Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
Clin Gastroenterol Hepatol. 2018 Mar;16(3):427-437. doi: 10.1016/j.cgh.2017.08.017. Epub 2017 Aug 18.
BACKGROUND & AIMS: Gallbladder cancer has a low rate of survival, a unique geographic distribution, and is associated with lifestyle factors that have changed in recent decades. We investigated recent mortality patterns and trends worldwide.
We collected data from the World Health Organization's Cancer Mortality Database to examine sex-specific, age-standardized rates of death from gallbladder and other biliary tract cancers (excluding intrahepatic bile duct cancer; International Classification of Diseases, 9th revision, code 156, or International Classification of Diseases, 10th revision, code C23-24). We compiled cross-sectional rates of mortality from 2009 through 2013 from 50 countries, and also trends over time from 1985 through 2014, using joinpoint regression analysis of data from 45 countries.
Among women, from 2009 through 2013, there was a 26-fold variation in rates of mortality from gallbladder and other biliary tract cancers; rates ranged from 0.8 deaths per 100,000 in South Africa to 21.2 deaths per 100,000 in Chile. Among men, rates varied 16-fold, from 0.6 deaths per 100,000 in the United Kingdom and Ireland to 9.9 deaths per 100,000 in Chile. Rates of mortality were higher for women than men in 22 of 48 countries for which comparison was possible. Mortality rates are decreasing in most countries, with decreases in the highest-risk populations of 2% or more annually (except Croatia). However, rates continued their long-term increase in Greece, by 1.4% annually in women and 4.7% annually in men from 1985 through 2012, and began increasing in the mid-2000s by 1.9% or more annually in women in the United Kingdom and The Netherlands and in men in Germany.
In an analysis of the World Health Organization's Cancer Mortality Database, we found that rates of death from gallbladder and other biliary tract cancers are decreasing in most countries but increasing in some high-income countries following decades of decline. These emerging trends may reflect lifestyle changes, such as increases in excess body weight.
胆囊癌的存活率较低，具有独特的地理分布，且与生活方式相关，这些生活方式因素在近几十年来发生了变化。我们研究了全球范围内最近的死亡率模式和趋势。
我们从世界卫生组织癌症死亡率数据库中收集数据，以检查胆囊和其他胆道癌（不包括肝内胆管癌；国际疾病分类，第 9 修订版，代码 156 或国际疾病分类，第 10 修订版，代码 C23-24）的男女死亡率标准化年龄。我们从 50 个国家汇编了 2009 年至 2013 年的死亡率横断面数据，并使用来自 45 个国家的数据进行 joinpoint 回归分析，以研究 1985 年至 2014 年的时间趋势。
在女性中，2009 年至 2013 年，胆囊和其他胆道癌的死亡率差异高达 26 倍；从南非的每 10 万人 0.8 例死亡到智利的每 10 万人 21.2 例死亡不等。在男性中，差异为 16 倍，从英国和爱尔兰的每 10 万人 0.6 例死亡到智利的每 10 万人 9.9 例死亡不等。在 48 个可比较的国家中，22 个国家女性的死亡率高于男性。大多数国家的死亡率呈下降趋势，最高风险人群的死亡率每年下降 2%或更多（克罗地亚除外）。然而，从 1985 年到 2012 年，希腊的死亡率继续呈长期上升趋势，女性每年上升 1.4%，男性每年上升 4.7%，从 2000 年代中期开始，英国和荷兰的女性以及德国的男性每年上升 1.9%或更多。
在对世界卫生组织癌症死亡率数据库的分析中，我们发现，大多数国家的胆囊和其他胆道癌死亡率呈下降趋势，但在几十年的下降之后，一些高收入国家的死亡率正在上升。这些新出现的趋势可能反映了生活方式的改变，例如超重的增加。
