Gallbladder Cancer Incidence Rates Research Articles

Gallbladder cancer incidence and mortality rate trends in China: analysis of data from the population-based cancer registry.

Gallbladder cancer is a major health concern in China, and awareness of the associated incidence and mortality rates is particularly important given the aging population. To determine trends in gallbladder cancer incidence and mortality rates over 12years and quantitatively analyze the influence of demographic factors on these rates in China. We performed a retrospective study of 98,860 Chinese citizens using the Chinese Cancer Registry, a national database. Gallbladder cancer incidence and mortality data pertaining to patients treated between 2005 and 2017 were collected. Joinpoint regression models were used to estimate the annual percentage change (APC) and average APC (AAPC). We used age-period-cohort analyses and decomposition methods to investigate differing trends in incidence and mortality. The age-standardized gallbladder cancer incidence and mortality rates in China trended downward between 2005 and 2017, with AAPCs of -2.023% and -1.603%, respectively. Coefficients of age effect for incidence rate increased with age up to 70years and peaked at 70-79years, while coefficients of age effect for the mortality rate showed a consistent increase with age. Both coefficients of period for incidence and mortality rates increased in more recent periods; in terms of the cohort effect, coefficients of cohort for rates generally decreased in later birth years but showed a partial rise between 1982 and 1996. The crude incidence rates of gallbladder cancer according to demographic and non-demographic factors were 626.09% and -526.09% respectively (366.23% and -266.23% among men, and 6068.93% and -5968.93% among women, respectively). The rates were 543.01% and -443.01%, respectively, in urban areas and were 68.22% and 31.78%, respectively, in rural areas. The mortality rates according to demographic and non-demographic factors were -495.93% and 595.93%, respectively (-1763.10% and -1863.10% for men and -270.56% and -370.56% for women, respectively). These rates were -930.33% and 1030.33%, respectively, in urban areas and were 101.48% and -1.48%, respectively, in rural areas. The overall standardized gallbladder cancer incidence and mortality rates in China are trending downward, but not sufficiently so. Proper living and eating habits should be encouraged while exploring the establishment of long-term, standardized gallbladder cancer screening programs.

Reconsidering Routine Histopathological Examination of Gallbladder Specimens in Cholecystectomy: Optimizing Clinical Practice and Resource Management.

Introduction Cholecystectomy, the surgical removal of the gallbladder, is a common procedure worldwide. Despite no visible anomalies, routine histopathological examination (HPE) of gallbladder specimens post-surgery is standard practice to exclude pathologies, notably gallbladder cancer (GBC). Incidence rates of GBC vary geographically and ethnically. Surgical intervention is recommended for advanced GBC stages, while early stages may require cholecystectomy alone. Although rare, GBC and bile duct cancers pose increased risks in certain demographics, such as women and individuals over 65. Routine HPE practices vary globally based on resource availability and GBC incidence. This study assesses the necessity of routine HPE by evaluating the selective processing of gallbladder specimens suspected of GBC, prioritizing patient safety. Materials and methods This retrospective cohort study conducted at Redland Hospital, a district general hospital in Australia, investigated the necessity of routine HPEfor excised gallbladder specimens. Adhering to routine HPE policy, the study encompassed all elective and emergency cholecystectomies performed from January 2023 to December 2023, excluding pediatric cases, concurrent surgical procedures, and those with suspected malignancy. Demographic data, surgery indications, intraoperative findings, histopathological results, and incidental gallbladder cancer (IGC)outcomes were analyzed. Pathology reports and case documentation were reviewed for cancerous pathology indicators. Results Over the one-year study period from January 2023 to December 2023, a total of 266 gallbladder specimens were subjected to HPEpost-cholecystectomy. Of these, 201 were female and 65 were male, yielding a male-to-female ratio of 3:1. Elective cholecystectomy was performed on 56.4% (150) of patients, while 43.6% (116) underwent emergency procedures. Laparoscopic cholecystectomy (LC) was the primary surgical approach, except for one case requiring conversion to an open procedure. None of the patients exhibited GBC; however, 3.3% (9) displayed premalignant histopathological features in their specimens. Conclusion In conclusion, adopting a selective approach, where only gallbladder specimens with macroscopic abnormalities undergo HPE, seems prudent, especially in regions with low GBCincidence. Our study, which revealed no cases of GBC, supports this approach. It not only reduces the risk of missing incidental carcinoma in clinically unsuspected cases but also proves cost-effective and reduces the histopathology department workload without compromising patient outcomes. Therefore, we advocate for routine macroscopic examination of gallbladder specimens for abnormalities before HPE submission, particularly in cholecystectomy patients with gallstone disease.

