The utility of screening ultrasound in early diagnosis of gall bladder cancer among high-risk population

Abstract

Background: Screening has led to reduction in mortality for cancers of the cervix, prostate, and colon. Advanced gall bladder carcinoma (GBC) have a poor prognosis, compared to early-stage GBC. The aim of this study was early detection of GBC by ultrasound screening, in a high-risk population. Data were analyzed to look at the impact of screening on staging, operability, and survival. Materials and Methods: In this prospective study spanning 4 years, 978 high-risk individuals as per defined criteria, were screened by ultrasound of the abdomen. The clinical profile of patients with screened GBC (S-GBC) and clinically evident GBC (C-GBC) was studied in terms of stage of detection, operability, and median overall survival (mOS). Results: Six cases of GBC were detected as S-GBC. These were compared with a control population of 119 GBC cases presenting to the cancer outpatient department (C-GBC) in the same period. It was found that S-GBC patients compared to C-GBC, had early stages of diagnosis (P = 0.001) and all underwent curative radical cholecystectomy compared to only 18.8% in C-GBC cases (P = 0.004). At 2 years follow-up, mOS was not reached for S-GBC patients as all patients were alive, compared to 9 months mOS in C-GBC cases (P < 0.05). Conclusions: Screening for GBC leads to the detection of GBC in early stages, ensures surgical resection, and significantly improves mOS. Ultrasound screening in high-risk population is recommended to improve the poor prognosis of GBC.