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India carries about a tenth of the world's gallbladder cancer, concentrated in the north and east, striking younger people than in the West, with gallstones present in four out of five patients and a list of environmental co-factors under suspicion.
Review from Chandigarh and Lucknow. India contributes about 10 percent of the global gallbladder cancer burden; incidence is high in north, north-east, central and east India and low in the south and west, and is rising in both sexes. Patients typically present in the fifth and sixth decades with advanced disease. Gallstones are present in 80 percent of Indian patients, yet incidence is out of proportion to gallstone prevalence, so co-factors are proposed: age, low socioeconomic status, chronic Salmonella Typhi and Helicobacter pylori infection, pollutants, heavy metals, chemicals, adulterated mustard oil and smoking, plus soil and water contamination. The authors call for large multicentre studies of attributable risk and, meanwhile, vigilance for incidental cancer and better access to gallstone care.
The Indian epidemiology matters to the NHS: people of South Asian heritage make up a large part of several English cities, and Asian ethnicity is a named risk factor in the European polyp guideline.
Shares Risk-targeted ultrasound screening in high-incidence regions, tested against usual care, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Risk-targeted ultrasound screening in high-incidence regions, tested against usual care, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Most of the world has almost no cancer care, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Most of the world has almost no cancer care, Gallbladder cancer and the tag gallbladder-evidence.
Shares Risk-targeted ultrasound screening in high-incidence regions, tested against usual care, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.