Racial and ethnic disparities in gallbladder cancer: A two-decade analysis of incidence and mortality rates in the US.

Gallbladder cancer (GBC) is an aggressive malignancy that is usually diagnosed at a late stage. Prior data showed increasing incidence of GBC in the US. However, little is known about race/ethnic-specific incidence and mortality trends of GBC per stage at diagnosis. Therefore, we aimed to conduct a time-trend analysis of GBC incidence and mortality rates categorized by race/ethnicity and stage-at-diagnosis. Age-adjusted GBC incidence and mortality rates were calculated using SEER*Stat software from the United States Cancer Statistics database (covers ~98% of US population between 2001 and 2020) and NCHS (covers ~100% of the US population between 2000 and 2020) databases, respectively. Race/Ethnic groups were Non-Hispanic-White (NHW), Non-Hispanic-Black (NHB), Hispanic, Non-Hispanic-Asian/Pacific-Islander (NHAPI), and Non-Hispanic-American-Indian/Alaska-Native (NHAIAN). Stage-at-diagnoses were all stages, early, regional, and distant stages. Joinpoint regression was used to generate time-trends [annual percentage change (APC) and average APC (AAPC)] with parametric estimations and a two-sided t-test (p-value cut-off 0.05). 76,873 patients were diagnosed with GBC with decreasing incidence rates in all races/ethnicities except NHB who experienced an increasing trend between 2001 and 2014 (APC = 2.08, p < 0.01) and plateauing afterward (APC = -1.21, p = 0.31); (AAPC = 1.03, p = 0.03). Among early-stage tumors (9927 patients), incidence rates were decreasing only in Hispanic (AAPC = -4.24, p = 0.006) while stable in other races/ethnicities (NHW: AAPC = -2.61, p = 0.39; NHB: AAPC = -1.73, p = 0.36). For regional-stage tumors (29,690 patients), GBC incidence rates were decreasing only in NHW (AAPC = -1.61, p < 0.001) while stable in other races/ethnicities (NHB: AAPC = 0.73, p = 0.34; Hispanic: AAPC = -1.58, p = 0.24; NHAPI: AAPC = -1.22, p = 0.07). For distant-stage tumors (31,735 patients), incidence rates were increasing in NHB (AAPC = 2.72, p < 0.001), decreasing in Hispanic (AAPC = -0.64, p = 0.04), and stable in NHW (AAPC = 0.07, p = 0.84) and NHAPI (AAPC = 0.79, p = 0.13). There were 43,411 deaths attributed to GBC with decreasing mortality rates in all races/ethnicities except NHB who experienced a stable trend (AAPC = 0.25, p = 0.25). Nationwide data over the last two decades show that NHB patients experienced increasing GBC incidence between 2001 and 2014 followed by stabilization of the rates. This increase was driven by late-stage tumors and occurred in the first decade. NHB also experienced non-improving GBC mortality, compared to other race and ethnic groups who had decreasing mortality. This can be due to lack of timely-access to healthcare leading to delayed diagnosis and worse outcomes. Future studies are warranted to investigate contributions to the revealed racial and ethnic disparities, especially in NHB, to improve early detection.

Gastrointestinal cancer trends in the Hispanic population: A SEER database population study (2000-2019).

