Epidemiology of biliary tract cancers: an update

Randi, G. ; Malvezzi, M. ; Levi, F. ; Ferlay, J. ; Negri, E. ; Franceschi, S. ; La Vecchia, C.

In: Annals of Oncology, 2008, vol. 20, no. 1, p. 146-159

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    Background: Biliary tract cancer (BTC) is a rare cancer in Europe and North America, characterized by wide geographic variation, with high incidence in some areas of Latin America and Asia. Materials and methods: BTC mortality and incidence have been updated according to recent data, using joinpoint regression analysis. Results: Since the 1980s, decreasing trends in BTC mortality rates (age-standardized, world standard population) were observed in the European Union as a whole, in Australia, Canada, Hong Kong, Israel, New Zealand, and the United States, and high-risk countries such as Japan and Venezuela. Joinpoint regression analysis indicates that decreasing trends were more favorable over recent calendar periods. High-mortality rates are, however, still evident in central and eastern Europe (4-5/100 000 women), Japan (4/100 000 women), and Chile (16.6/100 000 women). Incidence rates identified other high-risk areas in India (8.5/100 000 women), Korea (5.6/100 000 women), and Shanghai, China (5.2/100 000 women). Conclusions: The decreasing BTC mortality trends essentially reflect more widespread and earlier adoption of cholecystectomy in several countries, since gallstones are the major risk factor for BTC. There are, however, high-risk areas, mainly from South America and India, where access to gall-bladder surgery remains inadequate