Epidemiological Study of Gallbladder Cancer Patients from North Indian Gangetic Planes—a High-Volume Centre’s Experience

Abstract

Current data suggest that the epidemiology of gallbladder cancer is constantly evolving, with much of this change caused by lifestyle, cultural and dietary factors. Balanced diet, prevention of malnutrition/adulteration, tobacco prevention and early intervention for cholelithiasis may help in decreasing the incidence of this dreaded disease. More structured studies need to be carried out to ascertain risk factors for GBC in our population subgroup.

Global epidemiological trends and variations in the burden of gallbladder cancer

“…In a recent epidemiological study from North India, gallstones were reported to be present in 80% of patients of GBC. The majority of these patients had multiple stones ( n = 319, 81.9%) compared to single stone ( n = 71, 18.1%) …”

“…In a study from a North Indian population cohort, right upper quadrant pain was the commonest complaint found in almost all patients of GBC (98%), followed by palpable lump in the right upper quadrant (9%), jaundice (8%), and ascites (3%), respectively, with mean duration of symptoms <3 months in 57% of patients . Close to two thirds of patients of GBC (>65%) in epidemiological studies from India were from low socioeconomic strata . Delay in seeking treatment for gallstones and subsequent prolonged inflammation induced by gallstones may be contributory factors for high incidence of GBC in lower socioeconomic strata in India.…”

“…Compared to the western world, there is also a high incidence of Incidental GBC (IGBC [3.5‐30%]) reported from various Indian studies . This could be attributable to overlooking the preoperative findings suspicious of GBC (focal/diffuse thick‐walled GB, GB mass) both by the sonologist and the surgeon.…”

“…21 8 Close to two thirds of patients of GBC (>65%) in epidemiological studies from India were from low socioeconomic strata. [24][25][26] Delay in seeking treatment for gallstones and subsequent prolonged inflammation induced by gallstones may be contributory factors for high incidence of GBC in lower socioeconomic strata in India. The lack of universal access to safe drinking water in India may also expose them to various carcinogens.…”

“…Incidental GBC (IGBC [3.5-30%]) reported from various Indian studies. 23,24,29 This could be attributable to overlooking the preoperative findings suspicious of GBC (focal/diffuse thick-walled GB, GB mass) both by the sonologist and the surgeon. A simple cholecystectomy is performed on these patients with the mistaken diagnosis of chronic cholecystitis.…”