725 Background: Cancer continues to be the leading cause of death in the Hispanic population. Gastrointestinal cancer surveillance data in Hispanic individuals has only recently become available in the last 3 decades. Differences in incidence rates among Hispanics and Non-Hispanic Whites (NHWs) need further elucidation. In this study, we analyzed trends in Hispanics and NHW populations across multiple gastrointestinal cancers. Methods: Gastrointestinal cancers (liver, colon and rectum, pancreas, esophagus, gallbladder, stomach, small intestine, anus, anal canal and anorectum) diagnosed between 2000-2019 were identified in the Surveillance, Epidemiology, and End Results Program (SEER) Database. We calculated incidence rates, confidence intervals and incidence rate ratios. Rates are per 100,000 and age adjusted to the 2000 US standard population. Rate ratios are the rounded rates in Hispanic individuals divided by the rounded rates in NHWs. Results: There was a higher incidence of liver, gallbladder, and stomach cancers among Hispanics when compared to NHWs between the years 2000-2019. Liver cancer incidence rate is (11.5 per 100,000) in Hispanics compared with (6.3 per 100, 000) in NHWs with an incidence rate ratio of 1.8. Gallbladder cancer incidence rate is (2.2 per 100,000) in Hispanics compared with (0.9 per 100,000) in NHWs with an incidence rate ratio of 2.4. Stomach cancer is (10.9 per 100,000) in Hispanics compared with (5.7 per 100,000) in NHWs with an incidence rate ratio of 1.9. The lowest incidence rate ratio was seen for anus, anal canal and anorectum cancers in Hispanics compared to NHWs. The incidence rate is (1.2 per 100,000) in Hispanics compared with (2.1 per 100,000) in NHWs with an incidence rate ratio of 0.6. Remaining cancers had incidence rate ratios less than 1.0 and were more likely to occur in NHWs. Conclusions: This study illustrates differing incidence rates of multiple gastrointestinal cancers among Hispanics compared to NHWs. Liver, gallbladder and stomach cancer incidence rates in Hispanics is double that of NHWs. Interestingly, the remaining gastrointestinal cancers had higher incidence rates among NHWs. Further research is warranted to understand the differences in cancer risk within the Hispanic population as well as healthcare access, language barriers and cultural differences that may play a role.[Table: see text]

Association of tea and coffee consumption and biliary tract cancer risk: The Biliary Tract Cancers Pooling Project.

Tea and coffee are widely consumed beverages worldwide. We evaluated their association with biliary tract cancer (BTC) incidence. We pooled data from 15 studies in the Biliary Tract Cancers Pooling Project to evaluate associations between tea and coffee consumption and biliary tract cancer development. We categorized participants as nondrinkers (0 cup/day), moderate drinkers (>0 and <3 cups/day), and heavy drinkers (≥3 cups/day). We estimated multivariable HRs and 95% CIs using Cox models. During 29,911,744 person-years of follow-up, 851 gallbladder, 588 intrahepatic bile duct, 753 extrahepatic bile duct, and 458 ampulla of Vater cancer cases were diagnosed. Individuals who drank tea showed a statistically significantly lower incidence rate of gallbladder cancer (GBC) relative to tea nondrinkers (HR=0.77; 95% CI, 0.64-0.91), and intrahepatic bile duct cancer (IHBDC) had an inverse association (HR=0.81; 95% CI, 0.66-1.00). However, no associations were observed for extrahepatic bile duct cancer (EHBDC) or ampulla of Vater cancer (AVC). In contrast, coffee consumption was positively associated with GBC, with a higher incidence rate for individuals consuming more coffee (HR<3 cups/day =1.29; 95% CI, 1.01-1.66; HR≥3 cups/day =1.49; 95% CI, 1.11-1.99, Ptrend=0.01) relative to coffee nondrinkers. However, there was no association between coffee consumption and GBC when restricted to coffee drinkers. There was little evidence of associations between coffee consumption and other biliary tract cancers. Tea consumption was associated with a lower incidence of GBC and possibly IHBDC. Further research is warranted to replicate the observed positive association between coffee and GBC.

