Temporal trends in the incidence, mortality, and prevalence of gallbladder and biliary diseases in high-income countries compared to the USA, 1990 to 2021.

BACKGROUND

Gallbladder and biliary diseases remain major global health concerns, with trends shaped by lifestyle, metabolic risk factors, and healthcare access. This study evaluated long-term changes in age-standardized incidence (ASIR), prevalence (ASPR), and mortality (ASMR) in high-Social Demographic Index (SDI) countries and the United States from 1990 to 2021.

METHODS

Data were obtained from the Global Burden of Disease 2021 database. ASIR, ASPR, and ASMR were extracted for both regions. Joinpoint regression analysis generated annual percentage changes with 95% confidence intervals to identify significant temporal shifts.

RESULTS

In high-SDI countries, males showed declines in ASMR (2.03 to 1.67), ASPR (3210.0 to 2962.4), and ASIR (987.4 to 932.0) per 100,000. Females showed similar reductions: ASMR 1.79 to 1.34, ASPR 5141.8 to 4352.3, and ASIR 1912.0 to 1706.7. In the US, ASMR, ASPR, and ASIR decreased from 1.57 to 1.29, 2495.8 to 2278.2, and 757.5 to 716.0 in males, and from 1.17 to 0.96, 4921.6 to 3796.5, and 1856.5 to 1519.4 in females.

DISCUSSION: Mortality and prevalence declined in both regions, while incidence showed modest reductions. The persistently higher US burden likely reflects obesity, metabolic disease, and healthcare disparities, emphasizing the need for targeted prevention and equitable access to care.