Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 1 Date: 27 Apr 2025
Reviewer's report:
This manuscript presents an epidemiological study assessing the burden of early-onset
gallbladder and biliary tract cancer (EOGBTC) among individuals under 50 years old from 1990
to 2021, using data sourced from the Global Burden of Disease Study 2021. The authors calculate
average annual percentage changes (AAPCs) and age-standardized rates (ASRs) to analyze
trends in incidence, prevalence, and mortality. Findings indicate a notable rise in prevalence
and incidence, with a significant burden concentrated in East Asia and South Asia, particularly
in regions classified as having middle, low-middle, and low socio-demographic indices (SDI).
Decomposition analysis identifies population growth as a critical factor influencing the disease
burden, while health inequalities have shown improvement over the study period. Projections
indicate an anticipated increase in global EOGBTC incidence and prevalence by 2040, despite
a downward trend in mortality and disability-adjusted life years (DALYs).
comments:
Please provide comprehensive details regarding the classifications of GBD super regions used in
this analysis. Understanding these classifications is important for contextualizing the geographic
disparities.
A more thorough explanation of the methodologies used for calculating confidence intervals
(CIs) is needed. Additionally, please improve the interpretation of these intervals in relation to
the study's findings to clarify their significance.
The authors should expand upon the public health implications of their findings. A discussion on
how this research can inform policy development, healthcare strategies, and resource allocation
would enhance the manuscript.
Additional context regarding the GBD modeling framework utilized would strengthen the
manuscript. Information on the assumptions, limitations, and analytical approaches in the GBD
framework would be valuable.
Please clarify how uncertainty intervals (UIs) were calculated in this study. Providing this
information will help the reader understand the reliability of the reported data.
The rationale for the study could be further developed. I recommend integrating more recent
literature to provide a stronger basis for the significance of investigating EOGBTC trends and
epidemiology.
The manuscript should maintain consistency in decimal representation throughout the text. It
would be helpful to standardize either one decimal place (e.g., 0.0) or two decimal places (e.g.,
0.00) to enhance professionalism and readability.
The manuscript includes some outdated references. I encourage the authors to incorporate more
recent literature to present updated estimates and insights on EOGBTC.
Sincerely,
Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 1 Date: 27 Apr 2025
Reviewer's report:
This manuscript presents an epidemiological study assessing the burden of early-onset
gallbladder and biliary tract cancer (EOGBTC) among individuals under 50 years old from 1990
to 2021, using data sourced from the Global Burden of Disease Study 2021. The authors calculate
average annual percentage changes (AAPCs) and age-standardized rates (ASRs) to analyze
trends in incidence, prevalence, and mortality. Findings indicate a notable rise in prevalence
and incidence, with a significant burden concentrated in East Asia and South Asia, particularly
in regions classified as having middle, low-middle, and low socio-demographic indices (SDI).
Decomposition analysis identifies population growth as a critical factor influencing the disease
burden, while health inequalities have shown improvement over the study period. Projections
indicate an anticipated increase in global EOGBTC incidence and prevalence by 2040, despite
a downward trend in mortality and disability-adjusted life years (DALYs).
comments:
Please provide comprehensive details regarding the classifications of GBD super regions used in
this analysis. Understanding these classifications is important for contextualizing the geographic
disparities.
A more thorough explanation of the methodologies used for calculating confidence intervals
(CIs) is needed. Additionally, please improve the interpretation of these intervals in relation to
the study's findings to clarify their significance.
The authors should expand upon the public health implications of their findings. A discussion on
how this research can inform policy development, healthcare strategies, and resource allocation
would enhance the manuscript.
Additional context regarding the GBD modeling framework utilized would strengthen the
manuscript. Information on the assumptions, limitations, and analytical approaches in the GBD
framework would be valuable.
Please clarify how uncertainty intervals (UIs) were calculated in this study. Providing this
information will help the reader understand the reliability of the reported data.
The rationale for the study could be further developed. I recommend integrating more recent
literature to provide a stronger basis for the significance of investigating EOGBTC trends and
epidemiology.
The manuscript should maintain consistency in decimal representation throughout the text. It
would be helpful to standardize either one decimal place (e.g., 0.0) or two decimal places (e.g.,
0.00) to enhance professionalism and readability.
The manuscript includes some outdated references. I encourage the authors to incorporate more
recent literature to present updated estimates and insights on EOGBTC.
Sincerely,
Please review this paper.
user
Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 1 Date: 27 Apr 2025
Reviewer's report:
This manuscript presents an epidemiological study assessing the burden of early-onset
gallbladder and biliary tract cancer (EOGBTC) among individuals under 50 years old from 1990
to 2021, using data sourced from the Global Burden of Disease Study 2021. The authors calculate
average annual percentage changes (AAPCs) and age-standardized rates (ASRs) to analyze
trends in incidence, prevalence, and mortality. Findings indicate a notable rise in prevalence
and incidence, with a significant burden concentrated in East Asia and South Asia, particularly
in regions classified as having middle, low-middle, and low socio-demographic indices (SDI).
Decomposition analysis identifies population growth as a critical factor influencing the disease
burden, while health inequalities have shown improvement over the study period. Projections
indicate an anticipated increase in global EOGBTC incidence and prevalence by 2040, despite
a downward trend in mortality and disability-adjusted life years (DALYs).
comments:
Please provide comprehensive details regarding the classifications of GBD super regions used in
this analysis. Understanding these classifications is important for contextualizing the geographic
disparities.
A more thorough explanation of the methodologies used for calculating confidence intervals
(CIs) is needed. Additionally, please improve the interpretation of these intervals in relation to
the study's findings to clarify their significance.
The authors should expand upon the public health implications of their findings. A discussion on
how this research can inform policy development, healthcare strategies, and resource allocation
would enhance the manuscript.
Additional context regarding the GBD modeling framework utilized would strengthen the
manuscript. Information on the assumptions, limitations, and analytical approaches in the GBD
framework would be valuable.
Please clarify how uncertainty intervals (UIs) were calculated in this study. Providing this
information will help the reader understand the reliability of the reported data.
The rationale for the study could be further developed. I recommend integrating more recent
literature to provide a stronger basis for the significance of investigating EOGBTC trends and
epidemiology.
The manuscript should maintain consistency in decimal representation throughout the text. It
would be helpful to standardize either one decimal place (e.g., 0.0) or two decimal places (e.g.,
0.00) to enhance professionalism and readability.
The manuscript includes some outdated references. I encourage the authors to incorporate more
recent literature to present updated estimates and insights on EOGBTC.
Sincerely,
assistant