Gallbladder cancer risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

## Overview

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The most potent risk factor in the development of gallbladder carcinoma is gallstones. Other risk factors include Porcelain gallbladder, gallbladder polyps, Primary sclerosing cholangitis, chronic infection, pancreaticobiliary maljunction (PBM) and biliary cysts.

## Risk factors

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### Common Risk Factors

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* Common risk factors in the development of gallbladder cancer include:
* Gallstones: Gallstones are found in 70 to 90 percent of patients with gallbladder cancer(GBC), With an 8.3x higher danger than the overall population.[1][2]
* Porcelain gallbladder:In 95 % of the cases, the porcelain gallbladder is associated with gallstones.The incidence of GBC in patients with a porcelain gallbladder levels about 2 to 3 percent..[3]
* Gallbladder polyps: Around 5% of all adults have gallbladder polyps.[4]

Benign polyps | Malignant polyps

|

Cholesterol polyps (60%)  | Adenocarcinoma (80%)
Adenomyomas (25%)
Inflammatory polyps (10%)
Adenomas (4%)  | Miscellaneous (20%)

Mucinous cystadenomas, Squamous cell carcinoma, and adenoacanthomas

Miscellaneous (1%)

Leiomyomas, Fibromas, and Lipomas

* Primary sclerosing cholangitis (PSC): PSC is a chronic inflammatory disease and is associated with increased risk of gallbladder cancer(GBC).[5]

* Cigarette smoking: cigarette smoking is one the important risk factor in causing gallbladder cancer.
* Chronic infection:
* Helicobacter: Exact mechanism is poorly understood but it is thought that gallbladder cancer may be related to the bacterial-induced degradation of bile acids.
* Liver flukes: Liver flukes especially Clonorchis sinensis and Opisthorchis viverrini are related in the gallbladder cancer.[6]
* Salmonella: Several reports and a meta-analysis of case-control and cohort studies advocate an association among chronic S. typhi carriage and increased hazard of GBC

### Less common risk factors

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Less common risk factors in the development of gallbladder carcinoma include:

* Pancreaticobiliary maljunction (PBM): PBM is due to failure of migration of embryological ducts into the duodenum.Gallbladder carcinoma is the most common malignancy seen in patients with a pancreaticobiliary maljunction problem.

* Congenital biliary cysts: Biliary cysts are cystic dilatations in the bile ducts.They were originally coined as choledochal cysts .Biliary cysts are more frequently seen in Asian populations. An abnormal pancreaticobiliary duct junction is present in approximately 70 percent of patients with biliary cysts.Particularly cholangiocarcinoma is associated with increased risk with biliary cysts.[7][8][9]

## References

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1. ↑ Muszynska C, Lundgren L, Lindell G, Andersson R, Nilsson J, Sandström P, Andersson B (2017). "Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry". Surgery. 162 (2): 256–263. doi:10.1016/j.surg.2017.02.009. PMID 28400123.
2. ↑ Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, Shen MC, Zhang BH, Niwa S, Chen J, Fraumeni JF (2007). "Gallstones and the risk of biliary tract cancer: a population-based study in China". Br. J. Cancer. 97 (11): 1577–82. doi:10.1038/sj.bjc.6604047. PMC 2360257. PMID 18000509.
3. ↑ Khan ZS, Livingston EH, Huerta S (2011). "Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature". Arch Surg. 146 (10): 1143–7. doi:10.1001/archsurg.2011.257. PMID 22006872.
4. ↑ Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.
5. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
6. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
7. ↑ Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.
8. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
9. ↑ Kaushik SP (2001). "Current perspectives in gallbladder carcinoma". J. Gastroenterol. Hepatol. 16 (8): 848–54. PMID 11555095.

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