Gallstones and gallbladder cancer

Gallstones represent an important association for this malignancy, being present in most (up to approximately 85%) patients with gallbladder cancer

• incidence of gallbladder cancer in a population with gallstones varies from 0.3% to 3% (1)
  
  
• higher risk of gallbladder cancer development in larger stones possibly reflects the greater duration and intensity of mucosal irritation causing chronic inflamation (2,3)
  • increasing stone size elevates the risk of developing gallbladder cancer. Gallstones larger than 3 cm are associated with a greater than tenfold increased risk of cancer compared with that of small gallstones (4)
  • composition and mutagenicity of gallstones have previously been studied with inconclusive results (5)
    
    
• a family history of gallbladder cancer, and prolonged cholelithiasis are potential risk factors for gallbladder cancer (5)
  
  
• gallbladder cancer rates are correlated with the prevalence of gallstone disease
  
  
• some suggest that prophylactic cholecystectomy would appear reasonable in individuals with larger asymptomatic gallstones (6)
  • but prospective study of 123 consecutive patients with asymptomatic gallstones who were followed-up for 10 years or longer revealed no cases of gallbladder cancer (5)

Reference:

• Singh V, Trikha B, Nain C, et al. Epidemiology of gallstone disease in Chandigarh: a community-based study. J Gastroenterol Hepatol 2001;16:560-3
• Csendes A, Becerra M, Rojas J, et al. Number and size of stones in patients with asymptomatic and symptomatic gallstones and gallbladder carcinoma: a prospective study of 592 cases. J Gastrointest Surg 2000;4:481-5
• Mlinari c -Vrbica S, Vrbica Z. Correlation between cholelithiasis and gallbladder carcinoma in surgical and autopsy specimens. Coll Antropol 2009;33:533-7
• Zatonski WA , Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, Jain M, Przewozniak K, Baghurst P, Moerman CJ, Simard A, Howe GR, McMichael AJ, Hsieh CC, Walker AM. Epidemiologic aspects of gallbladder cancer: a case- control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst 1997; 89 : 1132-1138
• Kai K et al. Gallbladder cancer: Clinical and pathological approach. World J Clin Cases. 2014 Oct 16;2(10):515-21.
• Le MD, Henson D, Young H, et al. Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol 2011;10:306-14.