# A Study on Gallbladder Carcinoma With Special Reference to Risk Factors

## TL;DR

This study examines gallbladder cancer risk factors in Assam, India, highlighting lifestyle and metabolic factors linked to the disease.

## Contribution

The study identifies modifiable risk factors for gallbladder carcinoma in a high-incidence region of India.

## Key findings

- Most patients were middle-aged or elderly, with a majority from rural areas.
- Common risk factors included hypertension, diabetes, alcohol use, and non-vegetarian diet.
- Despite small sample size, clustering of modifiable risk factors was observed.

## Abstract

Introduction: Gallbladder cancer (GBC) has been identified as one of the most fatal forms of gastrointestinal cancers worldwide by exhibiting a high incidence in North-Eastern India. This cancer mostly presents at an advanced stage, and various lifestyle, metabolic, and environmental elements have been linked to the onset. The objectives of the study were to evaluate the risk factors for gallbladder carcinoma and to establish the incidence pattern among patients visiting a tertiary cancer centre in the state of Assam.

Methods: A hospital-based prospective study was conducted for six months, starting from May to October 2024, at the State Cancer Institute, Guwahati. Patients diagnosed with carcinoma of the gallbladder and attending the Surgical Oncology Outpatient Department were included in the study after obtaining informed consent on the day of data collection. Data were collected using a pre-tested structured proforma. Data analysis and visualisations for this study were assisted using Julius AI (Rahul Sonwalkar, San Francisco, CA, USA). Results are presented using descriptive and inferential statistics, including chi-square tests.

Results: The study included 25 patients, with a mean age of 56.0 ± 14.7 years. Most participants were classified as middle-aged or elderly. Males constituted 16 (64%) of the cases, and 15 (60%) patients resided in rural areas. The mean BMI was 25.3 kg/m². Hypertension was present in 13 (52%) patients and diabetes mellitus in 10 (40%). Alcohol consumption was reported by 15 (60%), while 6 (24%) were current smokers. A non-vegetarian diet was followed by 16 (64%) of the participants, and 8 (32%) reported a family history of cancer. No statistically significant associations were observed between smoking and alcohol use (p = 0.255), hypertension and diabetes (p = 1.000), or BMI and hypertension (p = 0.825). However, there was clear clustering of modifiable risk factors among patients. The continued caseload at the centre reflected the persistent high regional burden of GBC.

Conclusions: Gallbladder carcinoma is recognised to remain a serious health problem in the state of Assam, mostly prevalent amongst the elderly population and in rural areas. The high incidence of exposures to metabolic and lifestyle factors strongly underscores the multifactorial theory of gallbladder carcinogenesis. Even though the statistical association had limitations due to sample size, the results strongly underscore the importance of targeted prevention and larger studies in high-incidence areas.