Introduction: Gall Bladder Cancer is third most common cancer of gastro-intestinal tract disease with variation of its prevalence geographically. According to ICMR’s report about 800,000 new cases and 5,50,000 death per year reported in India. Commonest etiological factors are gall stone and chronic inflammation. Chronic cholecystitis, due to bacterial Colonization causes Carcinogenesis. Gall stone disease and gall bladder cancer reported high incidence in Gangetic belt in India. Gall bladder cancer is one of the malignancies with high mortality with < 1-year overall survival. Commonest presentation is asymptomatic presentation leads to progression of diseases in advanced stage. In India, Gall bladder cancer is more common in females and usually presented at younger age. Majority of the patients presented with Jaundice. About 10% patients presented in early stage of disease in which Radical Cholecystectomy with advanced treatment is advisable as standard treatment and can achieve about 63% of 5-year survival rate.

Material and Method: Retrospective study was conducted in the department of Radiation oncology, State Cancer Institute, IGIMS Patna. Diagnosed and histopathologically proven Gall Bladder cancers were included and details of patient data were retrieved from hospital records.

Result: In total 500 patients, common age of patients were 45 to 55 years in males and 40 to 50 years in female, 323 (64.6%) were females and 177 (35.4%) males. Commonest symptom was pain in abdomen 415 (83%), nausea and vomiting (38%), Jaundice 240 (48%).

Discussion: According to Globocon 2018, gall bladder cancer is 22nd Cancer worldwide with 219,420 new cases which is 1.2% of malignancies and about 165,087 deaths contributing 17% of cancer related death. Incidence of gall bladder cancer varies according to geographic region. High rate of incidence reported in Central and South America, Eastern Europe and South-east Asia. India has second highest number of incidences of gall bladder cancer after China.

Conclusion: Based on all available data in HBCR registry, Ca gall bladder cancer is the commonest cancer and showing increasing trend of Ca gall bladder cancer. Due to lack of awareness, poor hygiene, habit of spicy food intake, lack of exercise and fruit intake, use of unfiltered drinking water, unavailability of diagnostic facilities at rural area. Patients usually present with advance stage of disease which resulted high morality. Majority of patients subjected to Palliative treatment in the form of chemotherapy

