Burden of gallbladder and biliary tract cancer (GBTC) in the middle east and North Africa (MENA) from 1990 to 2021: from the global burden of disease (GBD)

Introduction: Gallbladder and biliary tract cancer (GBTC) is a rare but aggressive malignancy with poor survival outcomes, mainly due to late-stage diagnosis and limited treatment options. Despite prominent global disparities in incidence and outcomes, comprehensive data on the GBTC burden in the Middle East and North Africa (MENA) region remain scarce. Materials and methods: We used Global Burden of Disease (GBD) 2021 data. We retrieved incidence, deaths, and DALYs, including crude and age-standardized rates per 100 000, with 95% uncertainty intervals for 21 MENA countries, the MENA region, and globally, stratified by year (1990–2021), sex, and age group. Results: In the MENA region, the age-standardized incidence rate (ASIR) remained at 1.4 per 100 000 in both 1990 and 2021 (−0.2% change), while globally it declined from 2.89 to 2.56 (−11.5%; 95% UI: −21.9 to −3.4). The age-standardized death rate (ASDR) decreased from 1.50 to 1.37 (−9.0%) in MENA versus 2.69 to 2.04 (−24.1%; 95% UI: −33.2 to −16.9) globally. The age-standardized DALY rate fell from 34.26 to 29.82 (−13.0%) in MENA and from 58.58 to 43.20 (−26.2%; 95% UI: −35.5 to −18.4) globally. Across years, females had higher age-standardized rates than males, rates increased with age, and the peak DALY rate shifted from 80–84 (1990) to 85–89 (2021). Conclusions: While the burden of GBTC has decreased in the MENA region and has consistently remained lower than the global average, there is considerable heterogeneity across countries in the region that warrants the attention of policymakers, particularly in countries with a higher burden of GBTC, such as Libya and the United Arab Emirates, and in countries with an increasing burden, such as Iran.