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Abstract
Background Although relatively rare, gallbladder cancer, characterized by its aggressive nature and poor prognosis, accounts for over 50% of all malignancies in the biliary tract. Contemporary mortality trends due to gallbladder cancer (GBC) are largely unknown. The study aims to examine the temporal trends of GBC-related deaths among older adults in the United States from 1999 to 2021.
Methods We utilized the Centers for Disease Control (CDC WONDER) database to access the national mortality records from 1999 to 2021. The demographic and mortality data were obtained for the United States elderly population aged ≥ 65 years. Gallbladder cancer-related deaths (ICD-10: C23) as a contributing or underlying cause of death were identified. Age-adjusted mortality rates (AAMR) per 100,000 population were calculated by standardizing deaths to the 2000 US Standard population. Using the Joinpoint regression program, we calculated the average annual percentage change (AAPC), along with 95% confidence intervals, to analyze trends.
Results 38,042 deaths associated with GBC occurred between 1999 and 2021 among individuals older than 65 years. Overall, there is a declining trend in GBC mortality, the total AAMR decreased from 5.0 in 1999 to 3.3 in 2021 (AAPC -1.9%, IDDF2024-ABS-0030 Figure 1. Overall trends). Females had consistently higher AAMR than males across all years. For females, AAMR decreased by 1.6% annually from 1999–2021, while for males AAMR decreased by 1.3% annually from 1999–2021(IDDF2024-ABS-0030 Figure 2. Trends by sex). When stratified by race, AAMR was highest among the Hispanic population, followed by Non-Hispanic (NH) Blacks and NH Asians. In brief, the AAMR have decreased for all races except for NH blacks. The Hispanic population has experienced the greatest decline in AAMR during the study duration (AAPC: -2.6%, IDDF2024-ABS-0030 Figure 3. Trends by race). Small/medium metropolitan areas observed a steeper decline in mortality rates than large metropolitan and non-metropolitan areas (IDDF2024-ABS-0030 Figure 4. Trends by level of urbanization).
Overall trends.
Trends by sex.
Trends by race.
Trends by level of urbanization.
Conclusions Over the past two decades, there has been a consistent decline in mortality rates associated with gallbladder carcinoma in the United States. This study demonstrates that gallbladder cancer death rates were higher among females than males, higher among Hispanics, Blacks and Asians populations compared with non-Hispanic Whites and higher in large metropolitan regions.