Keywords: Gall Bladder Cancer; Vomiting; Jaundice

References

1. Pandey M., et al. “Carcinoma of the gallbladder: a retrospective review of 99 cases”. Digestive Diseases and Sciences 46 (2001): 1145-1151.
2. Shukla VK., et al. “Primary carcinoma of the gall bladder: a review of a 16-year period at the University Hospital”. Journal of Surgical Oncology 28 (1985): 32-35.
3. Diehl AK. “Epidemiology of gallbladder cancer: a synthesis of recent data”. Journal of the National Cancer Institute 65 (1980): 1209-121.
4. Waterhouse J., et al. “Cancer Incidence in the Continents”. Lyon: IARC Scientific Publications (1976).
5. Indian Council of Medical Research (ICMR). Annual Report of Population Based Cancer Registries of the National Cancer Registry Programme (1993), Vol. 18. New Delhi: ICMR Publication (1996).
6. Lazcano-Ponce EC., et al. “Epidemiology and molecular pathology of gallbladder cancer”. CA: Cancer Journal of Clinics6 (2001): 349-364.
7. Kapoor VK and McMichael AJ. “Gall bladder cancer: an ‘Indian’ disease”. The National Medical Journal of India 16 (2003): 209-213.
8. Sharma A., et al. “Gallbladder cancer epidemiology, pathogenesis and molecular genetics: Recent update”. World Journal of Gastroenterology 23 (2017): 3978-3998.
9. Batra Y., et al. “Gallbladder cancer in India: A dismal picture”. Journal of Gastroenterology and Hepatology 20 (2005): 309-314.
10. Kiran RP., et al. “Incidence pattern and survival for gallbladder cancer over three decades-An analysis of 10301 patients”. Annals of Surgical Oncology 14 (2007): 827-832.
11. Levy AD., et al. “Gallbladder carcinoma: radiologic-pathologic correlation”. Radiographics 2 (2001): 295-314.
12. Boutros C., et al. “Gallbladder cancer: past, present and an uncertain future”. Surgical Oncology 21 (2012): e183-91.
13. Randi G., et al. “Gallbladder cancer (13) worldwide: geographical distribution and risk factors”. International Journal of Cancer 118 (2006): 1591-1602.
14. Mhatre S., et al. “Common genetic variation and risk of gallbladder cancer in India: a case-control genome-wide association study”. Lancet Oncology 18 (2017): 535-544.
15. Hundal R and Shaffer EA. “Gallbladder cancer: epidemiology and outcome”. Clinical Epiderniology 6 (2014): 99-109.
16. Mehrotra R., et al. “Genetic landscape of gallbladder cancer: global overview”. Reviews in Mutation Research 778 (2018): 61-71.
17. Indian Council of Medical Research. National cancer registry programme: population-based cancer registries (2018).
18. Jain K., et al. “Risk factors for gallbladder cancer: a case-control study”. International Journal of Cancer 132 (2013): 1660-1666.
19. Pandey M and Shukla VK. “Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer”. European Journal of Cancer Prevention 12 (2003): 269-272.
20. Unisa S., et al. “Population-based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic Basin of North India”. HPB 13 (2011): 117-125.
21. Dwivedi AND., et al. “ Gall bladder carcinoma: aggressive malignancy with protean loco-regional and distant spread”. World Journal of Clinical Cases 3 (2015): 231-244.
22. Henson DE., et al. “Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates”. Cancer 6 (1992): 1493‐1497.
23. Fong Y., et al. “Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention”. Annals of Surgery4 (2000): 557‐569.
24. D'Hondt M., et al. “Carcinoma of the gallbladder: patterns of presentation, prognostic factors and survival rate. An 11-year single centre experience”. European Journal of Surgical Oncology 6 (2013): 548-553.
25. Buettner S., et al. “Changing odds of survival over time among patients undergoing surgical resection of gallbladder carcinoma”. Annals of Surgical Oncology13 (2016): 4401‐4409.
26. ICMR Three-Year Report of the PBCRs: 2012-2014. (2015).
27. Misra S., et al. “Carcinoma of the gall bladder”. The Lancet Oncology3 (2003): 167-176.
28. National Cancer registry programme. Consolidated report of population based cancer registries: 2012-14.
29. Phadke P., et al. “Trends in gall bladder cancer incidence in the high and low risk regions of India”. Indian Journal of Medical and Paediatric Oncology 40 (2019): 90.
30. Gupta A., et al. “Demographic and clinicopathological Profile of Gall Bladder Cancer Patients: Study from a tertiary care center of the Sub-Himalayan region in Indo-Gangetic Belt”. Journal of Carcinogen 20 (2021): 6.
31. Shukla VK., et al. “Biliary heavy metal concentrations in carcinoma of the gall bladder: case-control study”. BMJ 317 (1998): 1288-1289.
32. Pandey M. “Risk Factors for Gall Bladder Cancer: a reappraisal”. European Journal of Cancer Prevention 12 (2003): 15-24.
33. Nath G., et al. “Association of carcinoma of the gall bladder with typhoid carriage in a typhoid endemic area using nested PCR”. The Journal of Infection in Developing Countries 2 (2008): 302-307.
34. Pandey M and Shukla VK. “Diet and Gall Bladder cancer: A case-control Study”. European Journal of Cancer Prevention 11 (2002): 365-368.
