Background Gallbladder cancer (GBC) is an aggressive malignancy with poor survival outcomes due to limited treatment options and late-stage detection. This study examined the global burden and temporal trends of premature mortality from GBC.

Methods Data were obtained from the World Health Organization mortality database and the Global Cancer Observatory (GLOBOCAN) database. Premature mortality (ages 30-69 years) was assessed using age-standardized mortality rates (ASMRs) based on the SEER*Stat standard world population. Temporal trends in GBC premature mortality were evaluated using joinpoint regression, calculating the average annual percentage change (AAPC) and 95% confidence intervals (CI). Analyses were stratified by age group (younger: 30-49 years; older: 50-69 years), sex, and Human Development Index (HDI) region.

Results Globally, there were 44,573 premature deaths from GBC in 2022. The overall ASMR for GBC premature mortality was 1.2 per 100,000, with a higher rate among females than males (1.6 vs. 0.87 per 100,000). Medium HDI regions had the highest premature ASMR of 2.4, surpassing the global level. The premature ASMRs for South-Central Asia, Northern Africa, and Melanesia were also higher than the global average (2.5, 1.4, and 1.3 per 100,000, respectively). Temporal trend analysis identified increasing premature mortality in 12 countries, with the largest increases observed in Iran (22.19%, 95% CI: 11.08-34.42, p<0.001), Antigua and Barbuda (17.43%, 95% CI: 14.04-20.92, p<0.001), and Greece (16.46%, 95% CI: 6.70-27.11, p<0.001). The upward trends were more pronounced in females and the older age group (50-69 years).

Conclusions This study revealed concerning upward trends in premature mortality from GBC, particularly among females and older adults. Further investigation into the contributing factors is crucial for informing healthcare planning and interventions to address this public health challenge.