Digestive diseases and sciences · 2025
Persistent Global Associations Between Gallbladder-Biliary Diseases and Pancreatic Cancer: Evidence from 204 Countries and Territories Over 32 years.
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Chen Xiaoyang, Xu Bin, Wang Shun, Shi Jinghong
Аннотация
BACKGROUND: Despite anatomical proximity and shared physiological pathways, population-level evidence examining temporal associations between gallbladder-biliary diseases and pancreatic cancer remains limited. We systematically evaluated correlational patterns using three decades of global health surveillance data.
METHODS: We conducted a population-based ecological analysis using Global Burden of Disease Study 2021 data spanning 1990-2021 across 204 countries and territories. Spearman correlations quantified temporal associations across five health metrics, with dose-response relationships assessed through decile-based categorization and spatial heterogeneity evaluated using continental-level comparisons.
RESULTS: Significant positive correlations emerged between gallbladder-biliary diseases and pancreatic cancer, with Spearman coefficients ranging from 0.740 to 0.843 (all p < 0.001), persisting after age-standardization. Temporal stability showed exceptional consistency, with a coefficient of variation of 2.2% across 32 years. The strongest correlations occurred in the 20-54 years age group despite the highest burden being in the 55 + years group, suggesting critical biological windows. Significant dose-response gradients existed (p < 0.001). Continental analysis revealed differential correlation strengths: Oceania (r = 0.93), Asia (r = 0.90), Europe (r = 0.70), Americas (r = 0.68), and Africa (r = 0.63). Pancreatic cancer burden escalated by 45.7% while gallbladder-biliary disease burden remained stable. Associations persisted following risk factor adjustment, suggesting disease-specific pathways.
CONCLUSIONS: This global analysis provides compelling population-level evidence for sustained temporal associations between gallbladder-biliary diseases and pancreatic cancer. The demonstrated dose-response relationships and age-specific patterns suggest biological linkages warranting integrated disease management and targeted surveillance strategies.
METHODS: We conducted a population-based ecological analysis using Global Burden of Disease Study 2021 data spanning 1990-2021 across 204 countries and territories. Spearman correlations quantified temporal associations across five health metrics, with dose-response relationships assessed through decile-based categorization and spatial heterogeneity evaluated using continental-level comparisons.
RESULTS: Significant positive correlations emerged between gallbladder-biliary diseases and pancreatic cancer, with Spearman coefficients ranging from 0.740 to 0.843 (all p < 0.001), persisting after age-standardization. Temporal stability showed exceptional consistency, with a coefficient of variation of 2.2% across 32 years. The strongest correlations occurred in the 20-54 years age group despite the highest burden being in the 55 + years group, suggesting critical biological windows. Significant dose-response gradients existed (p < 0.001). Continental analysis revealed differential correlation strengths: Oceania (r = 0.93), Asia (r = 0.90), Europe (r = 0.70), Americas (r = 0.68), and Africa (r = 0.63). Pancreatic cancer burden escalated by 45.7% while gallbladder-biliary disease burden remained stable. Associations persisted following risk factor adjustment, suggesting disease-specific pathways.
CONCLUSIONS: This global analysis provides compelling population-level evidence for sustained temporal associations between gallbladder-biliary diseases and pancreatic cancer. The demonstrated dose-response relationships and age-specific patterns suggest biological linkages warranting integrated disease management and targeted surveillance strategies.