35. Gupta SK and Shukla VK. “Gall bladder cancer etiopathology and treatment”. Health Administrator CVII (2005): 134-142.
36. Pandey M., et al. “Bile, Bactaria, and gall bladder carcinogenesis”. Journal of Surgical Oncology 58 (1995): 282-283.
37. Rehana Z., et al. “Genotoxicity of the Ganges water at Narora (UP) India”. Mutation Research 367 (1996): 187-193.
38. Gupta SK., et al. “Copper, Zinc, and Cu/Zn ration in carcinoma of the gall bladder”. Journal of Surgical Oncology 91 (2005): 204-208.
39. Shukla Y and Arora A. “Enhancing effects of mustard oil on preneoplastic hepatic foci development in Wistar rats”. Human and Experimental Toxicology 22 (2003): 51-55.
40. Shukla VK., et al. “Diagnostic Value of serum CA 242, CA 19-9, CA 15-3 and CA 125 in patients with carcinoma of the gall bladder”. Tropical Gastroenterology 27 (2006): 160-165.
41. Dutta U., et al. “Epidemiology of gallbladder cancer in India”. Chinese Clinical Oncology4 (2019): 33.
42. Kumar S. “Infection as a risk factor of gall bladder cancer”. Journal of Surgical Oncology 93 (2006): 633-639.
43. Routh D. “Gall Bladder Carcinoma: A reason to wrooy in North and North-eastern India”. Clinical Surgery 2 (2017): 1661.
44. Hundal R and Shaffer EA. “Gall bladder cancer: epidemiology and outcome”. Clinical Epidemology (2014): 99-109.
45. Alvi AR., et al. “Risk factors of gall bladder cancer in Karachi- a case-control Study”. World Journal of Surgical Oncology 9 (2011): 164.
46. Khan MR., et al. “Gall bladder intestinal metaplasia in Pakistani patients with gall stones”. International Journal of Surgery 9 (2011): 482-485.
47. Kowalewski K and Todd EF. “Carcinoma of the Gallbladder Induced in Hamsters by Insertion of Cholesterol Pellets and Feeding Dimethylnitrosamine”. Proceedings of the Society for Experimental Biology and Medicine 136 (1971): 482-486.
48. Jain K., et al. “Risk factors for gallbladder cancer: a case-control study”. International Journal of Cancer 132 (2013): 1660-1666.
49. Bhagabaty S., et al. “A Profiles of gall bladder cancer reported in the hospital cancer registry of a Regional Cancer Center in the North-East India”. International Journal of Research in Medical Sciences 2 (2014): 1683.
50. Baskaran V., et al. “Do the Progesterone Receptors Have a Role to Play in Gall Bladder Cancer?” International Journal of Gastrointestinal Cancer 35 (2005): 61-68.
51. Randi G., et al. “Gallbladder cancer worldwide: geographical distribution and risk factors”. International Journal of Cancer 118 (2006): 1591-1602.
52. Shrikhande SV., et al. “Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause!” European Journal of Surgical Oncology 36 (2010): 514-519.
53. Jain K., et al. “Sequential occurrence of preneoplastic lesions and accumulation of loss of heterozygosity in patients with gallbladder stones suggest causal association with gallbladder cancer”. Annals of Surgery 260 (2014): 1073-1080.
54. Koshiol J., et al. “Association of aflatoxin and gallbladder cancer”. Gastroenterology 153 (2017): 488-494.
55. Chow WH., et al. “Gallstones, cholecystectomy and risk of cancers of the liver, biliary tract and pancreas”. British Journal of Cancer 79 (1996): 640-644.
56. Ishiguro S., et al. “Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification”. Cancer Causes Control 19 (2008): 33-41.
57. Khan ZR., et al. “Risk factors for biliary tract cancers”. American Journal of Gastroenterology 94 (1996): 149-152.
58. Zatonski WA., et al. “Risk factors for gallbladder cancer: a Polish case-control study”. International Journal of Cancer 51 (1992): 707-711.
59. Diehl AK. “Gallstone size and the risk of gallbladder cancer”. JAMA 250 (1983): 2323-2326.
60. Shaffer EA. “Gallstone disease: epidemiology of gallbladder stone disease”. Best Practice and Research Clinical Gastroenterology 20 (2006): 981-996.
61. Lowenfels AB., et al. “Gallstone growth, size, and risk of gallbladder cancer: an interracial study”. International Journal of Epidemiology 18 (1989): 50-54.
62. Zatonski WA., et al. “Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer”. Journal of the National Cancer Institute 89 (1997): 1132-1138.
63. Ryu S., et al. “Gallstones and the risk of gallbladder cancer mortality: a cohort study”. American Journal of Gastroenterology 111 (2016): 1476-1487.
64. Khan ZS., et al. “Reassessing the need for prophylactic surgery in patients with porcelain gall bladder: case series and symmetric review of the literature”. Archives of Surgery 146 (2011): 1143-1147.
65. Gonzalez-Escobedo G., et al. “Chronic and acute infection of the gall bladder by Salmonella Typhi: under- standing the carrier state”. Nature Reviews Microbiology 9 (2011): 9-14.
66. Matsukura N., et al. “Association between Helicobacter bilis in bile and biliary tract malignancies: H. bilis in bile from Japanese and Thai patients with benign and malignant diseases in the biliary tract”. Japanese Journal of Cancer Research 93 (2002): 842-847.
