Download PDF
CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1809374
Perspective

Could Microplastics Be the Reason for the High Gallbladder Cancer Incidence in Northern India?

Jeffrey Mathew Boby
1   Department of Medicine, Government Medical College, Kozhikode, Kerala, India
,
Aju Mathew
2   Department of Oncology, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kerala, India
› Author Affiliations
Funding None.
› Further Information
Also available at
  Permissions and Reprints

Abstract

India accounts for more than 15% of all gallbladder cancer (GBC) diagnosed worldwide, with around 21,000 new cases diagnosed in 2022. However, a large proportion of these cases are concentrated along the banks of river Ganges flowing through northern and northeastern parts of India. GBC incidence in the Gangetic belt is around 10 times more than the rates reported from the rest of the country. In our article, we evaluated the various factors responsible for this geographic disparity and propose microplastic contamination of the river Ganges as the possible etiology for increased GBC prevalence along the Gangetic belt. Here, we attempted to describe existing literature on the harmful effects of microplastics particularly focusing on its carcinogenic potential. Although no proven association exists between GBC and microplastics, we believe there is strong circumstantial evidence to support this claim. However. extensive studies on the role of microplastics in GBC pathophysiology should be performed before any conclusion can be made on its carcinogenic potential.

Keywords

cancer - gallbladder cancer - microplastics

Authors' Contributions

A.M. conceptualized and designed the study. J.M.B. and A.M. were involved in the data collection, analysis, and interpretation of results. J.M.B. and A.M. prepared the draft manuscript. Both authors reviewed the results and approved the final version of the manuscript.


Patient's Consent

Patient consent was not required.




Publication History

Article published online:
27 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Global Cancer Observatory. . Cancer Today. Accessed July 31, 2024 at: https://gco.iarc.fr/today/en/dataviz/pie?mode=population&group_populations=0&cancers=12
  • 2 Dutta U, Bush N, Kalsi D, Popli P, Kapoor VK. Epidemiology of gallbladder cancer in India. Chin Clin Oncol 2019; 8 (04) 33
    CrossrefPubMedSearch in Google Scholar
  • 3 Jain K, Sreenivas V, Velpandian T, Kapil U, Garg PK. Risk factors for gallbladder cancer: a case-control study. Int J Cancer 2013; 132 (07) 1660-1666
    PubMedSearch in Google Scholar
  • 4 Madhawi R, Pandey A, Raj S. et al. Geographical pattern of carcinoma gallbladder in Bihar and its association with river Ganges and arsenic levels: retrospective individual consecutive patient data from Regional Cancer Centre. South Asian J Cancer 2018; 7 (03) 167-170
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Dwivedi S, Mishra S, Tripathi RD. Ganga water pollution: a potential health threat to inhabitants of Ganga basin. Environ Int 2018; 117: 327-338
    PubMedSearch in Google Scholar
  • 6 Mariya A, Kumar C, Masood M, Kumar N. The pristine nature of river Ganges: its qualitative deterioration and suggestive restoration strategies. Environ Monit Assess 2019; 191 (09) 542
    PubMedSearch in Google Scholar
  • 7 Shukla Y, Arora A. Enhancing effects of mustard oil on preneoplastic hepatic foci development in Wistar rats. Hum Exp Toxicol 2003; 22 (02) 51-55
    PubMedSearch in Google Scholar
  • 8 Kumar S, Kumar S, Kumar S. Infection as a risk factor for gallbladder cancer. J Surg Oncol 2006; 93 (08) 633-639
    PubMedSearch in Google Scholar
  • 9 Nath G, Singh YK, Kumar K. et al. Association of carcinoma of the gallbladder with typhoid carriage in a typhoid endemic area using nested PCR. J Infect Dev Ctries 2008; 2 (04) 302-307
    PubMedSearch in Google Scholar
  • 10 Shukla VK, Prakash A, Tripathi BD, Reddy DC, Singh S. Biliary heavy metal concentrations in carcinoma of the gall bladder: case-control study. BMJ 1998; 317 (7168) 1288-1289
    PubMedSearch in Google Scholar
  • 11 Shridhar K, Krishnatreya M, Sarkar S. et al. Chronic exposure to drinking water arsenic and gallbladder cancer risk: preliminary evidence from endemic regions of India. Cancer Epidemiol Biomarkers Prev 2023; 32 (03) 406-414
    PubMedSearch in Google Scholar
  • 12 Mhatre S, Wang Z, Nagrani R. et al. Common genetic variation and risk of gallbladder cancer in India: a case-control genome-wide association study. Lancet Oncol 2017; 18 (04) 535-544
    PubMedSearch in Google Scholar
  • 13 Prata JC. Microplastics and human health: integrating pharmacokinetics. Crit Rev Environ Sci Technol 2023; 53 (16) 1489-1511
    Search in Google Scholar
  • 14 Lee Y, Cho J, Sohn J, Kim C. Health effects of microplastic exposures: current issues and perspectives in South Korea. Yonsei Med J 2023; 64 (05) 301-308
    PubMedSearch in Google Scholar
  • 15 Domenech J, Annangi B, Marcos R, Hernández A, Catalán J. Insights into the potential carcinogenicity of micro- and nano-plastics. Mutat Res Rev Mutat Res 2023; 791: 108453
    PubMedSearch in Google Scholar
  • 16 Boran T, Zengin OS, Seker Z. et al. An evaluation of a hepatotoxicity risk induced by the microplastic polymethyl methacrylate (PMMA) using HepG2/THP-1 co-culture model. Environ Sci Pollut Res Int 2024; 31 (20) 28890-28904
    PubMedSearch in Google Scholar
  • 17 “Data Page: Global plastics production”, part of the following publication: Hannah Ritchie, Veronika Samborska and Max Roser ( 2023 ) - “Plastic Pollution”. Data adapted from Geyer et al., OECD. Accessed May 14, 2025 at: https://ourworldindata.org/grapher/global-plastics-production
  • 18 Schmidt C, Krauth T, Wagner S. Export of plastic debris by rivers into the sea. Environ Sci Technol 2017; 51 (21) 12246-12253
    PubMedSearch in Google Scholar
  • 19 Napper IE, Baroth A, Barrett AC. et al. The distribution and characterisation of microplastics in air, surface water and sediment within a major river system. Sci Total Environ 2023; 901: 166640
    PubMedSearch in Google Scholar
  • 20 Napper IE, Baroth A, Barrett AC. et al. The abundance and characteristics of microplastics in surface water in the transboundary Ganges River. Environ Pollut 2021; 274: 116348
    PubMedSearch in Google Scholar