Trends in Gallbladder and Biliary Tract Cancer Global Burden (1990–2021): A Socioeconomic Gradient Analysis and Projections for 2040

Abstract

Background: Gallbladder and biliary tract cancers (GBTCs) are highly lethal malignancies with a heterogeneous global burden. Most existing epidemiological studies have been regional and descriptive, and have lacked systematic analysis of worldwide spatiotemporal trends, socioeconomic associations, and future projections. Therefore, this study was aimed at comprehensively assessing global GBTCs burden from 1990 to 2021, analyzing its association with socioeconomic development, and projecting trends to 2040.

Methods: Using data from the Global Burden of Disease (GBD) 1990–2021 study, we evaluated global trends in GBTC incidence, mortality, prevalence, and disability adjusted life years (DALYs). Age standardization was applied for comparability. Analytical methods included joinpoint regression for temporal trends, correlation analysis with the Socio-demographic Index (SDI), frontier analysis to benchmark performance, and AIMA modeling to project age-standardized incidence and mortality rates to 2040.

Results: The analysis revealed a dual burden pattern characterized by global declining age-standardized mortality and DALY rates alongside rising absolute case counts attributable to population growth and aging. Age-standardized incidence rates positively correlated with SDI. Males consistently carried a higher burden than females across all metrics. Projections indicated a continuing increase in male age-standardized incidence rates through 2040, whereas female rates were predicted to remain stable.

Conclusions: The global GBTC burden is characterized by a dual challenge of decreasing severity but expanding scale, including sex and socioeconomic gradients. These findings support a need for differentiated public health strategies. High-SDI regions should target metabolic risk factors and survivorship care, whereas low- and moderate-SDI regions require enhanced efforts in early diagnosis and management of traditional risk factors. Tailored, context-specific interventions are essential for effective global cancer control.

Keywords

Burden projection / frontier analysis / GBTCs / GBD / SCI

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