see also:

• neoplasia / cancer / tumours
• pancreatic cancer

• gallbladder cancers are rare and often diagnosed late with poor prognoses
• bile duct cancers (cholangiocarcinomas) are often small, difficult to reach and surrounded by inflammation or scar tissue, standard biopsy and cytology methods often fail to give clear diagnosis hence new biomarkers such as BiliSeq have been developed to improve diagnosis sensitivity from below 50% to over 80%

• in Victoria in 2023, gallbladder cancer was diagnosed at a rate of 3.8 per 100,000 males and 3.1 per 100,000 females with median age at diagnosis of gallbladder cancer is 72 years in males and 74 in females, accounting for 0.7% of all cancers diagnosed and 1.8% of all cancer-related deaths - only 3 of these were Dx at age under 40yrs ¹⁾

• said to be female HOWEVER, in 2023, 294 Victorians were diagnosed with gallbladder cancer, of these, there were 152 males and 142 females
• age > 65 (average age at Dx is 72 yrs)
• cholelithiasis (gallstones)
• gallbladder polyps
• chronic cholecystitis
• chronic Salmonella typhi (typhoid enteric fever) infection
• porcelain gallbladder
• primary sclerosing cholangitis / primary biliary cirrhosis
• choledochal cysts
• obesity
• possibly smoking and industrial chemical exposures
• there is no strong evidence that pregnancy independently makes gallbladder cancer biologically more aggressive in a predictable way, or that it consistently speeds tumor growth, but pregenancy does increase the risk of gallstones and generally will delay surgical management of these until post-partum and this could delay Dx.

• age > 50yrs
• smoking
• primary sclerosing cholangitis / primary biliary cirrhosis
• chronic biliary inflammation / bile‑duct stasis - cholelithiasis (gallstones), chronic cholecystitis
• chronic bacterial cholangitis
• Fasciola (liver flukes) infection: Opisthorchis viverrini and Clonorchis sinensis infestations in Southeast Asia
• congenital biliary cysts - choledochal cysts, Caroli disease, and polycystic liver disease cause structurally abnormal, dilated ducts prone to stone formation and chronic inflammation
• chronic hepatitis C virus/hepatitis B virus, cirrhosis
• steatohepatitis (fatty liver) / obesity
• alcoholic cirrhosis
• familial syndromes (e.g., Lynch syndrome, cystic fibrosis), inflammatory bowel disease (IBD)
• HIV / AIDS
• industrial solvents like dichloromethane

• diagnosis is often late (only 20% are diagnosed early) as it mimics gallbladder disease and may only be diagnosed after cholecystectomy for biliary diease
• raised CEA and CA 19-9 levels may suggest this diagnosis but is not specific
• ultrasound + CT or MRI may detect a mass
• MRCP
• laparoscopy

• 5-year survival rate for localized gallbladder cancer which can be resected surgically is 66%
• 5-year survival rate for metastatic disease is 2%