Worldwide distribution, associated factors, and trends of gallbladder cancer: A global country-level analysis

Junjie Huang; Harsh K Patel; Daniel Boakye; Viveksandeep Thoguluva Chandrasekar; Anastasios Koulaouzidis; Don Eliseo Lucero-Prisno Iii; Chun Ho Ngai; Ching Nei Pun; Yijun Bai; Veeleah Lok; Xianjing Liu; Lin Zhang; Jinqiu Yuan; Wanghong Xu; Zhi-Jie Zheng; Martin Cs Wong

doi:10.1016/j.canlet.2021.09.004

Worldwide distribution, associated factors, and trends of gallbladder cancer: A global country-level analysis

Cancer Lett. 2021 Sep 10:521:238-251. doi: 10.1016/j.canlet.2021.09.004. Online ahead of print.

Authors

Junjie Huang¹, Harsh K Patel², Daniel Boakye³, Viveksandeep Thoguluva Chandrasekar⁴, Anastasios Koulaouzidis⁵, Don Eliseo Lucero-Prisno Iii⁶, Chun Ho Ngai¹, Ching Nei Pun¹, Yijun Bai¹, Veeleah Lok⁷, Xianjing Liu⁸, Lin Zhang⁹, Jinqiu Yuan¹⁰, Wanghong Xu¹¹, Zhi-Jie Zheng¹², Martin Cs Wong¹³

Affiliations

¹ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
² Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA, United States.
³ School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK.
⁴ Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, United States.
⁵ Department of Social Medicine & Public Health, Pomeranian Medical University, Szczecin, Poland.
⁶ Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁷ Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁸ Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁹ Centre of Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
¹⁰ Clinical Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China; Scientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
¹¹ School of Public Health, Fudan University, Shanghai, China.
¹² Department of Global Health, School of Public Health, Peking University, Beijing, China. Electronic address: zhengzj@bjmu.edu.cn.
¹³ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Global Health, School of Public Health, Peking University, Beijing, China. Electronic address: wong_martin@cuhk.edu.hk.

PMID: 34506845
DOI: 10.1016/j.canlet.2021.09.004

Abstract

This study aimed to evaluate the global distribution, associated factors, and epidemiologic trends of gallbladder cancer (GBC) by country, sex, and age groups. The Global Cancer Observatory was interrogated for the disease burden of GBC using age-standardized rates (ASR). The prevalence of different potential risk factors for each country was extracted from Global Health Observatory and their associations with GBC incidence and mortality were examined by linear regression analysis using beta coefficients (β). The Cancer Incidence in Five Continents I-XI and the WHO Mortality database were searched and Average Annual Percent Change (AAPC) was generated from joinpoint regression analysis. The incidence (ASR = 2.3) and mortality (ASR = 1.7) of GBC varied globally in 2018 and were higher in more developed countries and among females. Countries with higher incidence had higher human development index (β_male = 0.37; β_female = 0.27), gross domestic products (β_male = 0.13) and higher prevalence of current smoking (β_female = 0.05), overweight (β_male = 0.02), obesity (β_male = 0.03), and hypercholesterolaemia (β_male = 0.07). Similar patterns of associations were also observed for mortality with an additional association found for diabetes (β_female = 0.07). Although there was an overall decreasing trend in mortality, an increasing trend in incidence was observed among some populations, particularly in males (AAPCs, 8.97 to 1.92) and in younger individuals aged <50 years (AAPCs, 12.02 to 5.66). The incidence of GBC varied between countries and was related to differences in the prevalence of potential risk factors. There was an increasing incidence trend among males and younger individuals. More intensive lifestyle modifications and disease surveillance are recommended for these populations.

Keywords: Cholecyst; Incidence; Malignancy; Mortality; Risk factors; Temporal pattern.