ArticleDigestive diseases and sciences2026
Persistent Global Associations Between Gallbladder-Biliary Diseases and Pancreatic Cancer: Evidence from 204 Countries and Territories Over 32 years.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite anatomical proximity and shared physiological pathways, population-level evidence examining temporal associations between gallbladder-biliary diseases and pancreatic cancer remains limited. We systematically evaluated correlational patterns using three decades of global health surveillance data.
methodsWe conducted a population-based ecological analysis using Global Burden of Disease Study 2021 data spanning 1990-2021 across 204 countries and territories. Spearman correlations quantified temporal associations across five health metrics, with dose-response relationships assessed through decile-based categorization and spatial heterogeneity evaluated using continental-level comparisons.
resultsSignificant positive correlations emerged between gallbladder-biliary diseases and pancreatic cancer, with Spearman coefficients ranging from 0.740 to 0.843 (all p < 0.001), persisting after age-standardization. Temporal stability showed exceptional consistency, with a coefficient of variation of 2.2% across 32 years. The strongest correlations occurred in the 20-54 years age group despite the highest burden being in the 55 + years group, suggesting critical biological windows. Significant dose-response gradients existed (p < 0.001). Continental analysis revealed differential correlation strengths: Oceania (r = 0.93), Asia (r = 0.90), Europe (r = 0.70), Americas (r = 0.68), and Africa (r = 0.63). Pancreatic cancer burden escalated by 45.7% while gallbladder-biliary disease burden remained stable. Associations persisted following risk factor adjustment, suggesting disease-specific pathways.
conclusionsThis global analysis provides compelling population-level evidence for sustained temporal associations between gallbladder-biliary diseases and pancreatic cancer. The demonstrated dose-response relationships and age-specific patterns suggest biological linkages warranting integrated disease management and targeted surveillance strategies.
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