Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.109245
Revised: May 30, 2025
Accepted: July 14, 2025
Published online: August 15, 2025
Processing time: 101 Days and 15.9 Hours
Gallbladder and biliary tract cancer (GBTC) is a highly aggressive malignant tumor with a high fatality rate. The global incidence and mortality of GBTC continue to increase, presenting a significant challenge to public health. Strategies for preventing and controlling GBTC in Brazil, Russian Federation, India, China and South Africa (BRICS) countries offer valuable lessons for other developing nations.
To investigate GBTC burden trends in BRICS countries and perform an age-period-cohort (APC) analysis of Global Burden of Disease (GBD) from 1990-2021.
Data on the incidences and crude incidence rates, the number of deaths and crude mortality rates, and the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of GBTC were obtained for BRICS countries from the GBD study 2021. Joinpoint regression analysis was employed to examine the trends in disease burden from 1990 to 2021. The APC model was utilized to assess the age, period, and birth cohort effects on the changes in GBTC disease burden worldwide and in the BRICS countries during the same time frame. Bayesian APC analysis was used to estimate the future burden.
The increases in incidence and deaths were 101.09% and 74.26%, respectively, compared with 1990. The ASMRs in Brazil, Russia, and China decreased, while those in India and South Africa increased. Among the BRICS countries, in most age groups in Brazil, Russia, India, and South Africa, the crude incidence and mortality rates in women were higher than those in men, whereas in China, the situation was the opposite. Joinpoint regression analysis revealed that from 1990 to 2021, the overall ASIR of gallbladder and bile duct cancer exhibited a declining trend. Although the incidence rate in China showed an increasing trend, the mortality rate exhibited a declining trend, which became more pronounced over time.
In BRICS countries, the number of incident cases and deaths from GBTC increased between 1990 and 2021, primarily due to rapid population growth. Nevertheless, the ASIR and ASMR declined during the same period.
Core Tip: The global burden of gallbladder and biliary tract cancer (GBTC) continues to rise, with marked heterogeneity across Brazil, Russian Federation, India, China, and South Africa (BRICS) nations. Using global burden of disease 2021 data, age-period-cohort modeling revealed a 101% increase in global GBTC incidence and 74% mortality growth from 1990-2021. Declining age-standardized mortality rates were observed in Brazil, Russia, and China, contrasting with increases in India and South Africa. Male predominance in China vs female predominance in other BRICS countries was noted. Trend analysis highlighted China's unique initial decline followed by a rebound in incidence, underscoring the urgent need for targeted prevention strategies.