Gastrointestinal cancer trends in the Hispanic population: A SEER database population study (2000-2019).

e16331 Background: Cancer continues to be the leading cause of death in the Hispanic population. Gastrointestinal cancer surveillance data in Hispanic individuals has only recently become available in the last 3 decades. Differences in incidence rates among Hispanics and Non-Hispanic Whites (NHWs) need further elucidation. In this study, we analyzed trends in Hispanics and NHW populations across multiple gastrointestinal cancers. Methods: Gastrointestinal cancers (liver, colon and rectum, pancreas, esophagus, gallbladder, stomach, small intestine, anus, anal canal and anorectum) diagnosed between 2000-2019 were identified in the Surveillance, Epidemiology, and End Results Program (SEER) Database. We calculated incidence rates, confidence intervals and incidence rate ratios. Rates are per 100,000 and age adjusted to the 2000 US standard population. Rate ratios are the rounded rates in Hispanic individuals divided by the rounded rates in NHWs. Results: There was a higher incidence of liver, gallbladder, and stomach cancers among Hispanics when compared to NHWs between the years 2000-2019. Liver cancer incidence rate is (11.5 per 100,000) in Hispanics compared with (6.3 per 100, 000) in NHWs with an incidence rate ratio of 1.8. Gallbladder cancer incidence rate is (2.2 per 100,000) in Hispanics compared with (0.9 per 100,000) in NHWs with an incidence rate ratio of 2.4. Stomach cancer is (10.9 per 100,000) in Hispanics compared with (5.7 per 100,000) in NHWs with an incidence rate ratio of 1.9. The lowest incidence rate ratio was seen for anus, anal canal and anorectum cancers in Hispanics compared to NHWs. The incidence rate is (1.2 per 100,000) in Hispanics compared with (2.1 per 100,000) in NHWs with an incidence rate ratio of 0.6. Remaining cancers had incidence rate ratios less than 1.0 and were more likely to occur in NHWs. Conclusions: This study illustrates differing incidence rates of multiple gastrointestinal cancers among Hispanics compared to NHWs. Liver, gallbladder and stomach cancer incidence rates in Hispanics is double that of NHWs. Interestingly, the remaining gastrointestinal cancers had higher incidence rates among NHWs. Further research is warranted to understand the differences in cancer risk within the Hispanic population as well as healthcare access, language barriers and cultural differences that may play a role. [Table: see text]

Short-term efficacy of cholecystectomy plus bile duct T-tube drainage or choledochojejunostomy in the treatment of gallbladder cancer and its effects on median survival time and postoperative complications.

To explore the short-term efficacy of cholecystectomy plus bile duct T-tube drainage or choledochojejunostomy (CJ) in the treatment of gallbladder cancer (GC) and its effects on the median survival time and postoperative complications. The clinical data of 121 patients who underwent laparoscopic cholecystectomy (LC) in department of hepatobiliary surgery of the hospital from January 2018 to December 2018 were retrospectively analyzed. According to the adjuvant treatment methods, the patients were divided into 2 groups: the control group (n = 61, LC + bile duct T-tube drainage) and experimental group (n = 60, LC + CJ). The perioperative indicators, short-term efficacy, median survival time, postoperative complications and immune stress response were compared between the 2 groups of patients before and after propensity score matching. The surgical time, postoperative anal first exhaust time, and intraoperative blood loss in the experimental group were no different from those in the control group (P > .05), but the hospital stay was shorter than that in the control group (P < .05). There was no difference in the effective rate of treatment and median survival time between the 2 groups (P > .05). The total incidence rate of complications in the experimental group at 14 days after surgery was lower than that in the control group (P < .05). Day 3 after surgery, the levels of immunoglobulin M (IgM) and immunoglobulin G (IgG) of the experimental group were higher than those of the control group (P < .05), while the level of C-reactive protein (CRP) was lower than that of the control group (P < .05). Compared with bile duct T-tube drainage, LC + CJ in the treatment of GC can better shorten the postoperative hospital stay and reduce the postoperative complications and immune stress response, but and the median survival time of the 2 is similar, which can be promoted in clinical practice.

