Epidemiology of biliary tract cancers: an update.
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.


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.
Randi
G
G
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. randi@marionegri.it
Malvezzi
M
M
Levi
F
F
Ferlay
J
J
Negri
E
E
Franceschi
S
S
La Vecchia
C
C
D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000401:mortality; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D016019:Survival Analysis