Most tumours of the gallbladder and extrahepatic bile ducts are carcinomas. Only a small proportion are adenomas, carcinoid and stromal tumours {35}.

Geographic distribution

The incidence of carcinoma of the gallbladder varies in different parts of the world and also differs among different ethnic groups within the same country. In the United States, carcinoma of the gallbladder is more common in Native Americans and Hispanic Americans than in whites or blacks; the rate among female Native Americans is 21 per 100,000 compared with 1.4 per 100,000 among white females. In Latin American countries, the highest rates are found in Chile, Mexico and Bolivia. In Japan, the incidence rates are intermediate. In the general population of the United States cancer of the gallbladder accounts for 0.17% for all cancers in males and 0.49% in females.

There are no geographic variations in the incidence of extrahepatic bile duct carcinoma which accounts for 0.16% of all invasive cancers in males and 0.15% in females in the general population of the United States {35}.

Fig. 9.01 Gallbladder carcinoma with a white, irregular cut surface next to a large gall stone.

Age and sex distribution

Carcinomas of the gallbladder and extrahepatic bile ducts are diseases of older age groups. Most patients are in the 6th or 7th decades of life. Gallbladder carcinomas have a strong female predominance, whereas extrahepatic bile duct carcinomas occur more frequently in males.

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