Surgical resection in oligo-metastatic gallbladder cancer: Study protocol for a phase II randomized clinical trial.

Background: Gallbladder cancer incidence rates in India, ranging from 11.8 to 17.1/100,000 population are amongst some of the highest reported in the world. With India accounting for roughly 10% of the global gallbladder cancer burden, it is a disease of endemic proportions in the sub-continent. Metastatic gallbladder cancer has a very poor survival, with systemic chemotherapy being the only proven treatment option, that too, with limited benefit. There is however, emerging evidence for curative surgical resection in patients with limited metastases. This study aims to evaluate the benefit of surgical resection in addition to palliative chemotherapy in oligo-metastatic gallbladder cancer (OGBCa).

The epidemiological trends of biliary tract cancers in the United States of America

BackgroundBiliary tract cancers (BTCs) are a series of heterogeneous malignancies that are broadly grouped based on the anatomical site where they arise into subtypes including intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gallbladder cancer (GBC), and ampulla of Vater cancer (AVC).Methods and ResultsThe present study provides an overview of the epidemiology of the various BTCs based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018. Distinct differences in both incidence and mortality rates were observed for these BTCs as a function of age, sex, ethnicity, and calendar year. In 2018, BTCs emerged as the fifth most prevalent form of alimentary tract cancer in the USA. While the incidence and mortality of ICC appear to be increasing, the incidence rates of GBC, ECC, and AVC have remained stable, as have the corresponding mortality rates. The most common and deadliest BTCs in 2018 were ICC and GBC among males and females, respectively. The ethnic groups exhibiting the highest incidence rates of these different BTCs were American Indians and Alaska Natives for GBC, and Asian and Pacific Islanders for ICC, ECC, and AVC. The incidence of all of these forms of BTC rose with age. There were some variations in BTCs in terms of staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes from 2000 to 2018.ConclusionsThe epidemiological characteristics, staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes were distinct for each of these BTCs.

Abstract 5888: Trends in incidence of gallbladder cancer in all 50 United States from 2001 to 2018

Abstract Background: Gallbladder cancer (GBC) is an aggressive malignancy of the gastrointestinal system that is historically more common among racial/ethnic minority populations in the US. We investigated trends in GBC incidence rates in all 50 states from 2001 to 2018, overall and stratified by race/ethnicity, sex, and different regions. Methods: Age-standardized incidence rates and trends in adults aged ≥35 years were calculated using data from the U.S. Cancer Statistics registry. We used joinpoint regression to compute annual percent changes (APC) and average annual percent changes (AAPC) and corresponding 95% confidence intervals (CI) for both sexes and used eleven 5-year age groups (35-39 years through 85+ years). Race/ethnic groups were classified as non-Hispanic Whites and Blacks (NHWs and NHBs), Hispanics, American Indians/Alaska Natives, and Asians and Pacific Islanders. Results: Overall, the age-standardized incidence rate for GBC decreased by 0.3% annually between 2001 and 2018 (95% CI -0.5%, -0.1%). However, secular trends varied by age-group, sex and race/ethnicity. APC increased among individuals aged 45-54 years from 1.2% to 1.4% but decreased among those who were ≥ 75 years (-0.7% to -1.6% per year). While GBC incidence rates were stable among men between 2001 and 2014, incidence rates decreased by over 2% per year between 2014 and 2018 (APC, -2.1%; 95%CI: -3.9, -0.3). GBC incidence remained relatively stable between 2001 and 2018 among women. While GBC rates declined in other racial/ethnic groups, the rates increased by 1.4% annually among non-Hispanic Blacks (NHBs) between 2001 and 2018 (APC=1.4%; 95%CI: 0.9%, 2.0%). Among NHBs, increasing trends were also noted in Northeast, Midwest, and South regions of US. Conclusions: The study shows increasing incidence trends for GBC in the US among NHBs from 2001-2018 compared to decreasing trends among other race/ethnic groups. The results also point to the need for studying equitable detection and treatment of underlying risk factors for GBC. Citation Format: Syed A. Raza, Wilson L. Costa, Aaron P. Thrift. Trends in incidence of gallbladder cancer in all 50 United States from 2001 to 2018 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5888.

