Where you areGallbladder cancer

Northern India and the Gangetic belt

India contributes about a tenth of the world's gallbladder cancer, and almost all of it comes from the north, north-east, centre and east of the country: the Gangetic plain from Delhi through Uttar Pradesh and Bihar to Assam. The south and west have rates as low as western Europe's.

Chile, Bolivia and the Andes

The two highest national rates in the world are Andean: GLOBOCAN 2022 puts Bolivia at 7.64 per 100,000 and Chile at 5.72, with women at 8.36 and 7.43. Chile has treated the cancer as a public health emergency for two decades and is the only country with a national prevention programme.

Pakistan

Gallbladder cancer is the second commonest gastrointestinal cancer in Pakistani women. The Karachi registry gave South Karachi women 13.8 per 100,000 in Randi's review, the second highest registry rate in the world after Delhi.

Nepal and Bangladesh

GLOBOCAN 2022 places Bangladesh third (5.25 per 100,000; 7.7 in women, the second highest women's rate anywhere) and Nepal fourth (4.36; 5.5 in women). Both are modelled estimates rather than registry counts, which the map marks.

Korea and Japan

East Asia is the one high-rate region where men are affected as often as women. Korea's rate (2.62 per 100,000, sixth in the world) is higher in men (2.93) than women (2.36); Japan's 1.88 is identical in both sexes. Both countries run national registries and have watched the age-standardised rate fall while case counts rise with ageing.

Native American and Hispanic populations of the Americas

The United States as a whole is a low-rate country (1.13 cases per 100,000 a year in 2007-2011), but American Indian and Alaska Native people have three times the rate of non-Hispanic whites, and in the Southwest and Alaska five to eight times. Hispanic Americans and Mexican Americans sit in between.

Central and eastern Europe

Poland, the Czech Republic and Slovakia have Europe's highest gallbladder cancer rates and Hungary had women's mortality above 6 per 100,000 until the early 1990s. The gap with western Europe has narrowed as cholecystectomy became routine, but it has not closed.

Chile: GES guarantee number 26, preventive cholecystectomy at 35 to 49

• Since 2006 Chile's Explicit Health Guarantees (GES, formerly AUGE) have listed 'Colecistectomía preventiva del cáncer de vesícula en personas de 35 a 49 años' as guaranteed problem number 26: anyone aged 35 to 49 with gallstones is entitled to have the gallbladder removed, with access, timeliness, quality and financial protection guaranteed by law.
• It is the only national programme in the world that removes gallbladders to prevent cancer. By 2024, 284,139 GES notifications had been issued to patients in the age band with gallstones, matching the cholecystectomies performed under the programme.
• What the evaluations show: national gallbladder cancer mortality fell, and fell faster in the 35 to 49 group, in the first years after 2006 (Mardones and Frenz, 2002 to 2014 data); but the Rev Med Chile analysis of 2024 notes mortality was already falling before the programme and that the regions with most notifications are not always the regions with most cancer; the American Journal of Epidemiology analysis of 2024, with US National Cancer Institute authors, is the most rigorous test yet of whether the programme itself moved the curve.
• Number needed to operate: a Chilean risk model puts it at 115 cholecystectomies to prevent one gallbladder cancer by age 70 for gallstone carriers as a group, falling to 92 with non-genetic risk factors (body mass index, education, Mapuche surnames, number of children, family history) and 80 when Mapuche ancestry and a risk genotype are added, an argument for targeting rather than age alone.

The Ministry of Health's own GES pages (auge.minsal.cl) refused automated reading on the check date (HTTP 403), so the programme's name and number are quoted from the Superintendencia de Salud's list of GES problems and its start year and age band from the peer-reviewed evaluations; the current clinical guideline PDF could not be located.

• Superintendencia de Salud (Chile): the GES problems of health, number 26, Colecistectomía preventiva del cáncer de vesícula en personas de 35 a 49 años (2026-09-24)
• Boekstegers et al, Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high-incidence country, Int J Cancer 2023 (2023)
• Samaniego et al, Gallbladder cancer: is it time to modify the Explicit Health Guarantees (GES) programme?, Rev Med Chile 2024 (2024)
• Mardones and Frenz, Changes in gallbladder cancer mortality and hospital discharges after the GES guarantee, Rev Med Chile 2019 (2019)
• Cid et al, Gallbladder cancer mortality in Chile: has the government programme targeting young gallstone patients had an impact?, Am J Epidemiol 2024 (2024)

