Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, Texas.
Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas.
Cancer Epidemiol Biomarkers Prev. 2022 Jul 1;31(7):1410-1417. doi: 10.1158/1055-9965.EPI-21-1452.
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.
在美国（US），胆囊癌的发病率因种族/民族亚组而异。我们调查了 2001 年至 2018 年 50 个州胆囊癌发病率的趋势。
使用美国癌症统计登记处的数据计算年龄调整后的发病率和成年人的趋势。我们使用 joinpoint 回归计算年变化百分比（APC）。我们通过年龄-时期-队列模型分析了不同时期、年龄组和出生队列的发病率趋势。
总体而言，2001 年至 2018 年期间，胆囊癌的年龄标准化发病率每年下降 0.3%[95%置信区间（CI）-0.5%至-0.1%]。然而，种族/民族之间的长期趋势有所不同。尽管其他种族/民族的胆囊癌发病率有所下降，但在 2001 年至 2018 年期间，非西班牙裔黑人（NHB）的发病率每年增加 1.4%（APC=1.4%；95%CI，0.9%-2.0%）。我们发现，随着 NHB 连续出生队列的增加，存在时期和出生队列效应的证据。与出生于 1946 年左右的 NHB 队列相比，出生于 1971 年左右的 NHB 队列的胆囊癌发病率高 85%[发病率比（IRR），1.85；95%CI，1.26-2.72]。与出生于 1946 年左右的队列相比，南部出生队列的 NHB 胆囊癌发病率更高（IRR，2.17；95%CI，1.27-3.73）。
在美国，NHB 人群中胆囊癌的发病率一直在持续上升。在南部、东北部和中西部地区，有证据表明存在出生队列效应，这一现象在 NHB 人群中观察到发病率显著增加。
在不同的美国地区，NHB 人群中观察到的队列效应，表明在不久的将来，美国的胆囊癌发病率将继续上升。