Epidemiological and Geographical Profile of Gall Bladder Cancer Patients from a Hospital-based Registry of Northern Gangetic Plains

Purpose: Gall bladder cancer (GBC) is one of the commonest and deadliest cancers of Northern and Eastern India. The absence of a population-based cancer registry in Uttar Pradesh and Bihar has resulted in a lack of statistical information even though data from several hospital-based registries suggests that incidence rates of GBC may be one of the highest in the world. We present the four-year data on GBC from our tertiary-level multispeciality hospital. Materials &amp; Methods: This is a retrospective and analytical study. All patients of histopathologically proven GBC over four years were included and geographic, demographic and clinical data was collected and presented. Follow up, where available, was used to assess survival at 12 months and factors affecting it. Results: A total of 245 patients with GBC were diagnosed during the study period of which more than two-thirds were women. The majority of cases at our hospital were from the state of Uttar Pradesh with the highest number coming from the Eastern districts closer to the river Ganga and its tributaries. 26.5% of cases were early stage and surgically resectable, 19.6% were locally advanced and unresectable while 53.9% were metastatic at presentation. Age, stage and radical surgery as treatment had a significant association with survival at 12 months. Conclusion: GBC has an extremely high incidence in the Northern plains of India. There is a high suspicion of its association with increasing pollution of the major rivers of the region. Early detection is crucial as definitive surgery is the only curative option with any significant improvement of survival.

Increasing Incidence of Gallbladder Cancer among Non-Hispanic Blacks in the United States: A Birth Cohort Phenomenon.

Gallbladder cancer incidence varies among racial/ethnic subgroups in the United States (US). We investigated trends in gallbladder cancer incidence rates in 50 states from 2001 to 2018. Age-adjusted incidence rates and trends in adults were calculated using data from the US Cancer Statistics registry. We used joinpoint regression to compute annual percentage of changes (APC). We analyzed incidence trends by time periods, age groups, and birth cohorts through age-period-cohort modeling. Overall, age standardized incidence rates for gallbladder cancer decreased by 0.3% annually between 2001 and 2018 [95% confidence interval (CI) -0.5% to -0.1%]. However, secular trends varied by race/ethnicity. Although gallbladder cancer rates declined in other racial/ethnic groups, rates increased by 1.4% annually among non-Hispanic Blacks (NHB) between 2001 and 2018 (APC = 1.4%; 95% CI, 0.9%-2.0%). We found evidence for period and birth cohort effects with increasing rates among successive birth cohorts of NHBs. Relative to NHB cohorts born circa 1946, gallbladder cancer rates were 85% higher in NHB cohorts born circa 1971 [incidence rate ratio (IRR), 1.85; 95% CI, 1.26-2.72). The rates among NHBs in South region were higher in cohorts born circa 1971 (IRR, 2.17; 95% CI, 1.27-3.73) relative to those born circa 1946. The incidence of gallbladder cancer has consistently increased in the US among NHBs. A notable increase in incidence was observed among NHBs with evidence of birth cohort effects in South, Northeast, and Midwest regions. The cohort effect observed among NHBs with increasing rates in different US regions suggests that gallbladder cancer rates will continue to rise in the US in the near future.

