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How do gallbladder polyps become cancerous?

Nov 07, 2025 Source: Cainiu Health
Dr. Gao Jun
Introduction
In general, gallbladder polyps that may undergo malignant transformation are associated with factors such as excessively large polyp diameter, special polyp type, rapid growth rate, coexisting gallbladder diseases, and patient age. It is important in daily life to maintain regular eating habits, avoid long-term consumption of high-fat and high-cholesterol foods to reduce the burden on the gallbladder, and undergo regular abdominal ultrasound examinations to dynamically monitor changes in the polyps, which helps lower the risk of malignant transformation.

Generally, gallbladder polyps that may undergo malignant transformation are associated with factors such as excessively large polyp diameter, special polyp type, rapid growth rate, coexisting gallbladder diseases, and patient age. The specific analysis is as follows:

1. Excessively large polyp diameter: When the diameter of a gallbladder polyp is ≥10 mm, the risk of malignancy increases. Larger polyps are more likely to exhibit abnormal cell proliferation and may compress the gallbladder wall, causing repeated local mucosal injury and repair. Long-term stimulation under these conditions increases the possibility of malignant transformation, so these polyps require close monitoring.

2. Special polyp type: Adenomatous polyps are well-recognized precancerous lesions among gallbladder polyps. They arise from hyperplasia of the gallbladder mucosal epithelium and exhibit cellular atypia. Over time, their risk of malignant transformation is significantly higher than that of benign polyps such as cholesterol or inflammatory polyps. Particularly, villous adenomas carry an even greater risk of cancerous change.

3. Rapid growth rate: A noticeable increase in polyp size over a short period—for example, growth exceeding 3 mm within six months—suggests possible abnormal proliferation. These polyps tend to have poor cellular stability and are more prone to malignant transformation, warranting vigilance for potential malignancy.

4. Coexisting gallbladder diseases: When chronic cholecystitis or gallstones are present, the gallbladder is subject to long-term inflammatory stimulation and mechanical friction from stones, resulting in persistent mucosal damage. This environment promotes polyp growth and increases the risk of malignant transformation. The synergistic effect between inflammation and polyps can accelerate the carcinogenic process.

5. Patient age factor: In individuals over 50 years of age, the risk of gallbladder polyp malignancy rises with advancing age. This is related to slower metabolism, reduced cellular repair capacity, and cumulative long-term exposure to various stimuli. Middle-aged and older patients should therefore pay greater attention to regular polyp monitoring.

In daily life, it is important to maintain regular eating habits and avoid prolonged consumption of high-fat, high-cholesterol foods to reduce the burden on the gallbladder. Regular abdominal ultrasound examinations to dynamically monitor changes in polyps can help lower the risk of malignant transformation.

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