Epidemiology of Gallbladder Cancer in the Unites States

A Population-Based Study

Motasem Alkhayyat; Mohannad Abou Saleh; Thabet Qapaja; Mohammad Abureesh; Ashraf Almomani; Emad Mansoor; Prabhleen Chahal


Chin Clin Oncol. 2021;10(3):25 

In This Article


Descriptive Epidemiology

Baseline characteristics of the study cohort (GBC cohort) and control are displayed in Table 1. Of the 56,197,690 individuals in the database above the age of 18 years old [1999–2019], 4,790 individuals with GBC were identified. The 20-year period prevalence rate of GBC was 8.5 per 100,000. The incidence of new cases reported last year [2018–2019] was 7.4 per 100,000 population. Elderly patients above the age of 65 years old accounted for 77% of the cases, the highest prevalence was among the age group 80–90 years old (Figure 1). The period prevalence rate was higher among females compared to males (9.7 vs. 7.0 per 100,000) and higher in Asian (13.6 per 100,000) compared to Caucasian, African-American, and Hispanic (10.5, 11.4, and 6.6 per 100,000 respectively) (Figure 2).

Figure 1.

Prevalence rate of GBC among different age groups, per 100,000. GBC, gallbladder cancer.

Figure 2.

Prevalence rate of GBC based on sex and race. GBC, gallbladder cancer.

Medical Comorbidities Associated With GBC Patients

Patients with GBC had a higher prevalence of multiple comorbidities compared to the general population including smoking and alcohol abuse. There was significantly higher prevalence of biliary diseases such as cholelithiasis (31.3% vs. 1.6%), choledocholithiasis (34.4% vs. 1.7%), chronic cholecystitis (5.2% vs. 0.2%), choledochal cyst (0.1% vs. 0.001%), and PSC (0.1% vs. 0.01%). History of chronic viral hepatitis infections (HBV and HCV), obesity, and DM were also more prevalent in patients with GBC compared to the general population.

Risk Factors for Development of GBC

After adjusting using multivariate analysis model, patients with GBC were more likely to be elderly (above 65 years old) (OR: 6.12; 95% CI: 5.75–6.52) and females (1.35; 1.28–1.43). The risk of GBC varied among different race groups; compared to Caucasian, the risk of GBC among African-American, Asian, and Hispanic were (1.08; 1.01–1.17), (1.32; 1.11–1.56), and (0.77; 0.61–0.97) respectively. Patients who developed GBC had a history of smoking (1.73; 1.61–1.87) and alcohol abuse (1.69; 1.44–1.99). In terms of predisposing medical conditions, individuals with GBC were more likely to have a diagnosis of cholelithiasis (15.23; 14.27–16.27), chronic cholecystitis (4.20; 3.74–4.72), PSC (7.22; 5.01–10.41), obesity (3.30; 3.04–3.58), DM (2.13; 2.00–2.26), family history (4.80; 3.99–5.75), chronic HBV (3.79; 1.89–7.60), and chronic HCV (4.17; 3.15–5.51) (Figure 3).

Figure 3.

Risk factors of GBC. GBC, gallbladder cancer.