Trends in Gallbladder Cancer Incidence and Survival in Korea

  • Wi, Youngjun (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Woo, Hyeongtaek (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Won, Young-Joo (Cancer Registration and Statistics Branch, National Cancer Center) ;
  • Jang, Jin-Young (Department of Surgery, Seoul National University College of Medicine) ;
  • Shin, Aesun (Department of Preventive Medicine, Seoul National University College of Medicine)
  • Received : 2017.06.09
  • Accepted : 2018.01.23
  • Published : 2018.10.15


Purpose The current study was undertaken to examine the trend in gallbladder cancer (GBC) incidence and survival in Korea. Materials and Methods GBC incidence data by histologic type were obtained from the Korea Central Cancer Registry. Age-standardized incidence rates were calculated using the mid-year Korean population of 2000 as a standard population, and a joinpoint regression model was used to calculate the annual percent change (APC) in incidence rates. Incidence by Surveillance, Epidemiology and End Results (SEER) summary stage and by geographical areas and female-to-male incidence rate ratios was also described. Results The number of new GBC cases increased between 1999 and 2013. Nevertheless, the age-standardized incidence rate decreased by 0.5% per year in men (p < 0.01), whereas the incidence rate in women did not change significantly over the same period (APC, -0.2; p=0.59). The most common histologic type was adenocarcinoma in both sexes. Based on the SEER stage, the distant stage was the most frequent stage (41%), followed by the regional stage (37%). Ulsan (4.31/100,000 for men and 4.09/100,000 for women in 2009-2013) and Gyeongsangnam-do (4.15/100,000 for men and 3.54/100,000 for women) showed the highest GBC incidence, whereas the lowest incidence was observed in Seoul and Gyeonggi-do. There were no significant sex differences in the incidence of GBC (female-to-male incidence rate ratio, 0.96). Conclusion The overall incidence of GBC in Korea did not change significantly over the 15-year period. Incidence for men and women was similar. However, geographical variation was found.


Supported by : Seoul National University Hospital


  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-86.
  2. Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol. 2014;6:99-109.
  3. Butte JM, Matsuo K, Gonen M, D'Angelica MI, Waugh E, Allen PJ, et al. Gallbladder cancer: differences in presentation, surgical treatment, and survival in patients treated at centers in three countries. J Am Coll Surg. 2011;212:50-61.
  4. Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, et al. Gallstones and the risk of biliary tract cancer: a population-based study in China. Br J Cancer. 2007;97:1577-82.
  5. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118:1591-602.
  6. Andia ME, Hsing AW, Andreotti G, Ferreccio C. Geographic variation of gallbladder cancer mortality and risk factors in Chile: a population-based ecologic study. Int J Cancer. 2008;123:1411-6.
  7. Sachidananda S, Krishnan A, Janani K, Alexander PC, Velayutham V, Rajagopal S, et al. Characteristics of gallbladder cancer in South India. Indian J Surg Oncol. 2012;3:228-30.
  8. Yagyu K, Kikuchi S, Obata Y, Lin Y, Ishibashi T, Kurosawa M, et al. Cigarette smoking, alcohol drinking and the risk of gallbladder cancer death: a prospective cohort study in Japan. Int J Cancer. 2008;122:924-9.
  9. Kayahara M, Nagakawa T. Recent trends of gallbladder cancer in Japan: an analysis of 4,770 patients. Cancer. 2007;110:572-80.
  10. Oh CM, Won YJ, Jung KW, Kong HJ, Cho H, Lee JK, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Cancer Res Treat. 2016;48:436-50.
  11. Dickman P [Internet]. [cited 2018 Jan 2]. Available from: http//
  12. Jin F, Devesa SS, Chow WH, Zheng W, Ji BT, Fraumeni JF Jr, et al. Cancer incidence trends in urban shanghai, 1972-1994: an update. Int J Cancer. 1999;83:435-40.
  13. West J, Wood H, Logan RF, Quinn M, Aithal GP. Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971-2001. Br J Cancer. 2006;94:1751-8.
  14. Siesling S, van Dijck JA, Visser O, Coebergh JW; Working Group of The Netherlands Cancer Registry. Trends in incidence of and mortality from cancer in The Netherlands in the period 1989-1998. Eur J Cancer. 2003;39:2521-30.
  15. Manfredi S, Benhamiche AM, Isambert N, Prost P, Jouve JL, Faivre J. Trends in incidence and management of gallbladder carcinoma: a population-based study in France. Cancer. 2000;89:757-62.
  16. Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder: histologic types, stage of disease, grade, and survival rates. Cancer. 1992;70:1493-7.
  17. Roa I, Araya JC, Villaseca M, Roa J, de Aretxabala X, Ibacache G. Gallbladder cancer in a high risk area: morphological features and spread patterns. Hepatogastroenterology. 1999;46:1540-6.
  18. Choi D, Lim JH, Lee KT, Lee JK, Choi SH, Heo JS, et al. Gallstones and Clonorchis sinensis infection: a hospital-based casecontrol study in Korea. J Gastroenterol Hepatol. 2008;23(8 Pt 2):e399-404.
  19. Qian MB, Chen YD, Liang S, Yang GJ, Zhou XN. The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma. Infect Dis Poverty. 2012;1:4.
  20. Kiran RP, Pokala N, Dudrick SJ. Incidence pattern and survival for gallbladder cancer over three decades: an analysis of 10301 patients. Ann Surg Oncol. 2007;14:827-32.
  21. Choi SB, Han HJ, Kim CY, Kim WB, Song TJ, Suh SO, et al. Incidental gallbladder cancer diagnosed following laparoscopic cholecystectomy. World J Surg. 2009;33:2657-63.
  22. Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer. J Korean Med Sci. 2009;24: 481-7.
  23. Jang JY, Kim SW, Lee SE, Hwang DW, Kim EJ, Lee JY, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. Ann Surg. 2009;250:943-9.
  24. Kim TS, Cho SH, Huh S, Kong Y, Sohn WM, Hwang SS, et al. A nationwide survey on the prevalence of intestinal parasitic infections in the Republic of Korea, 2004. Korean J Parasitol. 2009;47:37-47.
  25. Park YW, Choi KB, Kim SK, Lee DG, Lee JH. Obesity in Korean men: results from the Fourth through Sixth Korean National Health and Nutrition Examination Surveys (2007-2014). World J Mens Health. 2016;34:129-36.
  26. Lowenfels AB, Walker AM, Althaus DP, Townsend G, Domellof L. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol. 1989;18:50-4.
  27. Shrikhande SV, Barreto SG, Singh S, Udwadia TE, Agarwal AK. Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol. 2010;36:514-9.
  28. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6:172-87.
  29. Lee J, Demissie K, Lu SE, Rhoads GG. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control. 2007;14:78-85.
  30. Jee SH, Yun JE, Park EJ, Cho ER, Park IS, Sull JW, et al. Body mass index and cancer risk in Korean men and women. Int J Cancer. 2008;123:1892-6.
  31. Shin A, Song YM, Yoo KY, Sung J. Menstrual factors and cancer risk among Korean women. Int J Epidemiol. 2011;40:1261-8.
  32. Carriaga MT, Henson DE. Liver, gallbladder, extrahepatic bile ducts, and pancreas. Cancer. 1995;75(1 Suppl):171-90.