Incidence, mortality, and survival of gallbladder, extrahepatic bile duct, and pancreatic cancers in Korea: A population-based study from 1999 to 2022.

Backgrounds/Aims: Biliary tract and pancreatic cancers remain leading contributors to cancer-related mortality in Korea, even though their incidence rates are comparatively low. This study evaluates long-term national patterns in these malignancies utilizing population-based data. Methods: Information from the Korea Central Cancer Registry was used to assess 258,854 patients newly diagnosed with gallbladder (n = 52,712), extrahepatic bile duct (n = 76,787), and pancreatic (n = 129,355) cancers between 1999 and 2022. Results: During the period from 1999 to 2022, the crude incidence rates for gallbladder (2.8 to 5.6 per 100,000), extrahepatic bile duct (3.6 to 9.8), and pancreatic cancers (5.5 to 19.1) all showed an upward trend. For pancreatic cancer, the age-standardized incidence rate rose markedly (5.6 to 8.4), whereas it stabilized for extrahepatic bile duct cancer (3.7 to 3.8), and declined for gallbladder cancer (2.9 to 2.2). The distributions of localized and regional disease stages remained largely consistent throughout the study period. There was an increase in the proportion of patients undergoing surgical intervention within the first 4 months post-diagnosis for gallbladder (42.3% to 48.2%) and pancreatic cancer (22.5% to 23.7%), while this proportion slightly declined in extrahepatic bile duct cancer (47.8% to 46.0%). The overall 5-year relative survival rate improved significantly in gallbladder (21.9% to 32.1%) and pancreatic (8.6% to 15.5%) cancers, and showed a modest improvement in extrahepatic bile duct cancer (23.1% to 27.2%). Conclusions: The crude incidence rates for gallbladder, extrahepatic bile duct, and pancreatic cancers have continuously risen in Korea. While survival rates have improved, the persistently high mortality rates highlight the critical need for earlier diagnosis and advancements in therapeutic approaches.