Global Concern: Rising Trend of Early-Onset Gallbladder Cancer

Early-onset gallbladder and biliary tract cancer (GBTC) has become a global health concern, with a rising trend in incidence among individuals under 50 years old. This shift in epidemiology necessitates a deeper understanding of the disease burden and trends over time. Gallbladder and biliary tract cancers are mainly adenocarcinomas, with distinct etiopathogenesis between cholangiocarcinoma and gallbladder carcinoma. Cholangiocarcinoma is associated with hepatobiliary fluke infections, while gallbladder cancer is linked to chronic cholecystitis and cholelithiasis. Regions with the highest incidence rates include Southeast Asia and Northern India. These cancers have a poor prognosis with a low five-year survival rate.

The global burden of early-onset gallbladder and biliary tract cancer has been on the rise since 1990, with over 24,555 prevalent cases, 13,611 new cases, and approximately 8777 deaths reported in 2021. The incidence and prevalence rates have increased, while mortality and disability-adjusted life years (DALYs) have shown a downward trend. East Asia and South Asia carry the heaviest disease burdens, especially in regions with middle, low-middle, and low socio-demographic index (SDI) levels. Population growth was identified as a primary factor influencing the disease burden, with health inequalities showing improvement over time.

Decomposition analysis revealed that the growth of the population primarily drove the burden in low-middle and low SDI regions, while epidemiological trends played a more significant role in high and high-middle SDI regions. Projections using the Nordpred model suggest a steady increase in EOGBTC incidence and prevalence by 2040, with a decrease in deaths and DALYs. Health disparities were also analyzed, showing a gradual decrease in EOGBTC burden with improving SDI levels.

Further research is needed to address the challenges posed by EOGBTC, especially in regions with high disease burdens. Innovative healthcare strategies and targeted interventions are crucial to mitigate the rising trend of early-onset gallbladder and biliary tract cancer globally. Policymakers and researchers should focus on developing region-specific interventions and public health initiatives to effectively manage and reduce the burden of this disease.