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Annals of Oncology Advance Access published online on July 29, 2008
Annals of Oncology, doi:10.1093/annonc/mdn533
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Epidemiology of biliary tract cancers: an update

G. Randi1,2,*, M. Malvezzi1,2, F. Levi3, J. Ferlay4, E. Negri1, S. Franceschi4 and C. La Vecchia1,2

1 Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan
2 Istituto di Statistica Medica e Biometria ‘G.A. Maccacaro’, Università degli Studi di Milano, Milan, Italy
3 Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchatel, Institut de médecine sociale et préventive (IUMSP); Centre Hospitalier Universitaire Vaudois et, Université de Lausanne, Lausanne, Switzerland
4 International Agency for Research on Cancer, Lyon, France

* Correspondence to: Dr G. Randi ScD., Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via La Masa, 19, 20156 Milan, Italy. Tel: +39-02-39014665; Fax: +39-02-33200231; E-mail: randi{at}marionegri.it

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.

Materials and 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.

biliary tract cancer, epidemiology, gall-bladder cancer, incidence, mortality, risk factors

Received for publication April 24, 2008. Revision received June 24, 2008. Accepted for publication June 26, 2008.


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