Gallbladder cancer rates had been stable or declining for most Americans over the last 2 decades, but cases steadily rose among non-Hispanic Black patients, with growing numbers not being diagnosed until later stages, according to a study presented at Digestive Disease Week 2024.
“Gallbladder cancer diagnosis at late stage can be highly detrimental,” said lead author Yazan Abboud, MD, internal medicine resident at Rutgers University New Jersey Medical School. “This could be due to a lack of timely access to health care leading to delayed diagnosis. Non-Hispanic Black [patients] have been lacking in improvement in the mortality of gallbladder cancer compared to other racial and ethnic groups, who experienced declining mortality.”
Researchers analyzed records for 76,873 patients diagnosed with gallbladder cancer from 2001-2020 in the U.S. Cancer Statistics database, which covers nearly 98% of the U.S. population. They found gallbladder cancer incidence rates were stable among White patients and declined at an average annual rate of 0.6% among Hispanic patients, while rates rose for non-Hispanic Black patients. Overall cancer rates among Black patients increased by an average of 1% per year, and the incidence of late-stage tumors increased at an average annual rate of 2.7%.
Among early-stage tumors, (12.9% of overall cases) rates decreased only in Hispanic patients and were stable among Black and White patients. For mid-stage tumors, (38.6% of overall cases), incidence rates declined for White patients and were stable for Black and Hispanic patients.
Dr. Abboud noted the importance of identifying risk factors associated with the study's main findings. "The next step is to conduct further research using a large national database that includes clinical variables, lab values, comorbidities, socioeconomic statuses, and insurance status. By creating a comprehensive model that incorporates all these variables, we can determine which factors might lead to a higher risk of developing gallbladder cancer in this specific population," he explained in an interview with Conexiant.
Gallbladder cancer is one of the most aggressive malignancies. With a 5-year survival rate of 19%, it is most often diagnosed at later stages, noted the study investigators. In the study, almost half of the gallbladder cancers were diagnosed at late stages, including 43.7% of cancers in Black patients compared with 40.8% in White patients and 41.1% of cases among Hispanic patients.
Due to the aggressive nature of gallbladder cancer, when it comes to raising awareness to the public underserved communities, Dr. Abboud noted the importance of screening and seeking surgical treatment. “[Patients] need to be aware of what they have. They need to know that this is risky, and this might develop cancer in the future.”
He also noted a need to "bridge the gap" in access to timely diagnosis and treatment. "For health care policy providers or public health personnel, I think it's essential to address socioeconomic status," said Dr. Abboud.
The results of this study continue to put emphasis on the urgency of gallbladder cancer diagnosis, especially within a specific population. Dr. Abboud and his colleagues agreed more research needs to be conducted, but Dr. Abboud expressed hope in the research and highlighting the topic.
“I think it's important and I'm hoping it will have some impact and will improve our patients’ outcomes. That's the end point of it," concluded Dr. Abboud.