Interpretation of consensus on the surgical management of benign gallbladder diseases (2021 edition)

Benign gallbladder diseases are common diseases in surgery,which are closely related to the occurrence of gallbladder cancer.Currently,nonstandard treatment exited in the surgical management of benign gallbladder diseases in China. Based on relevant domestic and foreign literature,guidelines,and expert consensus,consensus on the surgical management of benign gallbladder diseases(2021 edition) has been formulated. Further,recommendations related to diagnosis and treatment were presented to improve the standardization of surgical diagnosis and treatment of benign gallbladder diseases in China,so as to eliminate the clinical harm of gallbladder diseases and reduce the incidence rate of gallbladder cancer and prevent the occurrence. After the publication of the consensus,it has aroused heated discussion. This paper will interpret the hot issues.

Consensus on the surgical management of benign gallbladder diseases(2021 edition)

Benign gallbladder diseases are common in surgery department,and the incidence rate is increasing in recent years.Currently,nonstandard treatment existed in the surgical management of benign gallbladder diseases in China.Based on relevant domestic and foreign literature,guidelines,and expert consensus,this consensus expounds on the diagnosis and surgical treatment of common benign gallbladder diseases such as gallstone,cholecystitis,gallbladder polypoid,gallbladder adenomyosis,gallbladder variation and deformity,complications after cholecystectomy.Further,recommendations related to diagnosis and treatment were presented to improve the standardization of surgical diagnosis and treatment of benign gallbladder diseases in China,so as to eliminate the clinical harm of gallbladder diseases and reduce the incidence rate of gallbladder cancer and prevent the occurrence.

Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea

BackgroundThere have been reports on regional variation in prevalence of hepatitis B and C, and Clonorchis sinensis (C. sinensis) infection, which indicates potential of spatial variation in liver cancer and gallbladder cancer incidence in Korea. Therefore, we aimed to assess the regional variation of liver and gallbladder cancer incidence and its determinants based on the regional distribution of risk factors, including hepatitis B infection in Korea.MethodsThis study used an ecological study design and district-level cancer incidence statistics generated by the National Cancer Center. Spatial clusters of liver and gallbladder cancer incidence were detected based on spatial scan statistics using SaTScan™ software. We set the size of maximum spatial scanning window of 25 and 35% of the population at risk for analyses of liver and gallbladder cancer, respectively. Significance level of 0.05 was used to reject the null hypothesis of no cluster. We fitted the Besag-York-Mollie model using integrated nested Laplace approximations to assess factors that influence the regional variation in cancer incidence.ResultsSpatial clusters with high liver cancer incidence rates were detected in the southwestern and southeastern regions of Korea. High gallbladder cancer incidence rates are clustered in the southeastern region. Regional liver cancer incidence can be accounted for the prevalence of high household income (coefficient, − 0.10; 95% credible interval [CI], − 0.18 to − 0.02), marital status (coefficient, − 0.14; 95% CI, − 0.25 to − 0.03), the incidence of hepatitis B (coefficient, 0.87; 95% CI, 0.29 to 1.44), and liver cancer screening (coefficient, 0.06; 95% CI, 0.00 to 0.12), while gallbladder cancer incidence was related to the prevalence of high household income (coefficient, − 0.03; 95% CI, − 0.05 to 0.00) and living close to a river with a high prevalence of liver fluke infection (coefficient, 0.55; 95% CI, 0.14 to 0.96).ConclusionsThis study demonstrated geographic variation in liver and gallbladder cancer incidence, which can be explained by determinants such as hepatitis B, income, marital status, and living near a river.

Inflammatory profiles in Chilean Mapuche and non-Mapuche women with gallstones at risk of developing gallbladder cancer

