title: Analysis of mortality rates for gallbladder cancer across the world.
abstract: OBJECTIVE
  Ethnic background and geographical location are important when measuring the incidence of gallbladder carcinoma leading to variable mortality rates across the world.
  
  
  METHODS
  Age standardized mortality rates [ASR(W)] were extracted separately for males and females from a database maintained by the International Agency for Research on Cancer for 50 countries across the world (Europe 32; the Americas 8; and Asia 10) for the period 1992-2002 and log-linear regression was performed to analyse trends in the last decade.
  
  
  RESULTS
  In the period 1992-2002, declining trends in mortality for both sexes were observed in Germany, Sweden, Japan, USA, and Hungary (p<0.001), and in France, Canada, United Kingdom, The Netherlands, and Hong Kong (p<0.01). Austria, Czechoslovakia, Slovenia, Denmark, Spain, and Israel exhibited decreasing mortality trends more significant in women (p<0.01) than in men (p<0.05). Decreasing female mortality trends were seen in Finland, Italy, and Portugal (p<0.01) and in Georgia, Luxembourg, and Belgium (p<0.05). Iceland, Costa Rica, and Korea were the only countries with an increase in male mortality (p<0.05).
  
  
  CONCLUSIONS
  Overall, there was a decline in ASR(W) for gallbladder cancer. Better diagnostic modalities resulting in appropriate staging of gallbladder/biliary cancers, as well as changes in the ICD classification and perhaps increased awareness, may have contributed to these trends.
authors.affiliation: Institute of Cancer, Barts and the London School of Medicine & Dentistry, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Hariharan
authors.forename: A
authors.initials: A
authors.lastname: Saied
authors.forename: H M
authors.initials: HM
authors.lastname: Kocher