title: 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).
abstract: 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.
authors.affiliation: Institute of Systematic Medical Therapy, University La Sapienza, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Angelico
authors.forename: M
authors.initials: M
authors.lastname: Del Ben
authors.forename: A
authors.initials: A
authors.lastname: Barbato
authors.forename: R
authors.initials: R
authors.lastname: Conti
authors.forename: G
authors.initials: G
authors.lastname: Urbinati
mesh_terms: 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