Chile has high incidence rates of gallbladder cancer globally, particularly among Amerindian women, who also have a high prevalence of gallstones. We examined differences in inflammatory biomarkers between Mapuche and non-Mapuche women from the Chile Biliary Longitudinal Study, a cohort of women with ultrasound-detected gallstones. We randomly selected 200 Mapuche women frequency matched to non-Mapuche women on age and statin use Inflammatory biomarkers were analyzed using a multiplex assay and linear regression to assess associations of a priori markers (CCL20, CXCL10, IL-6, and IL-8) with ethnicity. Novel biomarkers were analyzed using exploratory factor analysis (EFA) and sufficient dimension reduction (SDR) to identify correlated marker groups, followed by linear regression to examine their association with ethnicity. The mean values of IL-8 were higher in Mapuche than non-Mapuche women (P = 0.04), while CCL20, CXCL10, and IL-6 did not differ significantly by ethnicity. EFA revealed two marker groups associated with ethnicity (P = 0.03 and P < 0.001). SDR analysis confirmed correlation between the biomarkers and ethnicity. We found higher IL-8 levels among Mapuche than non-Mapuche women. Novel inflammatory biomarkers were correlated with ethnicity and should be studied further for their role in gallbladder disease. These findings may elucidate underlying ethnic disparities in gallstones and carcinogenesis among Amerindians.

Age-specific incidence rates of gallbladder cancer in the world.

Age-specific incidence rates of gallbladder cancer in the world.

MiR-125b suppresses cellular proliferation by targeting c-FLIP in gallbladder carcinoma.

Gallbladder carcinoma (GBC) is the most common malignant tumor of the biliary tract. The incidence rate of gallbladder cancer ranks sixth among gastrointestinal types of cancer, and its incidence is increasing each year. Further clarification of the pathogenesis of GBC is essential, and identification of novel effective treatments is required. It has been previously demonstrated that high expression of the anti-apoptotic protein cellular Fas-associated death domain-like interleukin-1-converting enzyme inhibitory protein (c-FLIP) in GBC inhibited apoptosis in gallbladder cancer cells. In subsequent experiments, it was observed that microRNA (miR)-125b could target c-FLIP and inhibit the protein expression of c-FLIP by binding to the 3'untranslated regions of c-FLIP mRNA. In addition, the expression of miR-125b in GBC was significantly decreased, and the growth of gallbladder cancer cells was inhibited by the overexpression of miR-125b. The present study demonstrated that miR-125b could suppress the proliferation of gallbladder cancer cells by targeting c-FLIP. c-FLIP enriched the target gene pathway of miR-125b and may serve as a novel target for the treatment of GBC.

The incidence rates and survival of gallbladder cancer in the USA.

Gallbladder cancer is a rare malignancy in most countries. The racial and sociodemographic factors associated with its incidence and survival are poorly defined. We aimed to investigate population-based gallbladder cancer incidence and survival trends on the basis of clinical characteristics and sociodemographic factors in the USA. Gallbladder cancer incidence and survival data from 2001 to 2012 were obtained from 18 registries of the Surveillance, Epidemiology, and End Results database. Incidence rates and Joinpoint trends were calculated by demographic subgroup. Survival trends were assessed using Cox proportional hazard models. A total of 7769 patients were identified. The overall gallbladder cancer incidence rates did not significantly change during the 2001-2012 period. Incidence rates were three times higher in Hispanics and 1.6 times higher in Blacks compared with Whites. Over the time period, incidence rates significantly increased among Blacks and decreased among Hispanics. Male sex [hazard ratio (HR): 1.10, 95% confidence interval (CI): 1.03-1.17], older age (HR: 1.73, 95% CI: 1.53-1.96), and single and divorced statuses (HR: 1.19, 95% CI: 1.09-1.30 and 1.12, 95% CI: 1.01-1.24) were independently associated with shorter overall survival, whereas higher education (HR: 0.89, 95% CI: 0.82-0.97) and higher income (HR: 0.89, 95% CI: 0.82-0.96) were associated with longer survival. Furthermore, overall survival has improved in all races/ethnicities except for Hispanics and Blacks. The overall incidence rates for gallbladder cancer were stable during 2001-2012. Hispanics have the highest incidence rates, but the incidence rates in Blacks are on the rise.

Gallbladder cancer incidence rates in the world from the Cancer Incidence in Five Continents XI.

Gallbladder cancer incidence rates in the world from the Cancer Incidence in Five Continents XI.