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Household cooking fuel and gallbladder cancer risk: a multi-centre case–control study in India

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Abstract

Purpose

Gallbladder cancers (GBC), unique to certain geographical regions, are lethal digestive tract cancers, disproportionately affecting women, with limited information on risk factors.

Methods

We evaluated the association between household cooking fuel and GBC risk in a hospital-based case–control study conducted in the North-East and East Indian states of Assam and Bihar. We explored the potential mediation by diet, fire-vents, ‘daily exposure duration’ and parity (among women). We recruited biopsy-confirmed GBC (n = 214) men and women aged 30–69 years between 2019 and 2021, and controls frequency-matched by age, sex and region (n = 166). Information about cooking fuel, lifestyle, personal and family history, female reproductive factors, socio-demographics, and anthropometrics was collected. We tested associations using multivariable logistic regression analyses.

Results

All participants (73.4% women) were categorised based on predominant cooking fuel use. Group-1: LPG (Liquefied Petroleum Gas) users in the previous 20 years and above without concurrent biomass use (26.15%); Group-2: LPG users in the previous 20 years and above with concurrent secondary biomass use (15.9%); Group-3: Biomass users for ≥ 20 years (57.95%). Compared to group-1, accounting for confounders, GBC risk was higher in group-2 [OR: 2.02; 95% CI: 1.00–4.07] and group-3 [OR: 2.01; 95% CI: 1.08–3.73] (p-trend:0.020). These associations strengthened among women that attenuated with high daily consumption of fruits-vegetables but not with fire-vents, ‘daily exposure duration’ or parity.

Conclusion

Biomass burning was associated with a high-risk for GBC and should be considered as a modifiable risk factor for GBC. Clean cooking fuel can potentially mitigate, and a healthy diet can partially reduce the risk among women.

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Data availability

The data used for the study are available with the PI and can be obtained with reasonable request.

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Acknowledgements

The authors thank Drs. Aastha Aggrawal, Ruby Gupta, Sumita Sarma Barthakur and Gayatri Bharali and Ms. Kritika Anand for their support during study inception.

Funding

This study was funded by the Public Health Foundation of India’s Centre for Environmental Health core funds to Dr. Krithiga Shridhar as part of her Research Development Grant Fellowship (2018–2021). Funders had no role in study design, data collection, analysis, or publication.

Author information

Authors and Affiliations

  1. Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India

    Krithiga Shridhar, Dimple Kondal,  D.Prabhakaran, Poornima Prabhakaran & Preet K. Dhillon

  2. Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India

    Krithiga Shridhar, Banti Kalita, Prakriti Snehil,  D.Prabhakaran & Poornima Prabhakaran

  3. Dr. Bhubaneshwar Borooah Cancer Institute, AK Azad Road, Gopinath Nagar Road, Bishnu Rabha Nagar, Guwahati, 781016, Assam, India

    Manigreeva Krishnatreya, Mouchumee Bhattacharyya & Amal Chandra Kataki

  4. Mahavir Cancer Sansthan and Research Centre, Phulwarisharif, Patna, 801505, Bihar, India

    Ranjit Kumar & Ashok Ghosh

  5. Central University of Himachal Pradesh, Dharamshala, Kangra, 176215, Himachal Pradesh, India

    Ranjit Kumar

  6. Akshat Seva Sadan, Yarpur, Gardanibagh, Patna, 800001, Bihar, India

    Amulya K. Singh

  7. Genentech Roche, San Francisco Bay Area, CA, 94080, USA

    Preet K. Dhillon

  8. London School of Hygiene and Tropical Medicine, Bloomsbury, London, UK

    D.Prabhakaran

Authors
  1. Krithiga Shridhar
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Contributions

Krithiga Shridhar: Conceptualization, Funding acquisition, Formal Analysis, Writing-Original Draft, Supervision, Resources, Project Administration. Manigreeva Krishnatreya: Resources, Supervision, Project Administration. review & editing Ranjit Kumar: Resources, Supervision, Project Administration, review & editing. Dimple Kondal: Formal Analysis, review & editing. Mouchumee Bhattacharyya: Resources, Project Administration. review & editing. Banti Kalita: Investigation, Data Curation, review & editing. Prakriti Snehil: Investigation, Data Curation, review & editing. Amulya K. Singh: Resources, Project Administration. review & editing. Amal Chandra Kataki: Resources, Supervision, review & editing. Ashok Ghosh: Resources, Supervision, review & editing. D. Prabhakaran: Resources, Supervision, review & editing. Poornima Prabhakaran: conceptualization, Resources, Supervision, review & editing. Preet K. Dhillon: Conceptualization, Methodology, supervision, review & editing.

Corresponding author

Correspondence to Krithiga Shridhar.

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Competing interests

The authors declare no conflicts of interest. We declare the commercial affiliation of one of our authors (Genentech Roche, CA, USA). The funder provided support in the form of salary for the author (PKD) but did not have any additional role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Ethical approval

Ethics committee approval was obtained from all participating institutions, which included the coordinating centre Public Health Foundation of India (TRC IEC-389/18), as well as from study hospitals (BBCI-TMC/Misc-119/MEC/231/2019; 09/RMRI/EC/2019; SSN/IEC/JAN/2019/29), and the procedures followed were in accordance with the ethical standards of the committee. All study participants provided informed consent. Information sheets in local language were given to the participants, and their signatures were obtained in the consent forms. Strict COVID control protocol as approved by the ethical committee was followed during COVID-Pandemic.

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Shridhar, K., Krishnatreya, M., Kumar, R. et al. Household cooking fuel and gallbladder cancer risk: a multi-centre case–control study in India. Cancer Causes Control 35, 281–292 (2024). https://doi.org/10.1007/s10552-023-01787-8

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