[Gallbladder Cancer: Is It Time to Modify the Explicit Health Guarantees (GES) Program?]

Abstract

Chile currently has one of the highest mortality rates from gallbladder cancer in the world. In 2006, the Chilean Ministry of Health included cholelithiasis (patients aged 35-49) and treatment with cholecystectomy within the Explicit Health Guarantees (GES) program.

Aim: To evaluate the results of the GES Preventive Cholecystectomy Program for Gallbladder Cancer as to consider the need to propose changes to the model.

Methods: retrospective analysis of official data from the Chile Ministry of Health and National Statistics Institute.

Results: Since the program's inception in 2006, 284.139 notifications have been issued to patients aged between 35 and 49 with gallstones. Notifications can be correlated with the number of cholecystectomies performed under the program. Gallbladder cancer standardized mortality has shown a decrease over the last two decades, even before the program was implemented. High and low incidences are observed throughout the country. Regarding notifications, there are areas with a high incidence that are not always correlated with the areas with high notifications.

Conclusion: The decrease in the standardized mortality of GBC in Chile requires modifying the present GES Preventive Cholecystectomy program for Gallbladder Cancer. Resources should be oriented to patients living in high-incidence areas with known risk factors.