TRENDS IN BILIARY-TRACT CANCER

Incidence data from a large number of cancer registries throughout the world are presented for cancers at various sub-sites of the biliary t ract, to assess whether the epidemiology of gall bladder cancer can be distinguished from cancer of the extra-hepatic bile ducts and cancer of the ampulla of Vater. Cancers of the biliary tract appear to be str ongly sex-related. A marked genetic susceptibility emerges from this r eview, not only for gall bladder cancer, as previously reported for Am erican Indians, but also perhaps for cancer of the extra-hepatic bile ducts, for which Japanese of both sexes have high rates. Mortality dat a for all biliary tract (mainly gall bladder) cancer are examined for the period 1958-85. A wide range of trends is observed, notably a cons istent decline in mortality among Anglo-Saxon populations, for both ma les and females. Dietary factors, possibly mediated through hormonal a nd genetic factors, are suggested as a major causal influence on bilia ry tract cancers.