Global, Regional, and National Burden of Gallbladder and Biliary Tract Cancer in Adults Aged 55 Years and Older: Analysis of the Global Burden of Disease 1990–2021

Objective Gallbladder and biliary tract cancers (GBTC) are highly aggressive tumors that pose an increasing burden on global health. This study examined the temporal trends and global disease burden across 204 countries and territories from 1990 to 2021. Methods GBTC data from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021, which included 204 countries and territories. Burden was assessed based on prevalence, incidence, and disability-adjusted life years (DALYs) stratified by age group and socio-demographic index (SDI). Temporal trends were analyzed using estimated annual percentage change (EAPC) and 95% confidence intervals (CIs). Results In 2021, gallbladder and biliary tract cancers (GBTC) accounted for 2.5 million prevalent cases, 2.0 million incident cases, and 3.1 million DALYs, reflecting increases of 58%, 51%, and 62% since 1990. Age-specific EAPCs were modest (prevalence, 0.32%; incidence, 0.05%; mortality,0.39%; and DALYs, 0.44%), indicating that demographic aging, rather than etiologic shifts drove the rising burden. Regionally, East Asia reported the highest DALY rates and fastest growth (EAPC ≈ 3.0), whereas Europe and North America showed either stable or declining trends. Older adults, particularly those aged ≥ 90 years, showed the steepest increase (> 160% DALY growth). Conclusions The global burden of GBTC has escalated in recent decades, reflecting the combined effects of demographic ageing and regionally heterogeneous risk factors. Targeted prevention strategies, enhanced early detection, and strengthened surveillance systems are essential to address disparities and mitigate the future impact of GBTC.