Relation of Gallbladder Cancer, Gallbladder Stones and Breast Cancer with Polluted Rivers – A Case Control Study in the Indo-Gangetic Plains

BACKGROUND Gallbladder cancer and breast cancer are two common malignancies seen along the Ganges River and the Indo-Gangetic plains of northern India, especially in the states of Uttar Pradesh and Bihar. Some of the postulated aetiologies include cholelithiasis (gallstones), typhoid carrier state, dietary factors, genetic predisposition and chemical carcinogens. Studies have also linked gallbladder cancer and breast cancer to carcinogens in polluted rivers. We undertook this study to investigate as to whether these conditions and gallstones were more prevalent in populations living close to polluted rivers. We also wanted to investigate as to whether there is any association between gallbladder cancer, gallstones and breast cancer with river pollution. METHODS This was a case-control study carried out in the Department of Oncology of a tertiary level defence hospital between 2018 and 2020. Patients who were diagnosed as having gallbladder cancer, gallstones or breast cancer in this tertiary institute, and were permanent residents of Uttar Pradesh or Bihar were included in the study. RESULTS In this study, we found that patients with gallbladder cancer, gallstones and breast cancer had their home closer to the river at a distance of around 53.9, 54 and 39.1 Kms. respectively compared to controls whose homes were at a distance of 76.7 Kms. CONCLUSIONS This study suggests that proximity to polluted rivers is one more factor in the aetiology of aforementioned diseases. Governmental agencies must consider monitoring and controlling the release of pollutants from the industries into the local nearby rivers. KEYWORDS Gallbladder Neoplasms, Drinking Water, Gallstones, Public Health