Long-term trends in gallbladder cancer incidence, mortality, and survival disparities: The impact of stage, age, ethnicity, and sex—Surveillance, Epidemiology, and End Results analysis.

Abstract

e16182 Background: Gallbladder cancer (GBC) is a rare but aggressive malignancy, with survival outcomes influenced by disease stage, patient age, ethnicity, and sex. It is unknown how incidence and survival have evolved over the past decades. This study analyzes long-term trends in GBC incidence, mortality, and survival rates in the United States from 1975 to 2022, using SEER data, including disparities. To our knowledge, no such study has systematically evaluated these trends. Methods: This retrospective cohort study examined trends in GBC incidence and mortality between 1975 and 2022, and 5-year relative survival rates (RSR) for GBC patients diagnosed between 2014 and 2020. Data were stratified by stage (localized, regional, distant, unstaged), age group (< 50, 50-64, 65+ years), ethnicity (White, Black, Asian/Pacific Islander, Hispanic), and sex (female, male). Survival outcomes were reported as 5-year RSRs with standard error (SE), 95% confidence intervals (C.I.), and case counts. The annual percent change (APC) and average annual percent change (AAPC) in incidence and mortality rates were calculated. Statistical significance was determined at p < 0.01. Results: Between 1975 and 2021, GBC incidence rates declined significantly with an APC of -2.4% (95% CI: -2.9% to -2%, p < 0.01), and mortality rates showed a similar decrease of -2.7% (p < 0.01). Localized GBC had an overall 5-year relative survival rate (RSR) of 68%, with younger patients (< 50 years) showing higher survival (91.7%). Regional GBC had a survival rate of 28.2%, with younger patients (41.2%) faring better. Distant GBC had a very low survival rate (3.6%), though patients < 50 years showed slightly better survival (5.9%). Unstaged GBC had an overall survival rate of 17.3%, with patients aged 50-64 showing the highest survival (27%). Ethnic disparities were noted, with White patients showing better survival in localized and regional stages compared to Black and Hispanic/Asian/Pacific Islander patients. For distant GBC, White patients had a 4.2% survival rate, while Black patients had 3.7%. Survival was similar for both sexes in localized GBC (females: 67%, males: 69.5%) and regional GBC (females: 28.4%, males: 27.6%). Distant GBC had extremely low survival rates for both sexes (females: 3.4%, males: 4.2%). Conclusions: This study reveals a significant decline in gallbladder cancer incidence and mortality rates over time, with early-stage diagnosis and younger age associated with better survival. Ethnic and sex disparities highlight the need for tailored interventions to improve outcomes, particularly for high-risk populations. Further research into biological, socioeconomic, and healthcare access factors is essential to understand the factors driving these trends and disparities and improve the outcomes for high-risk populations.