智利的胆囊癌（GBC）死亡率是全球最高的之一。 2006年，智利政府启动了一项计划，保证35-49岁患者接受胆囊手术（胆囊切除术）。我们评估了该计划对消化道癌症死亡率的影响。在对智利卫生统计和信息部公开的 2002 年至 2018 年住院和死亡率数据进行中断时间序列分析后，我们计算了 10 年来无胆囊个体比例的变化。然后，我们根据无胆囊个体比例的变化来估计年龄、性别、地区和历年标准化死亡率（SMR）。实施健康计划后，胆囊切除术率每年每 10 万人增加 45 例（95%CI 19-72）。 10 年来，无胆囊个体的比例每增加 1%，GBC 死亡率就会降低 0.73%（95% CI -1.05% 至 -0.38%），但这种负相关仅限于女性、智利南部和年龄60 岁以上。我们还发现，随着无胆囊个体比例的增加，肝外胆管癌、肝癌、食道癌和胃癌的死亡率下降。总而言之，智利胆囊切除计划启动 12 年后，胆囊切除率发生了显着且不同程度的变化。基于汇总数据的结果表明，无胆囊个体的比例与胆囊癌和其他消化道癌症导致的死亡率之间存在负相关，这需要使用个体水平的纵向数据进行验证，以减少生态偏差的潜在影响。© 2024 ）。约翰·威利出版的《国际癌症杂志》

Gallbladder cancer (GBC) mortality in Chile is among the highest worldwide. In 2006, the Chilean government launched a programme guaranteeing access to gallbladder surgery (cholecystectomy) for patients aged 35-49 years. We evaluated the impact of this programme on digestive cancer mortality. After conducting an interrupted time series analysis of hospitalisation and mortality data from 2002 to 2018 publicly available from the Chilean Department of Health Statistics and Information, we calculated the change in the proportion of individuals without gallbladder since 10 years. We then estimated age, gender, region, and calendar-year standardised mortality ratios (SMRs) as a function of the change in the proportion of individuals without gallbladder. The cholecystectomy rate increased by 45 operations per 100,000 persons per year (95%CI 19-72) after the introduction of the health programme. Each 1% increase in the proportion of individuals without gallbladder since 10 years was associated with a 0.73% decrease in GBC mortality (95% CI -1.05% to -0.38%), but the negative correlation was limited to women, southern Chile and age over 60. We also found decreasing mortality rates for extrahepatic bile duct, liver, oesophageal and stomach cancer with increasing proportions of individuals without gallbladder. To conclude, 12 years after its inception, the Chilean cholecystectomy programme has markedly and heterogeneously changed cholecystectomy rates. Results based on aggregate data indicate a negative correlation between the proportion of individuals without gallbladder and mortality due to gallbladder and other digestive cancers, which requires validation using individual-level longitudinal data to reduce the potential impact of ecological bias.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.