India: the National Cancer Registry Programme and the hospital registries

• India has no national population register of cancer. The ICMR has run the National Cancer Registry Programme since 1982 from Bengaluru (ICMR-NCDIR, now ICMR-NINE); its 2020 report pools 28 population-based and 58 hospital-based registries for 2012-2016 and projects national counts from them, which is why India's estimates differ between sources.
• For gallbladder and biliary tract cancer (ICD-10 C23-C24) the report's Figure 5.12 ranks Kamrup urban first in both sexes (age-adjusted rate 16.2 per 100,000 in women, 7.9 in men), then Cachar (11.9 and 5.6), Delhi (11.6 and 5.4) and, in women, Papumpare (10.7). The registry publishes the gallbladder together with the extrahepatic bile ducts; a gallbladder-only (C23) rate is not given in the chapters read.
• Trends: in Delhi the age-adjusted rate in men rose 4.2 percent a year and in Dibrugarh district (Assam) 10.8 percent a year over the registry's trend window; Delhi's 25-year series shows both sexes rising after 2004. The report's summary paper singles out Kamrup urban's rise in all cancers combined (3.8 percent a year).
• Hospital registries fill the gaps: Tata Memorial's gallbladder cancer registry (Patkar 2025) describes the presenting stage and treatment of a national referral population, and the Mumbai case-control programme behind the place-of-birth and mustard-oil papers drew 1,170 cases from the same hospital.

The registry's report page and chapter PDFs were read directly on the check date (HTTP 200); the JCO Global Oncology summary paper of the same report gives the projected national count of 1,392,179 cancers for 2020 and names the Kamrup urban trend, but does not itself carry the gallbladder rates, which sit in Chapter 5.

• ICMR-NCDIR, Report of National Cancer Registry Programme 2020: report page and chapter downloads (2026-09-24)
• ICMR-NCDIR, Report of National Cancer Registry Programme 2020 (2012-2016), Chapter 5, Fig. 5.12: gall bladder (C23-C24), comparison of age-adjusted incidence rates of 28 PBCRs (2020)
• ICMR-NCDIR, Report of National Cancer Registry Programme 2020 (2012-2016), Chapter 13: trends in cancer incidence (Delhi, Dibrugarh) (2020)
• Mathur et al, Cancer Statistics, 2020: report from National Cancer Registry Programme, India, JCO Global Oncology 2020 (2020)
• Malhotra et al, Gallbladder cancer incidence in Delhi urban: a 25-year trend analysis, Indian J Cancer 2017 (2017)
• Mhatre et al, Mustard oil consumption, cooking method, diet and gallbladder cancer risk in high- and low-risk regions of India, Int J Cancer 2020 (2020)

Japan: registry, guideline and surgical practice

• Japan counts every case through its national cancer registry and publishes gallbladder and bile duct cancer together: 20,926 diagnoses in 2023, 17,232 deaths in 2024, crude incidence 16.8 per 100,000 and five-year relative survival 24.8 percent (27.5 percent in men, 21.7 in women) for those diagnosed in 2018.
• The Japanese Society of Hepato-Biliary-Pancreatic Surgery has published clinical practice guidelines for biliary tract cancers since 2007; the third edition (2019, English 2021) answers 31 clinical questions on six topics, the first of which is prophylactic treatment, followed by diagnosis, biliary drainage, surgery, chemotherapy and radiotherapy, with 14 strong and 14 weak GRADE recommendations.
• The Society's own registry of 18,606 biliary tract cancers treated between 2008 and 2013 reports five-year survival of 39.8 percent for gallbladder cancer in this operated population, against 24.2 percent for perihilar and 39.1 percent for distal bile duct cancer; an earlier community series of 4,774 patients (1988-1997) found survival tracking stage, 77 percent at five years in stage I falling to 3 percent in stage IVB, with no survival gain from more aggressive resection or adjuvant chemotherapy over that decade.
• There is no population screening programme for gallbladder cancer in Japan; the abdominal ultrasound that is part of routine health checks finds polyps and stones, and the guideline's prophylactic-treatment section is where the decision to remove a gallbladder for a large polyp, a porcelain gallbladder or an anomalous pancreaticobiliary junction is set out.

The National Cancer Center statistics page was read in Japanese on the check date; the survival and registry figures are quoted from the abstracts of the papers named. The guideline recommendations themselves are behind the journal's paywall and are described here only as far as the abstract goes.

• National Cancer Center Japan, Cancer Information Service: gallbladder and bile duct cancer statistics (胆のう・胆管), national cancer registry 2023 and vital statistics 2024 (2026-09-24)
• Nagino et al, Clinical practice guidelines for the management of biliary tract cancers 2019: the 3rd English edition (Japanese Society of Hepato-Biliary-Pancreatic Surgery), J Hepatobiliary Pancreat Sci 2021 (2021)
• Ishihara et al, Biliary tract cancer registry in Japan from 2008 to 2013, J Hepatobiliary Pancreat Sci 2016 (2016)
• Kayahara and Nagakawa, Recent trends of gallbladder cancer in Japan: an analysis of 4,770 patients, Cancer 2007 (2007)
• Makiuchi and Sobue, Descriptive epidemiology of biliary tract cancer incidence and geographic variation in Japan (national cancer registry 2016-2017), Eur J Cancer Prev 2023 (2023)