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Gallbladder cancer: an 'Indian' disease
1Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow 226014, Uttar Pradesh, India. vkkapoor@sgpgi.ac.in
The National Medical Journal of India
|November 11, 2003
Summary
Gallbladder cancer, a common biliary malignancy, is surprisingly frequent in North India, especially among women, and linked to gallstones. This "Indian disease" affects migrants and locals, highlighting regional risk factors.
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- Gallbladder cancer is the most common biliary malignancy, with significant geographical and racial variations in prevalence.
- While generally considered rare in India, gallbladder cancer incidence is notably high in North and Central India, becoming the most common gastrointestinal cancer in women.
- Indian migrants exhibit an elevated risk of gallbladder cancer compared to native populations in their host countries.
Purpose of the Study:
- To investigate the epidemiological patterns and risk factors associated with gallbladder cancer in India.
- To understand the correlation between gallstone disease and the high incidence of gallbladder cancer in specific Indian regions.
Main Methods:
- Review of epidemiological data on gallbladder cancer incidence and prevalence.
- Analysis of the association between gallstone disease characteristics (size, duration) and gallbladder cancer risk.
- Comparison of disease patterns in Indian populations versus Western populations.
Main Results:
- Gallbladder cancer incidence in North and Central India is exceptionally high, particularly in women.
- A strong correlation exists between gallbladder cancer prevalence and gallstone disease.
- Gallstone disease in North India occurs at a younger age and presents later for treatment, leading to prolonged gallbladder exposure to stones.
Conclusions:
- Gallbladder cancer, despite its rarity elsewhere, is a significant health concern in North India, often termed an "Indian disease".
- Gallstone disease, characterized by early onset and delayed treatment, is a primary contributing factor to the high incidence of gallbladder cancer in this region.
- Further research into other potential etiological factors beyond gallstones is warranted to fully understand and combat gallbladder cancer in India.