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Chile has guaranteed gallbladder removal for people aged 35 to 49 with gallstones since 2006 to prevent gallbladder cancer; this review of official data finds deaths falling but already falling before the programme, and uptake not matching the regions where the cancer is commonest.
Retrospective analysis of official Chilean Ministry of Health and National Statistics Institute data on the GES preventive cholecystectomy programme, which since 2006 has included cholelithiasis in patients aged 35 to 49 with cholecystectomy as guaranteed treatment. Since inception 284,139 notifications had been issued to patients in that age band with gallstones, correlating with cholecystectomies performed under the programme. Standardised gallbladder cancer mortality has fallen over two decades, including before the programme began. Incidence varies across the country and high-incidence areas are not always the areas with most notifications. The authors conclude the programme should be modified to direct resources to patients in high-incidence areas with known risk factors.
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.
The most rigorous evaluation of the Chilean programme available; read alongside Mardones and Frenz (2019) and Samaniego and colleagues (2024).
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.
Shares Prophylactic (preventive) cholecystectomy, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed 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 Screening, 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 Screening, 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, Screening, 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 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.