In the Journals

Gallbladder cancer rates fall in men; late-stage diagnosis rates on the rise

Gallbladder cancer rates have continued to decrease among men in recent years, but do not show the same trend among women, and the rate of late-stage diagnosis increased overall, according to new research published in Cancer Medicine.

“Although gallbladder cancer is a rare gastrointestinal malignancy, it is the most common cancer to affect the organs that control the production, storage and secretion of bile,” Jamal Ibdah, MD, PhD, professor of medicine, Raymond E. and Vaona H. Peck Chair in Cancer Research at the University of Missouri School of Medicine, said in a press release. “It also is a very aggressive disease with poor outcomes because symptoms usually are not present until late-stage, and often is diagnosed incidentally.”

Jamal Ibdah, MD, PhD

Jamal Ibdah

To evaluate trends in gallbladder cancer diagnosis and survival from 1973 to 2009 within the U.S. population, Ibdah and colleagues performed an observational study using the SEER database to identify 18,124 cases, accounting for 1.4% of all GI cancer diagnoses reported in the database.

They found gallbladder cancer was significantly more common in women (71%; P < .0001), and the age-adjusted incidence rate (1.4 cases per 100,00 patients) was significantly higher in women (1.7 vs. 1; P < .0001). Further, while the overall incidence rate has generally declined over the past 4 decades and incidence continued to decline among men in recent years, incidence in women “leveled-off.”

“Analysis showed that gallbladder cancer rates have steadily decreased for men since 1973,” Ibdah said in the press release. “However, this same analysis showed that although the rates for women had been decreasing, this trend stopped in the mid-1990s.”

Since then, the incidence rate among women has remained stable, Ibdah and colleagues noted. They also found that a higher proportion of gallbladder cancer patients are being diagnosed with late-stage disease.

“Even more alarming was that late-stage diagnosis of gallbladder cancer has been on the rise since 2001 after a decreasing pattern since 1973,” Ibdah said in the press release. “The significance is that earlier diagnosis correlates to better outcomes.”

Importantly, the investigators also observed that survival has “improved considerably over time,” and that women have better survival compared with men, while Asian/Pacific Islanders have better survival compared with other racial groups.

“However, the most significant information about survivability that we gleaned from our study was that a combination of surgery and radiation resulted in the best outcomes,” Ibdah said in the press release.

He concluded that additional research is warranted to better understand the disparity in gallbladder cancer rates between men and women. “We also need a better understanding of why late-stage diagnosis is on the rise,” he added. “However, the information in this study will allow us to focus on these areas so that over time and through clinical trials, we may one day develop a cost-effective, evidence-based screening technique to reverse these trends.” – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.

Gallbladder cancer rates have continued to decrease among men in recent years, but do not show the same trend among women, and the rate of late-stage diagnosis increased overall, according to new research published in Cancer Medicine.

“Although gallbladder cancer is a rare gastrointestinal malignancy, it is the most common cancer to affect the organs that control the production, storage and secretion of bile,” Jamal Ibdah, MD, PhD, professor of medicine, Raymond E. and Vaona H. Peck Chair in Cancer Research at the University of Missouri School of Medicine, said in a press release. “It also is a very aggressive disease with poor outcomes because symptoms usually are not present until late-stage, and often is diagnosed incidentally.”

Jamal Ibdah, MD, PhD

Jamal Ibdah

To evaluate trends in gallbladder cancer diagnosis and survival from 1973 to 2009 within the U.S. population, Ibdah and colleagues performed an observational study using the SEER database to identify 18,124 cases, accounting for 1.4% of all GI cancer diagnoses reported in the database.

They found gallbladder cancer was significantly more common in women (71%; P < .0001), and the age-adjusted incidence rate (1.4 cases per 100,00 patients) was significantly higher in women (1.7 vs. 1; P < .0001). Further, while the overall incidence rate has generally declined over the past 4 decades and incidence continued to decline among men in recent years, incidence in women “leveled-off.”

“Analysis showed that gallbladder cancer rates have steadily decreased for men since 1973,” Ibdah said in the press release. “However, this same analysis showed that although the rates for women had been decreasing, this trend stopped in the mid-1990s.”

Since then, the incidence rate among women has remained stable, Ibdah and colleagues noted. They also found that a higher proportion of gallbladder cancer patients are being diagnosed with late-stage disease.

“Even more alarming was that late-stage diagnosis of gallbladder cancer has been on the rise since 2001 after a decreasing pattern since 1973,” Ibdah said in the press release. “The significance is that earlier diagnosis correlates to better outcomes.”

Importantly, the investigators also observed that survival has “improved considerably over time,” and that women have better survival compared with men, while Asian/Pacific Islanders have better survival compared with other racial groups.

“However, the most significant information about survivability that we gleaned from our study was that a combination of surgery and radiation resulted in the best outcomes,” Ibdah said in the press release.

He concluded that additional research is warranted to better understand the disparity in gallbladder cancer rates between men and women. “We also need a better understanding of why late-stage diagnosis is on the rise,” he added. “However, the information in this study will allow us to focus on these areas so that over time and through clinical trials, we may one day develop a cost-effective, evidence-based screening technique to reverse these trends.” – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.