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:

1. 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
2. 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
3. Mlinari c -Vrbica S, Vrbica Z. Correlation between cholelithiasis and gallbladder carcinoma in surgical and autopsy specimens. Coll Antropol 2009;33:533-7
4. Zatonski WA et al. 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
5. Kai K et al. Gallbladder cancer: Clinical and pathological approach. World J Clin Cases. 2014 Oct 16;2(10):515-21.
6. Le MD, Henson D, Young H, et al. Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol 2011;10:306-14.