Objectives: Primary gallbladder cancer (GBC) is the most common biliary tract cancer with poor survival despite aggressive treatment. This study aimed to investigate the trends of GBC incidence and incidencebased mortality (IBM) over the last 4 decades.Materials and Methods: GBC cases diagnosed between 1973 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence rates, IBM rates, and annual percent changes (APCs) were calculated and stratified according to population and tumor characteristics.
Results:The cohort consisted of 10,792 predominantly white (81%) and female (71%) GBC patients. The overall GBC incidence decreased by 1.65% (95% confidence interval [CI]: 1.45% to 1.84%) per year since 1973, but has plateaued since 2002. IBM decreased by 1.69% (95% CI: 1.22% to 2.16%) per year from 1980 to 2015; the rate of decrease in IBM rates was lower during 1997 to 2015 (APC: −1.19%, 95% CI: −1.68% to −0.71%) compared with 1980 to 1997 (APC: −3.13%, 95% CI: −3.68% to −2.58%).
Conclusions:The incidence and IBM rates of GBC have been decreasing over the last 40 years, but the decrease plateaued over the last 2 decades. The effects of treatment modalities, including laparoscopic cholecystectomy, adjuvant chemotherapy, and radiation on the incidence and IBM of GBC need to be further investigated.
e16133 Background: Primary gallbladder carcinoma (GBC) is the most common biliary tract cancer with poor survival despite aggressive treatment. The purpose of our study was to investigate the trends of GBC incidence and incidence-based mortality (IBM), as well as to identify the factors responsible for any observed changes. Methods: GBC cases diagnosed between 1973 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results database (SEER) database. Incidence and IBM rates age-adjusted to the 2000 US standard population were calculated and were stratified according to population and tumor-associated characteristics. Joinpoint Regression Analysis program was used to calculate the annual percent changes (APCs) for trend analysis. Results: Among the 10,792 patients with GBC, there was a predominance of white (81%) and female (71%) patients. The overall incidence rate was 1.086 (95% CI: 1.065 to 1.106) and the overall IBM rate was 0.995 (95% CI: 0.976 to 1.015). GBC incidence decreased by 1.645% (95% CI: 1.448 to 1.842, p < 0.001) per year, but the decreasing trend was only statistically significant from 1973 to 2002, after which the incidence rates stabilized. Conversely, IBM decreased by 1.689% (95% CI: 1.217 to 2.159, p < 0.001) per year from 1980 to 2015; the degree of decline in IBM rates during 1997-2015 (-1.194, 95% CI: -1.680 to -0.705, p < 0.001) was lower compared to that during 1980-1997 (-3.132, 95% CI: -3.682 to -2.578, p < 0.001). Mortality rates of GBC decreased in all age groups and in all races except for African American. There was a significant decrease in IBM in all SEER stages of GBC, except for distant stage GBC. Conclusions: GBC incidence and IBM rates have been decreasing over the last 40 years. However, the decrease in incidence and IBM appeared to have plateaued in the last two decades. The roles of increasing widespread use of laparoscopic cholecystectomy and use of newer treatment modalities, such as adjuvant chemotherapy and radiation, need to be investigated further.[Table: see text]
Background: Malaria is an endemic disease especially in tropical areas transmitted by Anopheles mosquito through their bites. Therefore, bednets are one of the best methods for protection against their bites. However, many regions have limited access to bednets and limited knowledge about their importance. Objectives: Primary objectives were to estimate bednet possession and usage rate for last 10 years. Secondary objectives aimed to calculate the prevalence of specific bednets’ types.Methods: We performed an electronic search on 12 databases, and 106 studies were included obeying the criteria. Results: 106 studies included in our meta-analysis. Study participants were mostly from Africa while a few from Asia and southern America. Overall bednet ownership rate per households among countries was 72.1% (95% CI: 62.9-79.7) while per individuals was 52.5% (95% CI: 37-67.4). In addition, overall bednet usage rate per households among countries was 41.2% (95% CI: 25.1-59.3) same as bednet usage per individuals.Conclusion: Our study suggests that the bednet ownership and usage rate among different countries are less satisfactory, hence not maximizing the potential benefit of the bed net. There is a crucial need to increase awareness towards the bednet usage across endemic areas and implement programs for free distribution of bednets.
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