67. Fox JG., et al. “Hepatic Helicobacter species identified in bile and gallbladder tissue from Chileans with chronic cholecystitis”. Gastroenterology 114 (1998): 755-763.
68. Murata H., et al. “Helicobacter bilis infection in biliary tract cancer”. Alimentary Pharmacology and Therapeutics 1 (2020): 90-94.
69. Strom BL., et al. “Risk factors for gallbladder cancer. An international collaborative case-control study”. Cancer 76 (1995): 1747-1756.
70. Caygill CP., et al. “Cancer mortality in chronic typhoid and paratyphoid carriers”. Lancet 343 (1994): 83- 84.
71. Stinton LM and Shaffer EA. “Epidemiology of gallbl adder disease: cholelithiasis and cancer”. Gut Liver 6 (2012): 172-187.
72. Calle EE., et al. “Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults”. The New England Journal of Medicine 348 (2003): 1625-1638.
73. Bandera E and Fay S. “The use and interpretation of anthropometric measures in cancer epidemiology: a perspective from the World Cancer Research Fund international continuous update project”. International Journal of Cancer 139 (2016): 2391-2397.
74. Calle EE., et al. “The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics”. Cancer 94 (2002): 2490-2501.
75. Li ZM., et al. “The association between BMI and gallbladder cancer risk: a meta-analysis”. Oncotarget 7 (2016): 43669-43679.
76. Abou-Alfa GK., et al. In: Abeloff's Clin- Acal Oncology - Liver and Bile Duct Cancer. Niederhuber JE, Armitage JO, Doroshow JH, et al. (eds.). 5th ed. Sanders, Philadelphia (2014): 1373-1396.
77. Dixit R and Shukla VK. In: Perspectives in Cancer Prevention-Translational Cancer Research - Why Is Gallbladder Cancer Common in the Gangetic Belt? Sudhakaran P. (2014): 145-151.
78. Bagnardi V., et al. “Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis”. British Journal of Cancer 112 (2015): 580-593.
79. Sharma A., et al. “Gall bladder cancer epidemiology, pathogenesis and molecular genetics: Recent update”. World Journal of Gastroenterology 23 (2017): 3978-3998.
80. Yagyu K., et al. “Cigarette smoking, alcohol drinking and the risk of gallbladder cancer death: a prospective cohort study in Japan”. International Journal of Cancer 122 (2008): 924-929.
81. Grainge MJ., et al. “The antecedents of biliary cancer: a primary care case-control study in the United Kingdom”. British Journal of Cancer 100 (2009): 178-180.
82. Kumar N., et al. “Clinical Spectrum of Carcinoma of the Gall bladder in the Indian States of Uttarakhand and Western Uttar Pradesh: A Retrospective Study from a Tertiary Care Hospital of Northern India”. Journal of Medical Evidence (2020).
83. Liu TY., et al. “Curcumin induces apoptosis in gall bladder carcinoma cell line GBC-SD cells”. Cancer Cell Int 13 (2013): 64.
84. Dubey AP., et al. “Carcinoma of gall bladder: Demographic and clinicopathological profile in Indian patients”. Oncology Journal of India 2 (2018): 3-6.
85. Clarke T., et al. “Gall bladder mass with carbohydrate antigen 19-9 level in the thousands: Malignant or benign pathology? Report of a case”. Surgery Today 27940 (2017): 342-344.
86. Srivastava K., et al. “Potential biomarkers in gall bladder cancer: present status and future directions”. Biomarkets 18 (2013): 1-9.
87. Stefanovic F., et al. “The evaluation of tumor markers levels in detemination of surgical procedure in patients with gall bladder carcinoma”. Medicinski Pregled 46 (1993): 58-59.
88. De Aretxabala X., et al. “Ca 19-9 and carcinoembryonic antigen in gall bladder cancer”. Revista Medica de Chile 124 (1996): 11-20.
89. Zhou G., et al. “Changes in the expression of serum markers CA 242, CA199, CA125, CEA , TNF-α and TSGF after cryosurgery in pancreatic patients”. Biotechnology Letter 34 (2012): 1235-1241.
90. Wang Y-F., et al. “Combined detection tumor markets for diagnosis and prognosis of gall bladder cancer”. World Journal of Gastroenterology 20 (2014)4085-4092.
91. Doval DC., et al. “A phase II study of gemcitabine and cisplatin in chemotherapy naïve, unresectable gall bladder cancer”. British Journal of Cancer 90 (2004): 1516-1520.
92. Andrex T., et al. “Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: A GERCOR study”. Annals of Oncology 15 (2004): 1339-1343.
93. Singh PK., et al. “Best Supportive care compared with chemotherapy and radiotherapy for unresectable gall bladder cancer: A tertiary care institute experience”. Clinical Cancer Investigation Journal (2014).
94. Behera MK., et al. “Clinical Profile and Survival of Patients with Carcinoma Gall Bladder: A Retrospective Study of 1002 Patients from Eastern India”. TG 2 (2023): 53-60.

Citation

Citation: Seema Devi., et al. “Epidemiology and Profile of Carcinoma Gall Bladder Patients”.Acta Scientific Cancer Biology 9.1 (2025): 12-22.

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Copyright: © 2025 Seema Devi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.