Thakur Chanda, Mahato Roshan Kumar, Marasini Sabina, Timalsena Dinesh, Sharma Krishna Sagar, Karmacharya Biraj Man
Department of Public Health, Kathmandu University Dhulikhel Hospital, Dhulikhel, Nepal.
Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
PLoS One. 2025 Jan 22;20(1):e0317249. doi: 10.1371/journal.pone.0317249. eCollection 2025.
Gallbladder cancer (GBC) is a rare, highly fatal disease with diagnosis in advanced stage and low survival rate. Nepal ranked 4th position with highest rates of GBC for 10 countries in 2020.
To find the association between socio-demographic, behavioral and environmental factors associated with the development of GBC.
A case-control study was conducted in 2021/22 with newly diagnosed gallbladder cancer cases from three cancer-specialized hospitals and one tertiary (superspeciality) hospital. Controls were selected from the same tertiary hospital and one additional hospital providing services to gallbladder pathologies for a huge population, making a total of five hospitals involved in the study. The ratio of cases to control was 1:1. The data collection was done through telephonic interviews using structured questionnaires. The risk factors for GBC were assessed by using unconditional logistic regression to find odds ratios and 95% confidence level for bivariate and multivariate analysis. The statistical analysis was carried out in STATA 18.
A total of 240 respondents were enrolled in the study, among them half were GBC patients (cases) and half were gallbladder patients (controls). The average age of the respondents was 54.82±12.3 years, with female preponderance among both groups. On multivariate analysis, the risk factors studied were; parity ≥3 (AOR = 2.80, 95% CI: 1.17-6.66, P value 0.020), being ethnic group of Terai/Madhesi (AOR = 7.88, 95% CI: 3.16-19.66, P value <0.001), being Janajati (AOR = 3.36, 95% CI: 1.17-6.61, P value <0.001), having gallbladder related disease (AOR = 2.00, 95% CI:1.00-4.02, P value 0.049), consuming alcohol ≥100ml/day (AOR = 3.44, 95% CI:1.11-10.63, P value 0.032), exposed with pesticides ≥2 times in a year (AOR = 4.04, 95% CI: 1.27-12.89, P value 0.018) and consuming less vegetables and fruits (<1 times per day in a week) (AOR = 2.69, 95% CI:1.34-5.40, P value 0.005).
The study reveals key GBC risk factors, offering vital insights for targeted screening, resource allocation, and public health measures to mitigate risks in Nepal.
胆囊癌（GBC）是一种罕见的、高度致命的疾病，通常在晚期才被诊断出来，生存率较低。在2020年10个国家中，尼泊尔的胆囊癌发病率排名第四。
探究社会人口学、行为和环境因素与胆囊癌发生之间的关联。
于2021/22年开展了一项病例对照研究，研究对象为来自三家癌症专科医院和一家三级（超专科）医院的新诊断胆囊癌病例。对照组从同一家三级医院和另一家为大量人群提供胆囊疾病服务的医院中选取，共有五家医院参与了该研究。病例与对照的比例为1:1。通过使用结构化问卷进行电话访谈来收集数据。采用无条件逻辑回归评估胆囊癌的危险因素，以确定二元和多变量分析的比值比及95%置信区间。统计分析在STATA 18中进行。
共有240名受访者参与了该研究，其中一半是胆囊癌患者（病例组），一半是胆囊疾病患者（对照组）。受访者的平均年龄为54.82±12.3岁，两组中女性均占多数。在多变量分析中，研究的危险因素包括：产次≥3（比值比=2.80，95%置信区间：1.17-6.66，P值0.020）、属于特莱/马德西族（比值比=7.88，95%置信区间：3.16-19.66，P值<0.001）、属于贾纳贾蒂族（比值比=3.36，95%置信区间：1.17-6.61，P值<0.001）、患有胆囊相关疾病（比值比=2.00，95%置信区间：1.00-4.02，P值0.049）、每天饮酒≥100毫升（比值比=3.44，95%置信区间：1.11-10.63，P值0.032）、每年接触农药≥2次（比值比=4.04，95%置信区间：1.27-12.89，P值0.018）以及蔬菜和水果摄入量少（每周<1次/天）（比值比=2.69，95%置信区间：1.34-5.40，P值0.005）。
该研究揭示了胆囊癌的关键危险因素，为尼泊尔的针对性筛查、资源分配和公共卫生措施提供了重要见解，以降低风险。
