La Vecchia C, Levi F, Lucchini F, Franceschi S
Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland.
Ann Epidemiol. 1995 May;5(3):215-20. doi: 10.1016/1047-2797(94)00108-6.
Trends in mortality rates from gallstones and other nonneoplastic gallbladder and biliary tract diseases between 1955 and 1990 for 38 countries (8 from America, 3 from Asia, 25 from Europe, Australia, and New Zealand) were analyzed. Age-adjusted mortality rates standardized on the world population were computed from official death certifications derived from the World Health Organization database. There were generalized and substantial declines in the rates in both sexes and all countries considered, except for males in Czechoslovakia and Poland. Over the calendar period considered, the average declines were over 70% for males and over 80% for females in North America, over 60% for males and 70% for females in Latin America, although mortality remained relatively high in Chile. The declines were 80% for both sexes in Japan and over 70% for males and 80% for females in Australia. The pattern was more heterogeneous in Europe, with decreases of approximately 70 to 80% in northern Europe, but more modest in central and southern Europe, with particularly moderate downward trends for males. In several countries the decreases were rather steady over the calendar period considered, but in a few others the decline was restricted or larger during the most recent calendar period. The trends in gallstone and other gallbladder disease mortality in various areas are affected by differences and potential biases in death certification reliability, and by underlying variations and changes in the prevalence of gallstones and gallbladder surgical removal. A likely interpretation for the generalized decline in mortality over the last calendar period is, however, improved diagnosis and treatment of gallstone disease.
分析了1955年至1990年间38个国家（8个来自美洲，3个来自亚洲，25个来自欧洲、澳大利亚和新西兰）胆结石及其他非肿瘤性胆囊和胆道疾病的死亡率趋势。根据世界卫生组织数据库中的官方死亡证明计算出以世界人口为标准的年龄调整死亡率。在所有考虑的国家中，除捷克斯洛伐克和波兰的男性外，男女的死亡率均普遍大幅下降。在所考虑的日历期间，北美洲男性的平均降幅超过70%，女性超过80%；拉丁美洲男性超过60%，女性70%，不过智利的死亡率仍然相对较高。日本男女的降幅均为80%，澳大利亚男性超过70%，女性超过80%。欧洲的情况更为多样，北欧降幅约为70%至80%，但中欧和南欧降幅较小，男性的下降趋势尤为平缓。在一些国家，在所考虑的日历期间降幅相当稳定，但在其他一些国家，降幅在最近的日历期间受到限制或更大。各个地区胆结石及其他胆囊疾病死亡率的趋势受死亡证明可靠性的差异和潜在偏差，以及胆结石患病率和胆囊手术切除的潜在变化和改变的影响。然而，对上一个日历期间死亡率普遍下降的一个可能解释是胆结石疾病的诊断和治疗得到了改善。
