Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO).
OBJECTIVE
To investigate the incidence, risk factors and natural history of gallstone disease, a random sample of females belonging to a rural population was enrolled in a ten-year longitudinal study.


METHODS
The study has been performed in a small town on the hills south of Rome. In 1985, a random sample of 426 females, aged 20-69 years, was screened by real-time ultrasonography for gallstones and previous cholecystectomy. Screening methods included anthropometry, collection of a blood sample and a questionnaire on the occurrence of abdominal symptoms. During 1995, all these subjects were invited for a 10-year follow-up examination.


RESULTS
The overall 10-year incidence of gallstone disease was 6.3% (5.5% of new gallstones and 0.8% of cholecystectomies). Only 23.1% of the women with gallstones were aware of their condition. More than three quarters (76.9%) had not suffered biliary pain. Univariate and multivariate analyses demonstrated a positive independent association of new gallstone disease with body mass index and parity. Out of the initially asymptomatic gallstone women, 15.4% experienced at least one episode of biliary pain, 23.1% were submitted to elective cholecystectomy and 61.5% remained asymptomatic.


CONCLUSIONS
The study demonstrates a high incidence of gallstone disease in women belonging to a rural free-living population in Italy and suggests body mass index and parity as possible true risk factors. Moreover, it confirms that a remarkable proportion of asymptomatic patients become symptomatic and eventually undergo cholecystectomy.
Angelico
F
F
Institute of Systematic Medical Therapy, University La Sapienza, Rome, Italy.
Del Ben
M
M
Barbato
A
A
Conti
R
R
Urbinati
G
G
D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population