A cross-sectional analysis and forward projection of China’s gallbladder and biliary-tract cancer burden

Gallbladder and biliary tract cancer (GBTC) remains highly lethal. We examined 32-year epidemiological trends in China and projected outcomes to 2050. Using 2021 Global Burden of Disease (GBD) data, we extracted annual GBTC incident and prevalent cases, deaths, and disability-adjusted life years (DALYs) for 1990 to 2021, stratified by sex, age, and socio-demographic index (SDI). The age-standardized rates (ASRs) were calculated, and ARIMA models forecast 2050 incidence and mortality. Globally, GBTC risk rises after age 60 and correlates with SDI ( R = 0.588). In China, cases increased from 17,077 in 1990 to 51,720 in 2021, raising the age-standardized incidence rate (ASIR) from 2.04 to 2.49/100,000 (+0.50% annually). Prevalent cases increased to 79,688 (age-standardized prevalence rate (ASPR) 3.77/100,000). Conversely, ASMR fell from 2.32 to 1.85/100,000 (−0.75%), and DALYs declined from 51.3 to 40.4/100,000 (−0.87%), driven by fewer years of life lost (YLL). Males drove incidence and prevalence. Projections suggest male incidence will keep rising until 2050, while female rates are projected to plateau; male mortality stays stable, and female mortality continues a gradual decline. Aging and rising SDI inflate GBTC incidence, yet improved care compresses mortality. Males carry an increasing share. Targeted prevention and early detection are critical to curb incidence and improve survival.