XGP is a rare chronic inflammatory condition that appears to be overrepresented by Maori and Pacific islanders in our cohort when compared with the overall patient pool. Surgical treatment is associated with significant morbidity but remains the only definitive option. Obesity and other conditions associated with metabolic syndrome may coexist at the time of presentation and may be contributing factors to the development of XGP and poor outcomes associated with it.

The significant financial burden on the health system, and the growing evidence for the effectiveness of pentoxifylline, tocopherol and clodronate, should prompt us to explore this alternative treatment further.

Although the evidence for plain packaging of tobacco is not strong, the evidence that is available indicates that it is an effective tobacco cessation policy.

Background: Gallbladder cancer is a high-mortality cancer with a wide range of incidence worldwide. Some indigenous populations are known to have a higher incidence of gallbladder cancer. Commonly, it is incidentally discovered during routine gallbladder surgery. The primary aim was to determine the incidence and characteristics of gallbladder cancer in a New Zealand population. The secondary aim was to determine if inequalities in gallbladder cancer rates between Māori and non-Māori have decreased. Methods: A retrospective cohort study utilizing an online database was conducted to identify all patients with gallbladder malignancy treated in the Waitemata District Health Board from 2003 to 2013. The outcomes measured were staging of cancer, histology, ethnicity, incidental finding and survival rates. Results: The age-standardized incidence (ASI) rate of gallbladder carcinoma is 0.60/ 100 000. The gender-specific ASI rates were 0.21/100 000 (men) and 0.76/100 000 (women). The incidence for Māori was 0.96/100 000 (men) and 1.37/100 000 (women). Gallbladder carcinoma was found incidentally in 0.44% of cholecystectomies, which made up 46.2% of all cases. Right upper quadrant pain was the most common presenting symptom (74.4%). Surgery was the most common treatment modality (66.7%). Mean survival across all patients was 12.24 months. Conclusion: Our study found that the ASI of gallbladder carcinoma when compared with the Koea et al. study has decreased for men from New Zealand, but appears to have increased slightly for women from New Zealand. The raw incidence for Māori men and women appears to have decreased, but inequality in gallbladder cancer incidence between Māori and non-Māori remains.