Biliary heavy metal concentrations in carcinoma of the gall bladder: case-control study

BMJ 1998;317:1288-1289 ( 7 November )

Papers

Biliary heavy metal concentrations in carcinoma of the gall bladder: case-control study

V K Shukla, professor of surgery, ^a A Prakash, senior resident in surgery, ^a B D Tripathi, reader, ^b D C S Reddy, reader in community medicine, ^a S Singh, research associate in surgery. ^a

^a Departments of Surgery and Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, India, ^b Department of Botany, Faculty of Science, Banaras Hindu University

Correspondence to: Professor Shukla vkshukla@banaras.ernet.in

The first 150 words of the full text of this article appear below.

Carcinoma of the gall bladder is the third most common malignancy of the gastrointestinal tract in the eastern Uttar Pradeshand western Bihar regions of India.¹ The two regions lie downstream of the river Ganges, which is the main source of drinking,bathing, and irrigation water in this part of India and receivesuntreated domestic sewage and industrial and agricultural effluent.High concentrations of cadmium have been reported in sewage, irrigationwater, and vegetables grown in the area, and higher concentrationsof heavy metals than recommended by the World Health Organisationhave been reported in water from this region. Heavy metals asenvironmental pollutants have been implicated in human carcinogenesis.²These metals, especially cadmium, are excreted and concentratedin the hepatobiliary system.³