolic diseases (obesity, diabetes), and alcohol consumption. Improved detection and treatment have reduced overall incidence, but adolescent incidence has risen in recent decades due to changing dietary habits and sedentary lifestyles.¹⁵ Possible reasons are as follows. One is that young and adult female may have been increasingly affected by the rapid changes of dietary habits and lifestyles in developing countries.¹⁵ Since the Western lifestyle, diet (rich of animal fat and sugar), excessive screen time and long sedentary duration are widespread among young people nowadays, especially female adolescents, who have dramatically seen increased numbers over the past three decades. The World Health Organization reported that adolescent obesity in China had grown more than 300%.¹⁶

Moreover, the development of primary care and community services has enabled wider early screening of diseases, such as abdominal sonography.¹⁶ Compared with ages above 25 years, incidence in younger women can be mainly reduced through tobacco prevention, better infectious disease control, and improved hygiene.¹⁷ Policies and medical interventions, including smoke reduction strategies, early minimally invasive surgery for cholelithiasis, and community health education, can further reduce incidence and prevent serious complications.^18,19 These measures highlight the importance of integrated public health strategies to curb disease growth and manage population risk. The regional comparative analysis of this study reveals a spatial disparity in the disease burden of pancreatitis among women aged 15–49 worldwide. Eastern Europe has emerged as the global focal point of this disease burden, with its age-standardized DALY rate (116.37 per 100,000 population) 19 times higher than Sub-Saharan Africa, and is the only region with worsening trends. At the national level, the highest burden is concentrated in the Russian Federation, Ukraine, and Moldova. Socio-behavioral and healthcare system roots driving the high burden in Eastern Europe: The unusually heavy disease burden in Eastern Europe is the combined result of its unique risk exposure patterns and socio-historical context. Long-term and widespread high levels of alcohol consumption and smoking, as key behavioral risk factors for pancreatitis, have become deeply entrenched cultural habits in the region.²⁰ This phenomenon has been further exacerbated by the pains of socioeconomic transformation in the post-Soviet era. Social unrest, rising unemployment, and mental health crises have further fueled the prevalence of risky behaviors. Coupled with systemic issues such as uneven distribution of medical resources and a weak prevention system, these factors have collectively led to the failure of disease prevention and insufficient early intervention.²¹ In stark contrast to the worsening trend in Eastern Europe, East Asia has achieved the most remarkable improvement. This can be attributed to the region’s robust comprehensive public health policies, such as national chronic disease prevention and control programs aimed at promoting healthy diets, strict tobacco control, and optimizing primary healthcare services, which have effectively reduced the level of population exposure to risks.²²

However, the extremely low reporting rate observed in Sub-Saharan Africa should be interpreted with caution. This is more likely to reflect a systemic underestimation caused by limited diagnostic capabilities, an infectious disease-prioritized prevention and control system, and a weak health data collection system in the region, rather than a true low incidence. Its actual disease burden is probably masked by the current data.²³ In summary, Eastern Europe has become an urgent front for the prevention and control of pancreatitis among women of childbearing age worldwide. There is an urgent need to implement targeted intensive interventions in this region, focusing on curbing alcohol abuse, popularizing health education, and improving medical accessibility to address this ongoing and worsening public health crisis.²⁴

