Worldwide, gallbladder cancer is relatively uncommon. In Delhi, however, it’s on the rise.
There are eleven cases of gallbladder cancer for every one lakh Delhiites, researchers from the All India Institute of Medical Sciences (AIIMS) estimate. This incidence may seem low. However, when one considers that the National Capital Region (NCR) is home to 24 million people, this represents a significant public health concern.
Gallbladder cancer now ranks as the third most common cancer among Delhi’s women and the ninth most common cancer among the capital’s men. By comparison, it was the fifth most common cancer among women and the 24th most common cancer among women in the NCR twenty years ago.
Delhi now accounts for the second highest number of gallbladder cases in the country. The Kamrup district of Assam – long known to be one of the world’s gallbladder cancer hotspots – has the highest figure, with seventeen cases for every 100,000 people.
The spike in cases in the NCR provides cause for concern. Gallbladder cancer tends not to present symptoms in its early stages and often goes undetected until it has progressed to an advanced and often noncurative stage. Symptoms of gallbladder cancer when they do occur may include abdominal pain, indigestion, weight loss, jaundice and vomiting.
Detecting gallbladder cancer is difficult. There are no blood tests which can reliably be used to screen for the disease. Owing to the small size of tumours in the disease’s early stages – and the fact that they are often embedded deep in the body – the disease cannot be detected using routine physical examination. This can allow the disease to grow undetected,contributing to a five-year survival rate as low as five percent.
Risk factors for the disease include a history of gallstones. This provides one explanation for the rising incidence of gallbladder cancer among Delhi’s women. Gallstones affect 21.5 women for every 100,000 in the NCR, according to a 2012 study. Obesity, old age and tobacco use are also risk factors.
The deadly nature of gallbladder cancer notwithstanding, doctors have expressed confidence that survival rates for those suffering the disease can improve with changes in treatment. Chemotherapy followed by surgery has shown promising results in the past as an effective treatment for gallbladder cancer.
Gallbladder cancer is emerging as a clear public health threat – one that is both deadly and difficult to treat. The absence of effective screening methods highlight the need for preventative measures to be taken, such as curbing rates of tobacco use and obesity rates, and routine checkups for patients with a history of gallstones. Unless a thorough response is taken, the gallbladder cancer crisis could get much worse in future.
This article was originally published in Health Issues India. It is reprinted here with permission.