Gallbladder cancer: review of a rare orphan gastrointestinal cancer with a focus on populations of New Mexico

Abstract

Gallbladder cancer is a rare malignancy of the biliary tract with a poor prognosis, frequently presenting at an advanced stage. While rare in the United States overall, gallbladder cancer has an elevated incidence in geographically distinct locations of the globe including Chile, North India, Korea, Japan and the state of New Mexico in the United States. People with Native American ancestry have a much elevated incidence of gallbladder cancer compared to Hispanic and non-Hispanic white populations of New Mexico. Gallbladder cancer is also one of the few bi-gendered cancers with an elevated female incidence compared to men. Similar to other gastrointestinal cancers, gallbladder cancer etiology is likely multi-factorial involving a combination of genomic, immunological, and environmental factors. Understanding the interplay of these unique epidemiological factors is crucial in improving the prevention, early detection, and treatment of this lethal disease. Previous studies have failed to identify a distinct genomic mutational profile in gallbladder cancers, however, work to identify promising clinically actionable targets is this form of cancer is ongoing. Examples include, interest in the HER2/Neu signaling pathway and the recognition that chronic inflammation plays a crucial role in gallbladder cancer pathogenesis. In this review, we provide a comprehensive overview of gallbladder cancer epidemiology, risk factors, pathogenesis, and treatment with a specific focus on the rural and Native American populations of New Mexico. We conclude this review by discussing future research directions with the goal of improving clinical outcomes for patients of this lethal malignancy.

A Metallomic Approach to Assess Associations of Serum Metal Levels With Gallstones and Gallbladder Cancer

“…Environmental exposures are likely important . Metals represent one environmental exposure of increasing interest . Previous studies have typically evaluated one metal or a handful of metals.…”

“…(8)(9)(10) Metals represent one environmental exposure of increasing interest. (11) Previous studies have typically evaluated one metal or a handful of metals. Metallomics, or the study of many metals simultaneously, is an emerging field, allowing a more comprehensive analysis of metals within a biological system.…”

Screening high risk populations for cancer: Hepatobiliary

“…Incidence is higher in women over men (ratio of 2.6:1) . Incidence is also elevated in Native Americans, southeast Asians, Mapuche Indians, residents of northern India, residents of south Karachi Pakistan, Poland, Israel, Japan, and Shanghai . The highest incidence being females from northern India at 21.5 of 100 000 .…”

“…The worldwide incidence of gallbladder cancer is <2 of 100 000 individuals . Incidence is higher in women over men (ratio of 2.6:1) . Incidence is also elevated in Native Americans, southeast Asians, Mapuche Indians, residents of northern India, residents of south Karachi Pakistan, Poland, Israel, Japan, and Shanghai .…”

Real-Life Evidence From Gallbladder Cancer: A Single Center Experience

“…Gallbladder cancer (GBC) is a rare and fatal tumor (1).The incidence of GBC in Turkey is 1.7 / 100,000 and it is quite similar to USA (2). It ranks sixth among all gastrointestinal system cancers, but it is the most frequent tumour of all the biliary tract (3,4).…”