Trends in mortality related to benign gallbladder disease in the United States: A twenty - five year retrospective study.

BACKGROUND

Diseases of the gallbladder are one of the frequently encountered cases in clinical settings, and affect millions of adults worldwide. Gallbladder diseases are predominantly benign and encompass gallstones, polyps, adenomyomatosis, and acute cholecystitis, with gallstones representing the most common manifestation. We seek to evaluate disparities and analyze the mortality trends in Benign Gallbladder disease-related mortality among adults in the U.S. from 1999 to 2023.

METHODS

Mortality data were obtained from death certificates in the CDC WONDER Multiple Cause of Death database for individuals aged ≥25 years with benign gallbladder disease from 1999 to 2023. AAMRs (age-adjusted mortality rates) were calculated, and standardized to 2000 U.S.

POPULATION: APCs (annual percent changes) were derived through Joinpoint regression analysis. Data was stratified by multiple demographic and regional variables, including age group, sex, and urban-rural status.

RESULTS

In total, 154,578 deaths were attributed to benign gallbladder diseases in the United States from 1999 to 2023. The 25-year analysis demonstrated an overall decline in the age-adjusted mortality rate (AAMR), from 3.4 per 100,000 to 1.9 (AAPC -2.7, p < 0.000001). Sex-stratified analyses showed persistently higher AAMRs among men compared with women (3.4 vs 2.4), with a significant temporal reduction observed in women (AAPC -0.70, p = 0.000966) but not in men (AAPC -0.3, p = 0.1346). Racial and ethnic stratification revealed the highest mortality burden among non-Hispanic American Indian or Alaska Native populations (AAMR 3.7; AAPC -1.3, p = 0.009652) and the lowest among non-Hispanic Asian or Pacific Islander populations (AAMR 2.4; AAPC -1.4, p = 0.005554). Geographically, the West region exhibited the highest regional mortality (AAMR 3.2; AAPC -0.52, p = 0.056539), while nonmetropolitan areas bore a greater burden than metropolitan areas (AAMR 3.4; AAPC -1.2, p = 0.000104). At the state level, New Mexico demonstrated the highest mortality (AAMR 4.1).

CONCLUSION

Despite overall declining mortality, significant demographic and geographic disparities persist, highlighting the need for targeted prevention strategies.