Simple Summary
Gallbladder cancer is a relatively rare cancer but is very often diagnosed at an advanced stage and has a poor prognosis. Its occurrence varies markedly across the world, with particularly high rates in parts of South America and Asia. This review examines the main factors associated with gallbladder cancer and considers how they may be used for prevention. Important opportunities include appropriate management of gallstones and other high-risk gallbladder conditions, prevention of excess body fat and physical inactivity, control of chronic Salmonella infection in endemic regions, and reduction of exposure to contaminants such as aflatoxins and heavy metals. However, the strength of the evidence and the feasibility of prevention differ substantially across risk factors. Prevention strategies should therefore be adapted to the baseline risk of different populations and to the expected benefits and harms of each intervention.
Abstract
Gallbladder cancer (GBC) is an uncommon but highly lethal malignancy, characterized by striking geographic clustering, late diagnosis, and a prevention profile that differs from other gastrointestinal malignancies. This narrative review synthesizes epidemiologic, mechanistic, clinical, and public-health evidence on GBC determinants with a prevention-oriented lens. Rather than merely cataloguing risk factors, we propose a pragmatic framework that combines epidemiologic credibility, population-attributable burden, baseline risk, biologic plausibility, feasibility, and the benefit-risk balance of possible interventions. The strongest opportunities for prevention arise from risk-stratified management of gallbladder disease and congenital biliary abnormalities, reduction of excess and dysfunctional adiposity, promotion of physical activity, control of chronic Salmonella carriage in endemic settings, and mitigation of selected food- and water-borne toxic exposures. Several other determinants, including diet, alcohol consumption, smoking, reproductive factors, and socioeconomic disadvantage, may inform risk stratification or broader cancer-prevention policy, but currently offer less specific actionability. Effective prevention will require matching interventions to context: population-wide metabolic and lifestyle prevention, targeted clinical management of high-risk gallbladder conditions, and endemic-area strategies addressing infection, environmental exposure, and access to surgery. GBC prevention is therefore possible through carefully evaluated risk-adapted strategies.
Keywords:
GBC; prevention; gallstones; obesity; physical activity; Salmonella Typhi; aflatoxin; risk stratification