Trends in disease burden of gallbladder and biliary tract cancer in Yunnan Province, China, 1990–2021, and projections to 2030_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SONG Aijing ¹ , CHEN Baohui ¹ , TANG Xian ² , YU Qiuli ² , PU Xueya ² ,  CHEN Yang ²

1. School of Public Health, Kunming Medical University, Kunming 650500, P. R. China;
2. Department of Chronic Non-Communicable Disease Prevention and Control, Yunnan Center for Disease Control and Prevention, Kunming 650500, P. R. China;

Corresponding?author：

CHEN Yang, Email: yncdccy@126.com

Keywords：

gallbladder cancer; biliary tract cancer; disease burden; Joinpoint regression; Bayesian age-period-cohort model; trend forecasting

DOI：

10.7507/1007-9424.202606066

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Objective To systematically analyze the temporal trends in the burden of gallbladder and biliary tract cancer (GBTC) in Yunnan Province, China, from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021), and to project the disease burden through 2030 to inform regional prevention and control strategies. Methods Data on crude prevalence, mortality, and disability-adjusted life year (DALY) rates for GBTC in Yunnan Province, China, from 1990 to 2021 were extracted from GBD 2021. Temporal trends in the age-standardized prevalence, mortality, and DALY rates (ASPR, ASMR, and ASDR) were analyzed using Joinpoint regression models, and the average annual percent change (AAPC) was calculated. Furthermore, the Bayesian age-period-cohort (BAPC) model was employed to project the disease burden from 2022 to 2030. Results From 1990 to 2021, the crude prevalence, mortality, and DALY rates of GBTC in Yunnan Province increased from 1.01/100 000, 1.00/100 000, and 27.50/100 000 in 1990 to 3.00/100 000, 1.78/100 000, and 43.29/100 000 in 2021, respectively. After age standardization, the ASPR showed an upward trend (AAPC=1.29%), whereas the ASMR (AAPC=–0.58%) and ASDR (AAPC=–0.70%) exhibited downward trends. Regarding sex disparities, the increase in ASPR was more pronounced in males than in females (AAPC: 1.88% vs. 0.67%), while the declines in ASMR and ASDR were less steep in males than in females (ASMR AAPC: –0.20% vs. –0.92%; ASDR AAPC: –0.29% vs. –1.06%). Age-stratified analysis revealed that the ASPR increase was most prominent in the 30–34-year age group (AAPC=2.63%), and the reductions in ASMR and ASDR were most substantial in the 50–59-year age group (AAPC: –1.20% and –1.18%, respectively). Projections based on the BAPC model indicate that by 2030, the ASPR will continue to rise to 3.17/100 000, whereas the ASMR and ASDR are projected to decline gradually to 1.44/100 000 and 34.86/100 000, respectively. Conclusions The absolute disease burden of GBTC in Yunnan Province keeps rising. While the ASMR and ASDR have shown a declining trend, the steady growth in the ASPR points to a substantial accumulation of prevalent cases. Future public-health programmes should prioritise targeted early-detection and treatment strategies for the young- and middle-aged population.

Citation： SONG Aijing, CHEN Baohui, TANG Xian, YU Qiuli, PU Xueya, CHEN Yang. Trends in disease burden of gallbladder and biliary tract cancer in Yunnan Province, China, 1990–2021, and projections to 2030. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(9): 1204-1211. doi: 10.7507/1007-9424.202606066 Copy

