Risk of Gallbladder Cancer in India’s Gangetic Plains- A Review

Abstract

Gallbladder Cancer (GBC) is a global health concern known for its poor prognosis, late diagnosis, and limited treatment options. It ranks as the 23rd most common cancer worldwide, with higher prevalence in certain regions, including Northern India, Pakistan, and Latin American countries. Gender disparity exists, with higher risk in women. Age, genetic mutations (in genes like PIK3CA, KRAS, CTNNB1 and TP53), family history, lifestyle choices (like diet, smoking, obesity), and environmental factors (like arsenic exposure, heavy metal contamination) and pre-existing conditions like gallbladder inflammation and Salmonella infection contribute to the risk of developing the disease. The Gangetic plain exhibits unusually high GBC rates, attributed to factors like gallstones, water pollution (from agricultural run-offs, sewage and industrial pollutants), poor sanitation, dietary habits (including consumption of contaminated mustard oil), and socio-economic disparities. Tobacco use and, possibly, oral contraceptive usage further elevate susceptibility in this region. Efforts to mitigate this high incidence of GBC in the Gangetic plains should focus on improving healthcare access, promoting healthy lifestyles, reducing pollution, supporting genetic screening, and raising awareness. Further research is needed to uncover additional risk factors and develop targeted interventions for this region which can help reduce the burden of GBC in the Gangetic plain.