{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:49:26Z","timestamp":1791607766981,"version":"4.3.4"},"reference-count":186,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Gallbladder cancer (GBC) is an uncommon but highly lethal malignancy, characterized by striking geographic clustering, late diagnosis, and a prevention profile that differs from other gastrointestinal malignancies. This narrative review synthesizes epidemiologic, mechanistic, clinical, and public-health evidence on GBC determinants with a prevention-oriented lens. Rather than merely cataloguing risk factors, we propose a pragmatic framework that combines epidemiologic credibility, population-attributable burden, baseline risk, biologic plausibility, feasibility, and the benefit-risk balance of possible interventions. The strongest opportunities for prevention arise from risk-stratified management of gallbladder disease and congenital biliary abnormalities, reduction of excess and dysfunctional adiposity, promotion of physical activity, control of chronic Salmonella carriage in endemic settings, and mitigation of selected food- and water-borne toxic exposures. Several other determinants, including diet, alcohol consumption, smoking, reproductive factors, and socioeconomic disadvantage, may inform risk stratification or broader cancer-prevention policy, but currently offer less specific actionability. Effective prevention will require matching interventions to context: population-wide metabolic and lifestyle prevention, targeted clinical management of high-risk gallbladder conditions, and endemic-area strategies addressing infection, environmental exposure, and access to surgery. GBC prevention is therefore possible through carefully evaluated risk-adapted strategies.<\/jats:p>","DOI":"10.3390\/cancers18193151","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:14:37Z","timestamp":1790694877000},"page":"3151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gallbladder Cancer: Epidemiology and Prevention"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-978X","authenticated-orcid":false,"given":"Spyridon","family":"Peppas","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0148-6401","authenticated-orcid":false,"given":"Gabriel","family":"Amorim Moreira Alves","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0740-1363","authenticated-orcid":false,"given":"Gisella","family":"Figlioli","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC), Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy"},{"name":"IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-0759","authenticated-orcid":false,"given":"Andreas G.","family":"Tsantes","sequence":"additional","affiliation":[{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"},{"name":"Laboratory of Haematology and Blood Bank Unit, School of Medicine, \u201cAttiko\u201d Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-8901","authenticated-orcid":false,"given":"Rozeta","family":"Sokou","sequence":"additional","affiliation":[{"name":"Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-0246","authenticated-orcid":false,"given":"Georgios K.","family":"Nikolopoulos","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Statistics, Epidemiology and Public Health, Medical School, University of Cyprus, Nicosia 1678, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fares","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-6579","authenticated-orcid":false,"given":"Stefanos","family":"Bonovas","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC), Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy"},{"name":"IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1414-6639","authenticated-orcid":false,"given":"Daniele","family":"Piovani","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC), Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy"},{"name":"IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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