Kidney scan found a 7 mm gallbladder polyp and no stones. GP says rescan in six months. Should I be pushing to have it out?

Had an ultrasound in August for a kidney thing (fine, as it turns out) and the report has a line at the bottom: "7 mm echogenic polypoid lesion arising from the gallbladder wall, non mobile, no posterior acoustic shadow. No calculi." I had to look up most of those words.

I have never had a single gallbladder symptom in my life. No pain after meals, nothing. GP rang and said it is very likely a harmless cholesterol polyp, they will rescan in six months, and not to worry.

The not to worry part is not going brilliantly. I am 55. My father had what the family always called "a growth in the stomach" in his sixties back in Gujarat, which nobody ever properly explained. I keep reading that polyps can turn into cancer and that over 10 mm they take the gallbladder out, and 7 is not that far off 10. Would I be mad to push for it to come out now and stop thinking about it?

Fellow incidental finding person here, mine was three stones on a scan for my kidneys too, so I know exactly the feeling of a casual line at the bottom of a report ruining your week.

For what it is worth, "non mobile, no acoustic shadow" is the bit that says it is not a stone. Stones roll about and cast a shadow on the scan. That is all I know about polyps though.

My sister had a little polyp found years ago and they scanned her a couple of times and then just stopped because it never changed. That was it. She still has the gallbladder.

I would not push for an operation for something that is not hurting you without a surgeon telling you it is worth it. The operation is easy for most of us but it is still an operation.

Both helpful, thank you. Denise, that is what I keep telling myself. Then I read another article.

Different situation, mine was stones and actual pain, so I had no choice. But one thing I would say is make sure the six month rescan actually gets booked. My follow up scan for sludge never arrived and nobody chased it, and I only found out when I ended up in A&E. Put a date in your phone and ring them if the letter has not come by then.

I am the surgical moderator here. I cannot tell you what your polyp is or what you personally should do, because that needs someone who has your scan and has examined you. But I can tell you how the decision is normally made, and there is one detail in your post that is worth taking to your GP.

Most gallbladder polyps found by chance on an ultrasound are not true polyps at all but small cholesterol deposits on the wall, which have no cancer potential. Threestones is right that "no acoustic shadow, non mobile" is what separates them from stones on the scan. Ultrasound cannot reliably tell a cholesterol polyp from a true one, though, which is why the European guideline uses size and risk factors to decide.

In the 2022 update of that guideline, removal is recommended at 10 mm or more. For 6 to 9 mm, which is where 7 mm sits, the advice depends on risk factors: age over 60, primary sclerosing cholangitis, Asian ethnicity, or a flat, broad based (sessile) polyp. With none of those, the advice is repeat ultrasound at 6 months, 1 year and 2 years, stopping if it has not grown. With one or more, removing the gallbladder is recommended if you are fit for and want surgery.

You have mentioned your family's background, and the guideline lists Asian ethnicity among its risk factors because gallbladder cancer is more common in some Asian populations. I would raise that with your GP directly and ask whether it changes their plan, and ask whether the report says the polyp is sessile or on a stalk. That is not me saying it should come out. It is a question your GP may simply not have had the information to consider.

Bridget has written the guideline up in plain terms, including the follow up schedule and what counts as growth, at gallbladder polyps.

Update. Took this thread and the article to the GP. She had not known about the ethnicity point and was quite open about it. She has referred me to the surgical clinic to discuss it rather than just waiting for the rescan, and said the surgeon might still say scan and watch, which I am fine with now that someone with the actual guideline in front of them will decide.

Appointment is in five weeks. The six month scan is booked anyway, as Kev said, date in my phone.