The epidemiology of cholelithiasis in southern Italy

Objective: To describe the prevalence and incidence of gallstones in a population sample from a typical Mediterranean area. Subjects and methods: A sample of 3500 subjects (2000 men and 1500 women, aged 30–69 years) was selected by systematic sampling from the electoral register of Castellana, a small town in southern Italy. Between May 1985 and June 1986, 2472 (70.6%) subjects (1429 men and 1043 women) had their gall bladders checked for gallstones by ultrasonography. Between May 1992 and June 1993, 1962 (87.7%) of the subjects without gallstones (1162 men and 800 women) agreed to be re-examined by ultrasonography. Results: A total of 226 subjects (92 men and 134 women) had gallstones, a prevalence rate of 9.2% (6.5 and 12.9% in men and women, respectively). On re-examination, 104 subjects (55 men and 49 women) had developed gallstones; an incidence rate of 7.9 per 1000 person-years (7.1 and 9.1 per 1000 person-years in men and women, respectively). Prevalence and incidence increased with age in both sexes but were higher in women than in men at all ages. Conclusion: This study suggests that the population of Castellana has a high incidence of cholelithiasis compared with populations studied in central and northern Italy and northern Europe.