This document summarizes prevalence and incidence data on benign biliary disease from 195 countries between 1990 and 2017. It finds that the highest prevalence is generally in Russia, Eastern Europe, and some South American countries for females, and Brunei, Norway and Eastern Europe for males. The highest incidence is in Scandinavian countries, Germany, Chile, and Argentina for females and Brunei, Japan, South Korea for males. Within England, the highest prevalence and incidence is in the North West and North East regions. Overall, the highest rates globally are found in Southern Latin America, high-income Islamic countries, and Eastern Europe.

1. Prevalence and incidence of benign biliary disease in 195
countries and territories between 1990 and 2017
Lunevicius R
Department of Surgery
Aintree University Hospital NHS FoundationTrust, Liverpool
5th July 2019
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2. Disclosures
None
Raimundas Lunevicius, FRCS (Engl.)
Consultant Surgeon,Aintree University Hospital NHS FoundationTrust, Liverpool
Directorate Lead for Mortality, Morbidity and Audit
Honorary Senior Clinical Lecturer, University of Liverpool, England
Educational Supervisor, University of Liverpool
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3. Background / common knowledge
• The prevalence of gallstone disease is higher inWestern countries,
and varies between 5 – 25%
BMJ 2014; 348: g2669
• Gallstone disease in all its forms constitute a significant proportion
of gallbladder / bile duct diseases
• Aim: to overview age-standardised prevalence / incidence of biliary
disease at global, national and local scales – emphasis on England
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4. Definition: Prevalence
• Prevalence is defined as the number of affected persons (i.e. prevalent
cases) present in a population at a specific time - expressed as a
proportion of the population
• Example: prevalence of 0.00011 for the UK’s 31,532,900 male individuals
at 30th of June 2013 means that there were 3,468.6 males affected by a
specific disease that day (0.00011 × 31,532,900); among females, there
were 3,583 individuals affected by by a specific disease, as mid-2013
female population estimate for the UK was 32,572,800 and prevalence
was 0.00011.
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5. Definition: Incidence
• Incidence is defined as the number of new cases per individual (or per
100,000 individuals) a year - expressed as a rate.
The incident case is defined as a newly diagnosed case in a population in a given period – a year.
• It is approximately measured by taking the number of new cases in a year
divided by the mid-year population of a country or region.
• Example: incidence at the level 0.0017558861581211 for one male
individual in 2013 means that incidence of the particular condition is 176
new cases per 100 000 men in 2013.
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6. PREVALENCE
195 countries and territories
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7. 21/10/2020 7
Map: prevalence, in females, in 195 countries, in 2017
Top 5 countries, 2017: Russia, Jordan, Romania, Ecuador, Chile (lowest: Indonesia)
Top 5 countries, 1990: Russia, Slovakia, Hungary, Romania, Check Republic

8. 21/10/2020 8
Map: prevalence, in males, in 195 countries, in 2017
Top 5 countries, 2017: Brunei, Norway, Slovakia, Check R, Romania (195th: Indonesia)
Top 5 countries, 1990: Brunei, Slovakia, Check Republic, Hungary, Slovenia

9. INCIDENCE
195 countries and territories
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10. 21/10/2020 10
Map: incidence, in females, in 195 countries, in 2017
Top 5 countries, 2017: Sweden, Chile, Germany, Argentina, Iceland (195th: Indonesia)
Top 5 countries, 1990: Sweden, Chile, Italy, Germany, Austria (195th: the Philippines)

11. 21/10/2020 11
Map: incidence, in males, in 195 countries, in 2017
Top 5 countries, 2017: Brunei, Norway, Japan, Singapore, S. Korea (195th: Indonesia)
Top 5 countries, 1990: Brunei, Japan, S. Korea, Singapore, Norway (195th: the Philippines)

12. PREVALENCE
ENGLAND, 2017:
by 150 UpperTier LocalAuthorities in England, including county councils, London boroughs, unitary
authorities, and metropolitan districts (City of London and Isles of Scilly not included due to small population sizes)
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13. 21/10/2020 13
Map: prevalence, in females, in England, in 2017
Prevalence in NorthWest and North East regions is higher than in other regions

14. 21/10/2020 14
Map: prevalence, in males, in England, in 2017
Prevalence in NorthWest and North East regions is higher than in other regions

15. INCIDENCE
ENGLAND, 2017
by 150 UpperTier LocalAuthorities in England, including county councils, London boroughs, unitary
authorities, and metropolitan districts (City of London and Isles of Scilly not included due to small population sizes)
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16. 21/10/2020 16
Map: incidence, in females, in England, in 2017
Incidence in NorthWest and North East regions is higher than in other regions

17. 21/10/2020 17
Map: incidence, in males, in England, in 2017
Incidence in NorthWest and North East regions is higher than in other regions

18. PREVALENCE of symptomatic episodes
England
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19. 21/10/2020 19
Map: prevalence (symptomatic disease), in females, in England, in 2017
Prevalence in NorthWest and North East regions is higher than in other regions

20. 21/10/2020 20
Map: prevalence (symptomatic disease), in males, in England, in 2017
Prevalence in NorthWest and North East regions is higher than in other regions

21. INCIDENCE AND PREVALENCE:
symptomatic and asymptomatic
Global scale
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22. 21/10/2020 22
Scatter: incidence and prevalence in males, in 2017

23. 21/10/2020 23
Scatter: incidence and prevalence in females, in 2017

24. TOP Region in terms of Incidence and
Prevalence in females, in 2017
• Southern LatinAmerica
– Chile, Uruguay, Argentina
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25. Common knowledge
• The prevalence of gallstone disease is higher inWestern
countries
BMJ 2014; 348: g2669;
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26. Conclusion
• The prevalence of gallstone disease is higher
– Southern LatinAmerica region
– In high-income Islamic countries (Brunei, Qatar, Jordan)
– East and Central Europe regions
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