Prevalence of gallstone disease in India: insights from a community-based cross-sectional study

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Background: Gallstone disease (GSD) is a prevalent gastrointestinal condition with known associations to gallbladder cancer (GBC). India exhibits heterogeneity in GSD burden across different geographic regions. However, limited data are available from high and low-risk regions. Methods: A community-based cross-sectional study was conducted across high-risk (Kamprup (Guwahati), Silchar, Mullanpur, Varanasi) and low-risk (Barshi) GBC regions using structured interviews. Self-reported history of gallstones was collected through interviewing participants from two sources, the Gallstone Survey (GS) and the 0.5 Million Indian Women Screening study. Per cent prevalence was estimated for GSD and stratified analysis based on sex, age and region was conducted. We estimated the population attributable fraction (PAF) for GSD in high and low risk GBC regions. Results: A total of 28 395 participants (9158 males, 19 237 females) aged 30-65 years were enrolled. Gallstone prevalence was highest in Mullanpur (10.8%, 95% CI 8.4% to 13.5%) and Kamprup (Guwahati) (10.7%, 95% CI (7.7% to 14.4%) and lowest in Barshi (0.3%, 95% CI 0.3% to 0.4%). Age and gender stratified analysis showed increasing gallstone prevalence with age among females in high-risk GBC regions, and no age-linked trends in GSD prevalence were observed in low-risk regions for both genders. The estimated overall PAF for high risk GBC regions was 2.7%, whereas in the low-risk region of Barshi the overall PAF was 0.2%. Conclusion: Significant regional and sex-based variation in GSD prevalence across India aligns with high-risk zones for GBC, underscoring the need for targeted surveillance and aetiologic research.

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