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Year : 2020  |  Volume : 57  |  Issue : 3  |  Page : 356--357

Future burden of gallbladder cancer in Delhi

Rajeev K Malhotra, Nalliah Manoharan 
 Delhi Cancer Registry, Dr. Bhim Rao Ambedkar Institute of Rotary Cancer Hospital, AIIMS, Delhi, India

Correspondence Address:
Rajeev K Malhotra
Delhi Cancer Registry Dr. Bhim Rao Ambedkar Institute of Rotary Cancer Hospital, AIIMS, Delhi

How to cite this article:
Malhotra RK, Manoharan N. Future burden of gallbladder cancer in Delhi.Indian J Cancer 2020;57:356-357

How to cite this URL:
Malhotra RK, Manoharan N. Future burden of gallbladder cancer in Delhi. Indian J Cancer [serial online] 2020 [cited 2020 Oct 24 ];57:356-357
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We would like to thank Krishratreya M.[1] for showing the deep interest in our article titled “Gallbladder cancer (GBC) in urban Delhi: A 25-year trend analysis.”[2] The reasons for rise in GBC incidence in Delhi urban region are multifactorial and consumption of contaminated Yamuna water and edible crop cultivated in soil with heavy metals may be one of them. Concentration of heavy metals in the waters of River Yamuna and in the soil of agricultural fields along its course in Delhi are reported from 13 sites.[3] Apart from the industrial contribution toward the contamination of environment, citizens of Delhi also contribute substantially. People are less aware about disposal of domestic waste items that contain the heavy metals and other toxic substances such as compact fluorescent lamp (CFL), e-waste, etc. A simple example is disposal of CFL bulb without proper guidelines of Central Pollution Control Board. People throw the used CFL bulb which contains the mercury, either into the dustbin or in open space that finally goes into the municipal garbage dumpsites. As a result of this air, water, and soil get contaminated with mercury.[4],[5] Lack of awareness and nonavailability of authorized collection centers for these wastes are the major problem in India.

In Delhi region, river Yamuna covers only 1% of its total length but generates >50% of pollutants found in Yamuna.[2] Recently, National Green Tribunal of India banned the cultivation of the edible crops on land along the sides of Yamuna bank in Delhi because soil near this river banks are contaminated with heavy metals. Stringent measures and proper regulation are needed to monitor the pollution control and waste management in Delhi. Furthermore, people should be educated about the health hazards due to heavy metals and other toxic pollutants to save the precious environment.

It was a good suggestion to project the future burden of GBC in Delhi urban area. We projected the GBC cases in both sexes for the period 2018–2022 applying similar approach used in recent articles to project the tobacco-related cancer incidence in Delhi urban area and also used in projecting the breast cancer in Thailand.[6],[7] Table shows the projected estimates of GBC in Delhi urban area according to gender. The GBC incidence cases in males increase to 2,604 in 2018–2022, which is 1.73-fold from 2008–2012 incidence cases, whereas in females, incidence cases grow in 2018–2022 by 1.91-fold as compared with 2008–2012 [Table]. The ratio of male to female incidence cases in 2008–2012 is approximate 1:2, while in 2018–2022 ratio will increase to 1:2.3. The age-adjusted rate (AAR) in males will reach 5.51 cases per 100,000 person-year in 2018–2022 from 4.82 cases per 100,000 in 2008–2012. Similarly, in females, AAR will increase from 10.52 to 12.56 cases per 100,000 person-year during this period. The projection estimates are based on the certain assumptions and accuracy depends upon the fulfilment of these assumptions in future.{Table}

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Conflicts of interest

There are no conflicts of interest.


1Krishnatreya M. Gall Bladder cancer in Delhi-some thoughts. Indian J Cancer 2019;56:182
2Malhotra 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.
3Sehgal M, Garg A, Suresh H, Dagar P. Heavy metal contamination in Delhi segment of Yamuna basin. Environ Monit Assess 2012;84:1181-96.
4Central Pollution Control Board. Guidelines for environmentally sound mercury management in fluorescent lamp sector, November 2008. Available from: [Last accessed on 2018 Aug 21].
5Shaflel L, Taymoori P, Yazdanshenas K. Awareness and attitude assessment regarding toxic metal contaminated rice based on health belief model. J Adv Environ Health Res 2016;4:78-87.
6Malhotra RK, Manoharan N, Nair O, Deo SV, Rath GK. Trend and future burden of tobacco related cancer in Delhi urban areas: 1988-2012. Indian J Public Health 2019;63:33-8.
7Virani S, Chindaprairt J, Wirasorn K, Soolprasert A, Somintara O, Vachirodom D, et al. Breast cancer trends and projection in North-eastern Thailand. J Epidemiol 2018;28:323-30.