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In the first years of Chile's preventive gallbladder surgery guarantee, deaths from gallbladder cancer among 35 to 49 year olds fell twice as fast as before, but the national trend did not visibly change.
Analysis of Chilean Ministry of Health mortality and hospital discharge databases for 2002 to 2014, standardised to the 2002 Chilean population, with Poisson regression for trends by region, sex and age, comparing the periods before and after the GES guarantee. Nationally there was a 4.5 percent decreasing mortality trend compared with before GES. Among people aged 35 to 49, mortality fell by 4 percent per period before GES and 8 percent after. Hospital discharges for biliary disease moved from a 1 percent decrease before GES to a 2 percent increase after, and in the 35 to 49 group from 0.1 to 2.9 percent. The authors conclude the rise in operations had not yet produced a break in the national mortality trend but did benefit the targeted age group.
Together with the 2024 evaluation and the American Journal of Epidemiology analysis, this is the evidence base for whether a prophylactic cholecystectomy policy prevents gallbladder cancer deaths: suggestive in the target age band, not yet convincing nationally.
The most rigorous evaluation of the Chilean programme available; read alongside Mardones and Frenz (2019) and Samaniego and colleagues (2024).
The only national prophylactic cholecystectomy programme in the world has run for nearly twenty years without a design that can show whether it works. Targeting by region and risk, and building in an evaluation, is the obvious next step.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed, Gallbladder cancer and the tag gallbladder-evidence.
Shares Redesign Chile's prophylactic cholecystectomy programme around risk, and evaluate it properly, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed, Gallbladder cancer and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.