Gall bladder carcinoma (GBC): Rising incidences in the Malwa belt region of northern India a hospital based cancer registry

 

Sapna Marcus^1*, Jasmeet Kaur², H P Yadav³

 

Department of Radiation Oncology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, INDIA.

Email: sapnamarcus@gmail.com  

 

Abstract              A prospective study conducted in the department of Radiation Oncology at Guru Gobind Singh Medical College and Hospital, Faridkot, including all the gall bladder cancers (GBC) presenting over a 48 months period and analysing how the epidemiological factors were influencing the disease. This data was collected from all over the Malwa region which comprises mainly of three regions, Malwa, Majha and Doaba. The total number of GBC cases registered in this area were 244 over this period. The rural versus urban distribution was 68.6% to 31.5%. Incidence reported were about Four cases per 100,000 populations per year. The peak incidence was observed in the 51 to 60 years age group (32.3%) patients. Female to male ratio was 3.36, as opposed to the male preponderance in other regions. The most common clinical presentation were pain abdomen and loss of appetite. Amongst the various risk factors, fatty diet along with spices in 175-180 (80-83%) patients and gall stones in 154 (71%) patients were found as the most common culprits. Out of all the cases, 29 (11.88%) patients were overweight with BMI between 25 and 29.9 (p = 0.003), as against the majority who presented as undernourished which correlated with advanced stages. Adenocarcinoma was the most common histopathology seen in 181(75.5%) patients. Subtle onset of symptoms explains the advanced stage at initial presentation. Almost 49.1% patients presented with T3 and 38.7% with T4 stage at the time of initial presentation. This data highlights high prevalence of gall bladder carcinoma in North-western belt of India. Better hygiene and water supply, prevention of malnutrition, early intervention for cholelithiasis, importance of balanced diet, increase in awareness about risk of tobacco and alcohol consumption ­all are highlighted as significant modifiable factors.

Key Words: Gallbladder carcinoma, Epidemiology, Cholelithiasis.