Demographic and temporal variations in gallbladder adenocarcinoma and neuroendocrine carcinoma: insights from a retrospective analysis of the national cancer database

Abstract

Introduction: Gallbladder adenocarcinoma is the most common histologic subtype of gallbladder malignancies. In contrast, gallbladder neuroendocrine carcinomas are rare and poorly studied. This study aims to identify the demographic variables that may be associated with each histologic subtype.

Methods: A retrospective analysis was conducted on 53,447 patients diagnosed with gallbladder neoplasms using data from the National Cancer Database (NCDB) between 2011 and 2020. Associations between demographic variables and the incidence of gallbladder adenocarcinoma and neuroendocrine carcinoma were compared using chi-square tests and post hoc analyses.

Results: A total of 51,694 (96.7%) patients had adenocarcinoma, and 1753 (3.3%) had neuroendocrine histologic subtypes. The comparative analysis revealed significant associations with age, gender, and race (p < 0.05). Neuroendocrine carcinoma patients were diagnosed at a younger age compared to those with adenocarcinoma (z = 14.7). Moreover, patients with privately managed insurance had a higher likelihood of neuroendocrine carcinoma (z = 5.7), while those with Medicare were less likely (z = - 4.7). Gender differences were also notable; males were more predisposed to neuroendocrine carcinoma (z = 4.4, OR = 1.3), while females were less so (z = - 3.1). A significant increase in neuroendocrine cases was observed after 2016 (z = 2.4), while the incidence of adenocarcinoma subtypes was stable. Notable racial disparities in the diagnosis of gallbladder cancer were identified with black patients more likely to have neuroendocrine carcinoma.

Conclusion: This study highlights the differences in demographic and clinical characteristics of patients diagnosed with gallbladder neuroendocrine carcinomas compared to adenocarcinoma tumors. These findings highlight potential opportunities for targeted screening programs to enhance early detection efforts.

Keywords: Adenocarcinoma; Demographic variables; Epidemiology; Gallbladder cancer; NCDB; Neuroendocrine carcinoma; Observational; Targeted screening.