10-YEAR INCIDENCE AND NATURAL-HISTORY OF GALLSTONE DISEASE IN A RURAL-POPULATION OF WOMEN IN CENTRAL ITALY

Aims, To investigate the incidence, risk factors and natural history o f gallstone disease, a random sample of females belonging to a rural p opulation was enrolled in a ten-year longitudinal study. Methods, The study has been performed in a small town on the hills south of Rome, I n 1985, a random sample of 426 females, aged 20-69 years, was screened by real-time ultrasonography for gallstones and previous cholecystect omy. Screening methods included anthropometry, collection of a blood s ample and a questionnaire on the occurrence of abdominal symptoms. Dur ing 1995, all these subjects were invited for a 10-year follow-up exam ination. Results. The overall 10-year incidence of gallstone gallstone disease was 6.3% (5.5% of new gallstones and 0.8% of cholecystectomie s). Only 23.1% of the women with gallstones were aware of their condit ion, More than three quarters (76.9%) had not suffered biliary pain. U nivariate and multivariate analyses demonstrated a positive independen t association of new gallstone disease with body mass index and parity . Out of the initially asymptomatic gallstone women, 15.4% experienced at least one episode of biliary pain, 23.1% were submitted to electiv e cholecystectomy and 61.5% remained asymptomatic. Conclusions. The st udy demonstrates a high incidence of gallstone disease in women belong ing to a rural free-living population in Italy ann suggests body mass index and parity as possible true risk factors. Moreover; it confirms that a remarkable proportion of asymptomatic patients become symptomat ic and eventually undergo cholecystectomy.