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Year : 2019  |  Volume : 56  |  Issue : 2  |  Page : 182-

Gall bladder cancer in Delhi - some thoughts

Manigreeva Krishnatreya 
 Department of Cancer Registry and Epidemiology, Dr. B Borooah Cancer Institute, Guwahati, Assam; Cancer Research Foundation, India

Correspondence Address:
Manigreeva Krishnatreya
Department of Cancer Registry and Epidemiology, Dr. B Borooah Cancer Institute, Guwahati, Assam; Cancer Research Foundation

How to cite this article:
Krishnatreya M. Gall bladder cancer in Delhi - some thoughts.Indian J Cancer 2019;56:182-182

How to cite this URL:
Krishnatreya M. Gall bladder cancer in Delhi - some thoughts. Indian J Cancer [serial online] 2019 [cited 2020 Apr 9 ];56:182-182
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I read with interest the article by Malhotra et al. on the epidemiology of gall bladder cancer (GBC) in urban Delhi over a 25-year period.[1] The authors must be commended for this excellent analysis.

The study has demonstrated a plateau in the incidences followed by a rise in GBC cases from 2005 onwards in both males and females, with an estimated average annual percentage change of 6.0% (95% confidence interval: 3.6–8.5). This assumes significance in the light of growing evidence that has implicated the role of heavy metals in the causation of GBC.[2],[3] Efforts should be made to look into the industrial policy or trends in the environmental pollution of the National Capital Region (NCR) of Delhi that took place in the 1990s, as it could have impacted the rising incidence of GBC. A white paper on water pollution of Delhi has shown the pollution load being discharged into River Yamuna, which is the main source of water for the NCR; there was a consistent rising biochemical oxygen demand from 1988 to 1996.[4] Biochemical oxygen demand is a marker for water pollution and is the amount of dissolved oxygen required by aerobic biological organisms to break down organic material present in a given water sample at a certain temperature over a specific period of time. Similarly, the growth of small-scale industries in Delhi has more than doubled from 42,000 in 1981 to 85,050 in 1991.[5] Reviewing environmental pollution and risk of cancer is assuming greater significance nowadays. Furthermore, recent research has shown an alarming contamination of groundwater and soil by heavy metals due to unauthorized e-waste recycling site in Delhi.[6]

From the data of the present study, it would also have been of scientific interest to project the current and future burden of GBC cases assuming that the same trends continue.

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1Malhotra RK, Manoharan N, Shukla NK, Rath GK. Gallbladder cancer incidence in Delhi urban: A 25-year trend analysis. Indian J Cancer 2017;54:673-7.
2Chhabra D, Oda K, Jagannath P, Utsunomiya H, Takekoshi S, Nimura Y, et al. Chronic heavy metal exposure and gallbladder cancer risk in India, a comparative study with Japan. Asian Pac J Cancer Prev 2012;13:187-90.
3Ai Z, Lu W, Qin X. Arsenic trioxide induces gallbladder carcinoma cell apoptosis via downregulation of bcl-2. Biochem Biophys Res Commun 2006;348:1075-81.
4White Paper on Pollution in Delhi with an Action Plan. Ch. 4. Ministry of Environment and Forests, Government of India. Available from: [Last accessed 2018 Aug 6].
5Economic Survey of Delhi 1999–2000. Industrial Development. Available from: [Last accessed 2018 Aug 6].
6Panwar RM, Ahmed S. Assessment of contamination of soil and groundwater due to e-waste handling. Curr Sci 2018;114:166-73.