Acute pancreatitis is rising faster than expected in South Australia, with new research revealing rates above the global average and climbing most sharply among women and people living in wealthier areas.
The condition, often stereotyped as a disease of heavy drinking and social disadvantage, is increasingly being driven by gallstones and metabolic risk factors, signalling a major shift in who is getting sick, and why.
The findings come from a major 16‑year population study led by Flinders University and published in the international journal, Pancreatology. The research analysed linked hospital and emergency department data between 2007 and 2022, identifying more than 15,000 South Australians who required care for acute pancreatitis.
Once considered largely alcohol‑related, acute pancreatitis is a sudden and painful inflammation of the pancreas that can cause severe abdominal pain, vomiting, extended hospital stays and, in serious cases, organ failure and death. Despite its impact, there remains no specific treatment, making prevention and early intervention critical.
The study found the overall incidence of acute pancreatitis in South Australia increased from around 51 cases per 100,000 people in 2007 to nearly 57 per 100,000 in 2022 - higher than the global average and comparable to rates seen in North America and parts of Central Asia. While men remain slightly more likely to develop the condition overall, the strongest growth over time was seen among women.
"The rise in acute pancreatitis in women matches the global data, and reflects changing risk factors that need urgent attention," says Professor Savio (George) Barreto, a Consultant, HPB and Liver Transplant Unit at Flinders Medical Centre, SALHN and researcher at Flinders University.
"What this study shows is a clear shift in acute pancreatitis away from alcohol and disadvantage, with rising cases in women and wealthier areas most likely driven by gallstones and metabolic risk factors."
Gallstones were identified as the leading cause of acute pancreatitis in South Australia, particularly among women and older adults, reflecting known links between gallstones, hormonal factors, ageing, obesity and metabolic health.
Alcohol‑related pancreatitis accounted for a smaller proportion overall, with researchers observing only a brief spike during the COVID‑19 pandemic, thereafter returning to pre‑pandemic levels.
Although people living in socioeconomically disadvantaged communities continue to experience the highest overall rates of acute pancreatitis, the study found the fastest growth occurring among those living in the least disadvantaged areas - an unexpected pattern that challenges long‑held assumptions about who is at risk.
Lead author Dr Eleonora Dal Grande says the findings gave one of the most comprehensive pictures to date of how the disease affects South Australians and how other diseases, or global social events, such as COVID, can have an impact on conditions.
"While the burden remains highest in disadvantaged communities, the rising incidence in more advantaged areas is something health systems must prepare for," she says.
Most people experienced only a single episode of acute pancreatitis, but nearly one in four returned to hospital with repeat presentations. The median age at first presentation was 55 years, meaning the disease often affects people during their working lives. Hospital stays typically last several days, contributing to significant healthcare costs and disruption for patients and families.
The study found that many cases were coded as having an unclear cause, despite international guidelines recommending that an underlying cause be identified for every episode of acute pancreatitis.
"This is an important gap and separate research shows that patients with an unclear cause of pancreatitis may harbour an underlying pancreatic cancer compared to those with more obvious causes like gallstones or alcohol," says Professor Barreto, group leader of FHMRI's PANACEA
The national research provides further reassurance, while highlighting the need for targeted investigation.
"Acute pancreatitis, itself, is not a risk factor for pancreatic cancer, but in some cases it can be a presenting symptom of an existing (underlying) cancer," says Professor Barreto.
Lead author, Lucas Wigston says, "The likelihood that a person presenting with acute pancreatitis has an underlying pancreatic cancer is very low - around one per cent overall - and the vast majority of cancers are identified within the first three months."
"However, the risk is not the same for everyone. Older patients and those without a clear cause for their pancreatitis may have a slightly higher likelihood and identifying these groups can help prioritise the use of CT scans and follow‑up care."
"This is about getting the balance right - ensuring early detection where needed, without exposing every patient to unnecessary testing."
"This is not a rare condition, and it is not going away. Acute pancreatitis is a growing and shifting health issue in South Australia that demands attention."
While the research focuses on South Australia, the authors say the findings are nationally and globally relevant, aligning with - and in some cases anticipating - emerging trends seen elsewhere in Australia and in other high‑income countries.
Professor Barreto, who is a Consultant Surgeon on the HPB and Liver Transplant Unit at Flinders Medical Centre, SALHN has recently published research relating to developments in young onset pancreatic cancers, early onset cancer survivors, and pancreatic cancer.
The paper, ' Epidemiological time trends in acute pancreatitis - A 16-year experience from South Australia', by Eleonora Dal Grande, Jacqueline H. Stephens, Mark E. Brooke-Smith, Minoti Apte (University of New South Wales), Daniel Croagh (Monash Health/Monash University), Rachel E. Neale (University of Queensland, Brisbane), Tony Pang (University of Sydney), Chee (Keith) Y. Ooi (University of New South Wales), Jeremy Wilson (University of New South Wales), Ross A. McKinnon, Richard C. Turner (University of Tasmania) and Savio George Barreto, was published in Pancreatology. DOI: 10.1016/j.pan.2026.03.024
See also, 'Absolute risk of pancreatic cancer in people with acute pancreatitis - the Australian experience' by Lucas Wigston, Eleonora D. Grande, Jacqueline Stephens, Mark E. Brooke-Smith, Minoti Apte, Daniel Croagh, Tony Pang, Chee Y. Ooi, Jeremy Wilson, Ross A. McKinnon, Richard C. Turner, Rachel E. Neale and Savio G. Barreto was published in HPB. DOI: 10.1016/j.hpb.2026.05.011
Acknowledgements: All research was supported as follows: SGB – Flinders Foundation grant (# 49358025).