Global age-period-cohort analysis of the situation of pancreatic inflammation in the period from birth cohort on a female aged from 15–49 years showed an evolutionary picture (period: 2021, SDI: low). The earliest cohorts experienced were from the 1950s to the 1970s which had the highest risks of occurrence, mainly attributed to the prevailing poor habits (eg., smoking and drinking), backward medical services, and other reasons that enhanced damage to patients’ pancreas.²⁵ It is not long before their risk lowered, as strong global tobacco control in the past decades with other public health activities aimed at avoiding unhealthy diets; basic medical conditions have also improved, hence lowering the chances for such people to suffer modifiable causes damages.²⁶ In contrast, the later cohorts from different periods of birth years from 1998 through 2008 saw an increase in incidence risks, especially in medium and low SDI regions. It was mainly due to globalise trends in bad lifestyles (like the rise of fat-rich and sugar diet), increasing obesity or more cases in type 2 diabetes; owing to insufficient options of therapies and health education in these local areas; thus, it is very hard to properly treat with the new risks of such lifestyle in the future generations. Thus, this rising trend lasted up to recent years.^27,28 Overall forecasts based on Bayes model indicate global incidence will likely increase again over the next several years with a predicted rise of about 10.15% from its level in 2021 by 2050. This can reflect the effects from population sizes, intensified urbanization, environmental changes, like high air pollution and rising stress, etc., still being difficult issues as important parts in public health, requiring timely measures aimed specifically for prevention and health preservation; eg., better promoting good diets, easier medicines access for treatment, monitoring systems for controlling these sources of risks, etc., thus would help lessening burden on diseases, especially in medium and low SDI regions.²⁹

The article’s greatest merit is using age-period-cohort BAPC model to show and foresee the burden of pancreatic inflammation in women aged 15–49 in different regions, allowing us to investigate the changes in such burden deeply within a range of population. At the same time, it has its limitations. First, since the data about global disease burden showed that there were serious biases and poor diagnostic ability (especially in low-middle SDI levels (socioeconomic development index) and poor SDI level areas, mainly Sub-Saharan Africa due to limited medical and health resource leading to under-estimate real burden). Therefore, the data cannot be sufficient or highly reliable compared to rich countries in respect of disease-related factors and interventions,³⁰ which makes us lack evidence and relevant data to support change in the proportion of patient over recent decades, even if we find it is changed by certain conditions or risk factors like metabolic diseases. Moreover, we cannot directly compare future incidence rates between developed and developing countries. Second, this research distinguishes none of several types of pancreatic inflammation (acute vs. chronic), nor does it consider any influence on trends caused by difference of particular causes of pancreatitis over certain period (like alcoholic vs. biliary pancreatitis). Then, important role or function of key factors like metabolic diseases or diets could be over/underestimated and also some characters specifically existed in local population may be overlooked.³¹ Meanwhile, the BAPC model mainly draws previous extrapolations instead of taking into account economic variables in the future. For instance, the speed of urbanization or health policy measure, weakening the idea of considering increase in incidence rate with generation from a cross generation angle in the past century, thus making it hard to discover uncertainty in estimating outcomes through comparison of future project rates more than 2050.³² Third, although authors pointed out some other factors (social habit in Russian federation countries or special state in Eastern Europe country during transitional socioeconomic pattern) would partially influence results by changing certain behaviors and so on. However, many problems still cannot get an answer clearly in the paper (such as will similar response exist if changes are caused by some patterns rather than certain factors, as male consumption cultures etc., and causal mechanisms involved would be similar to general populations or not), which make intervention suggestion obscure and unviable.³³

Conclusion

From 1990 to 2021, the global burden of pancreatitis among women aged 15–49 increased in total DALYs and new cases, despite significant declines in age-standardized DALY rates and age-standardized incidence rates, with DALY rates decreasing more rapidly. Marked regional and age-related disparities were observed: high-middle SDI regions had the highest age-standardized DALY rates, whereas low SDI regions experienced rising incidence trends. Women aged 45–49 years bore the greatest burden, while younger age groups showed increasing incidence. Eastern Europe exhibited the highest burden and was the only region with a worsening trend, whereas East Asia and several European countries demonstrated notable improvements. Projections suggest a continued acceleration in incidence through 2050, particularly among younger and later-born cohorts.

These findings provide a comprehensive overview of the temporal, regional, and demographic patterns of pancreatitis among women of reproductive age. They highlight the public health importance of addressing emerging risks in younger populations and persistent inequalities across regions, supporting the need for targeted and evidence-based prevention strategies.