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21.	Maeng CH, Han K, Hong JY, et al. Association between premature menopause and the risk of biliary tract cancer: a nationwide cohort study [J/OL]. Eur J Cancer, 2025, 220: 115387. doi: 10.1016/j.ejca.2025.115387.
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1. Song X, Hu Y, Li Y, et al. Overview of current targeted therapy in gallbladder cancer [J/OL]. Signal Transduct Target Ther, 2020, 5(1): 230. doi: 10.1038/s41392-020-00324-2.
2. 中國研究型醫院學會精準醫學與腫瘤MDT專業委員會. 中國膽道腫瘤多學科綜合治療專家共識 [J/CD]. 腫瘤綜合治療電子雜志, 2023, 9(3): 57-68.
3. Zhang W, Wang YJ, Liu JM, et al. Burden of biliary tract carcinoma in China (1990–2021): findings from the 2021 Global Burden of Disease Study [J]. Sci Bull (Beijing), 2024, 69(22): 3547-3557.
4. Jiang Z, Jiang Q, Wang P, et al. Gallbladder and biliary tract cancer burdens in China from 1990 to 2021 and projection to 2044: findings from the 2021 Global Burden of Disease study [J/OL]. Front Med (Lausanne), 2025, 12: 1592621. doi: 10.3389/fmed.2025.1592621.
5. Lei S, Huang G, Li X, et al. Global burden, trends, and inequalities of gallbladder and biliary tract cancer, 1990–2021: a decomposition and age-period-cohort analysis [J/OL]. Liver Int, 2025, 45(2): e16199. doi: 10.1111/liv.16199.
6. 張桐. 云南省鄉村人口空間分布格局及演變特征 [J]. 黑龍江糧食, 2022(7): 92-95.
7. 劉燕. 欠發達地區農村老年慢性病健康管理困境的探析–基于云南、四川和山西的調查 [J]. 中國衛生事業管理, 2022, 39(12): 931-935.
8. 許群, 金水高, 張立興. 失能調整壽命年(DALY)—測量疾病負擔的新指標 [J]. 中國防癆雜志, 1999, 21(3): 167-170.
9. Bao W, Qiao L, Li M, et al. Trends and cross-country inequalities in the global, regional, and national burden of gallbladder and biliary tract cancer from 1990 to 2021, along with the predictions for 2035 [J/OL]. Cancer Epidemiol, 2025, 96: 102802. doi: 10.1016/j.canep.2025.102802.
10. Gunasekaran G, Bekki Y, Lourdusamy V, et al. Surgical treatments of hepatobiliary cancers [J]. Hepatology, 2021, 73 Suppl 1: 128-136.
11. Zhang X, Xu C, Zhang H, et al. Gallbladder cancer incidence and mortality rate trends in China: analysis of data from the population-based cancer registry [J/OL]. BMC Public Health, 2024, 24(1): 3122. doi: 10.1186/s12889-024-20584-9.
12. Mullens CL, Sinamo JK, Hallway A, et al. Contemporary outcomes of cholecystectomy [J]. JAMA Surg, 2026, 161(4): 398-405.
13. 吳官華, 陳勇軍. 腹腔鏡肝門部膽管癌根治術新進展 [J]. 中華肝膽外科雜志, 2021, 27(9): 709-712.
14. Peng Y, Liang A, Chen Z, et al. The efficacy of adjuvant chemotherapy for curative resected biliary tract cancers: a systematic review and network meta-analysis of randomized clinical trials [J]. Int J Surg, 2025, 111(2): 2182-2194.
15. Zheng-Lin B, Shibuki T, Kosiorek HE, et al. Survival outcomes with matched targeted therapy in advanced biliary tract cancer: a large global cohort analysis [J/OL]. NPJ Precis Oncol, 2026. doi: 10.1038/s41698-026-01457-3.
16. 張穎. 我國新型農村合作醫療制度的發展與完善 [J]. 法制與社會, 2014, (16): 33-34.
17. Akkus E, Cammarota A, Izquierdo-Sanchez L, et al. Epidemiology, clinical, molecular features, and prognosis of early-onset biliary tract cancer: a systematic review and meta-analysis [J/OL]. JHEP Rep, 2025, 8(1): 101613. doi: 10.1016/j.jhepr.2025.101613.
18. Huang J, Patel HK, Boakye D, et al. Worldwide distribution, associated factors, and trends of gallbladder cancer: a global country-level analysis [J]. Cancer Lett, 2021, 521: 238-251.
19. 楊曉靜, 王家冉, 靳婷, 等. 2000–2021年浙江省腫瘤登記地區膽囊癌的流行現狀與趨勢分析 [J]. 中國普外基礎與臨床雜志, 2025, 32(6): 714-721.
20. 吳春曉, 龐怡, 陳蕾, 等. 2002–2020年上海市膽道癌發病和死亡情況分析: 基于人群基礎的研究 [J]. 外科理論與實踐, 2025, 30(3): 214-222.
21. Maeng CH, Han K, Hong JY, et al. Association between premature menopause and the risk of biliary tract cancer: a nationwide cohort study [J/OL]. Eur J Cancer, 2025, 220: 115387. doi: 10.1016/j.ejca.2025.115387.
22. Gunchick V, Wen W, Jia G, et al. Dietary intake, obesity, and physical activity in association with biliary tract cancer risk: results from meta-analyses of individual-level data from prospective cohort studies of 723 326 adults [J]. Int J Cancer, 2024, 155(10): 1721-1730.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Trends in disease burden of gallbladder and biliary tract cancer in Yunnan Province, China, 1990–2021, and projections to 2030

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