Epidemiology of biliary tract cancers: an update

Ann Oncol. 2009 Jan;20(1):146-59. doi: 10.1093/annonc/mdn533. Epub 2008 Jul 29.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biliary Tract Neoplasms / epidemiology*
  • Biliary Tract Neoplasms / mortality
  • Cohort Studies
  • Female
  • Gallbladder Neoplasms / epidemiology
  • Gallbladder Neoplasms / mortality
  • Geography
  • Humans
  • Male
  • Middle Aged
  • Sex Characteristics
  • Survival Analysis