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The following is a summary of “Global burden of gallbladder and biliary diseases (1990–2021) with healthcare workforce analysis and projections to 2035,” published in the April 2025 issue of the BMC Gastroenterology by Dai et al.

Gallbladder and biliary tract diseases present a growing public health concern, despite improvements in age-standardized rates. This study offers a comprehensive evaluation of global patterns from 1990 to 2021, explores disparities in healthcare workforce distribution relative to disease burden, and projects future trends through 2035 using data from the Global Burden of Disease Study 2021.

Researchers analyzed global data on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for gallbladder and biliary tract diseases. Temporal trends were assessed using Estimated Annual Percentage Change (EAPC). Decomposition analysis was applied to identify the effects of demographic and epidemiological shifts on mortality. Health inequality was evaluated using the concentration index, and projections to 2035 were generated using a Bayesian Age-Period-Cohort (BAPC) model. Additionally, the study group examined country-level correlations between healthcare workforce density and disease burden.

Between 1990 and 2021, the global age-standardized incidence rate declined by 12.84%, reaching 865.4 per 100,000. Age-standardized prevalence, DALYs, and mortality also declined by 13.31%, 20.98%, and 28%, respectively. Despite these reductions, the absolute number of cases increased by 60.11%, driven largely by population aging and growth. Decomposition analysis revealed that aging accounted for 95.37% and population growth for 73.96% of the rise in global deaths, while advances in epidemiology offset 69.33% of this burden.

Significant geographic disparities were observed. Western Europe reported the highest prevalence, while low-resource countries such as Honduras faced high disease burdens with limited healthcare capacity—48.3 health workers per 10,000 population compared to Austria’s 385.5, despite similar prevalence. Health inequality worsened, with the concentration index for mortality rising from 0.24 in 1990 to 0.31 in 2021.

Projections indicate that by 2035, absolute cases will increase by 20.3%, DALYs by 26.1%, and deaths by 36.9%, despite continued declines in age-standardized rates, primarily due to demographic shifts.While progress has been made in reducing age-standardized rates, the rising absolute burden of gallbladder and biliary tract diseases highlights the need for targeted interventions. These include improved screening, expanded surgical capacity in underserved areas, and strategies to mitigate modifiable risk factors. Equally important is addressing healthcare workforce disparities, which remain a critical barrier to equitable disease management worldwide.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03842-x