2011, Number 3
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Ann Hepatol 2011; 10 (3)
Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy?
Le MD, Henson D, Young H, Albores-Saavedra J
Language: English
References: 31
Page: 306-314
PDF size: 103.60 Kb.
ABSTRACT
Background. Gallstone disease affects over 20 million people in the U.S. and is a major risk factor for gallbladder
cancer (GBC). In 1988, a less invasive, low-cost procedure, laparoscopic cholecystectomy (LC), was
introduced and became the standard of care for management of gallstones.
Methods. GBC incidence
(1973-2007) and mortality rates (1969-2006) were calculated using SEER Program data. LC rates (1993-2008)
were obtained from NAMCS, NHAMCS, and HCUP. Annual percent change was estimated by gender, age,
and race, and the statistical significance was assessed at p ‹ 0.05. Correlation analysis was performed on
GBC and LC trends.
Results. Since the early 1970s, GBC incidence and mortality rate have declined. Women
and older age groups continue to have the highest risk for GBC, despite having greater declines. Incidence
significantly decreased among whites, but did not among blacks. The number of inpatient LC
procedures increased by 15% between 1994 and 2008; however, inpatient and outpatient LC rates remained
stable. LC rate was not significantly correlated with either GBC incidence or mortality.
Conclusions.
The decline in incidence and mortality of GBC began decades before the introduction of LC and apparently
has stabilized in the past decade. No temporal relationship existed between LC rate and the incidence
and mortality rates of GBC. Our study suggests that prevention of a rare tumor may be extremely difficult
if the surgical removal of a risk factor is involved.
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