被限定于特定地理区域的胆囊癌（GBC）是一种致命的消化道癌症，其对女性的影响超过男性，有关其风险因素的信息有限。我们在印度的阿萨姆邦和比哈尔邦进行了一项基于医院的病例-对照研究，评估了家庭烹饪燃料与GBC风险之间的关联。我们研究了饮食、火炉通风、每日暴露时间和生育率（仅限女性）在其中的中介作用。我们在2019年至2021年间招募了年龄在30-69岁之间的经过活检确认的GBC男性和女性（n = 214），并与年龄、性别和区域进行了频率匹配的对照组（n = 166）。收集了有关烹饪燃料、生活方式、个人和家族病史、女性生殖因素、社会经济学和人体测量学的信息。我们使用多变量 logistic 回归分析进行了相关性检验。所有参与者（73.4％为女性）根据主要使用的烹饪燃料被分为不同的组。组1：在过去的20年及以上使用液化石油气（LPG）而没有同时使用生物质燃料的人（26.15％）；组2：在过去的20年及以上使用液化石油气（LPG）同时有次要生物质燃料使用的人（15.9％）；组3：在过去的≥20年中一直使用生物质燃料的人（57.95％）。在考虑混杂因素的情况下，与组1相比，组2 [OR：2.02；95％CI：1.00-4.07] 和组3 [OR：2.01；95％CI：1.08-3.73] 的 GBC 风险更高（p-趋势：0.020）。这些关联在女性中更为明显，而在高水果蔬菜摄入量的情况下有所减弱，但并不受火炉通风、每日暴露时间或生育率的影响。生物质燃烧与GBC存在高风险相关性，应将其视为GBC的可调控风险因素。清洁烹饪燃料可以潜在地减轻风险，而健康饮食可以在一定程度上减少女性的风险。© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Gallbladder cancers (GBC), unique to certain geographical regions, are lethal digestive tract cancers, disproportionately affecting women, with limited information on risk factors.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.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.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.© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.