Association Between Screen-Detected Gallstone Disease and Cancer in a Cohort Study

Shabanzadeh, Daniel Mønsted; Sørensen, Lars Tue; Jørgensen, Torben

doi:10.1053/j.gastro.2017.02.013

Cited by 51 publications

(40 citation statements)

References 56 publications

(63 reference statements)

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“…Through the alteration of the bile flow rhythm and the enterohepatic circulation of bile acids, the gut microbiota will be changed after cholecystectomy [33]. Moreover, our study is in agreement with the study from Shabanzadeh et al, to show that cholecystectomy cannot diminish the risk of prostate cancer [34]. Cholecystectomy has been shown to be capable of increasing the serum levels of cholecystokinin and secretin, and it is suggested to measure their serum levels before and after the removals of gallstones to ascertain whether this alteration is related to increased risk of prostate cancer [35,36].…”

Section: Discussionsupporting

confidence: 92%

Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones

Chen

Lin

Kao

2020

Cancers

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Objectives: To assess the association of cholecystectomy with the risk of prostate cancer in patients with gallstones. Methods: This nationwide population-based cohort study was conducted by retrieving the Longitudinal Health Insurance Research Database (LHID2000) for inpatient claims in the Taiwan National Health Insurance (NHI) program. The study cohort consisted of 72,606 men aged ≥ 20 years with gallstones undergoing cholecystectomy between 2000 and 2010. The control cohort consisted of the men with gallstones, but without cholecystectomy, by 1:1 propensity score matching with the study cohort based on age, sex, urbanization, occupation, comorbidities, and the index date. We compared the hazard ratio of prostate cancer between both of the cohorts. Results: The incidence of prostate cancer was 0.76/1000 person-years for the non-cholecystectomy cohort and 1.28/1000 person-years for the cholecystectomy cohort [aHR (adjusted hazard ratio) = 1.67, 95% confidence interval (CI = 1.45–1.92), respectively (p < 0.001). When compared with the non-cholecystectomy cohort, the hazard ratio of prostate cancer for the cholecystectomy cohort was 1.49-fold greater (95% CI = 1.04–2.11) for follow-up ≤ 1 year, 1.52-fold greater (95% CI = 1.24–1.86) for follow-up 1–5 years, and 1.99-fold greater (95% CI = 1.56–2.53) for follow-up > 5 years, respectively. Conclusions: Cholecystectomy is associated with an increased hazard ratio of prostate cancer in gallstones patients, and the risk increases with an incremental period of follow-up. This observational study cannot ascertain the detrimental mechanisms of cholecystectomy for the development of prostate cancer, and cholecystectomy is not recommended for the prevention of prostate cancer based on our study.

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Section: Discussionsupporting

confidence: 92%

Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones

Chen

Lin

Kao

2020

Cancers

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“…Furthermore, an association between gallstones and CRC was found only among women in a meta‐analysis of 28 case–control studies conducted in Chinese populations . In contrast, screen‐detected gallstones were associated with right‐sided colon cancer in the general population of Copenhagen, but no interaction by sex was found . In the large Surveillance, Epidemiology, and End Results (SEER) database, gallstones were inversely associated with rectal cancer, marginally associated with lower risk of distal colon cancer, and not associated with CRC overall .…”

Section: Discussionmentioning

confidence: 99%

“…Current epidemiologic evidence on the association between gallstones and CRC is inconclusive, with results indicating either no association, a positive association or inconsistent associations by CRC subsite . The available studies differ notably in sample size and adjustment for covariates: large population‐based cohorts had high numbers of gallstone cases (e.g., 42,000) but were limited to clinical covariate data, whereas studies with more extensive data on potential confounders (e.g., diet, alcohol, anthropometry, serum lipids) had fewer gallstone cases (e.g., <600) . Additionally, differences in the relationship between gallstones and CRC by sex require further study, as women are at higher risk of both gallstones and developing more aggressive right‐sided (proximal) colon cancer than men.…”

Section: Introductionmentioning

confidence: 99%

Gallstones and incident colorectal cancer in a large pan‐European cohort study

Ward

Murphy

Weiderpass

et al. 2019

Intl Journal of Cancer

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Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined the association between history of gallstones and CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a prospective cohort of over half a million participants from ten European countries. History of gallstones was assessed at baseline using a self-reported questionnaire. The analytic cohort included 334,986 participants; a history of gallstones was reported by 3,917 men and 19,836 women, and incident CRC was diagnosed among 1,832 men and 2,178 women (mean follow-up: 13.6 years). Hazard ratios (HR) and 95% confidence intervals (CI) for the association between gallstones and CRC were estimated using Cox proportional hazards regression models, stratified by sex, study centre and age at recruitment. The models were adjusted for body mass index, diabetes, alcohol intake and physical activity. A positive, marginally significant association was detected between gallstones and CRC among women in multivariable analyses (HR = 1.14, 95%CI 0.99-1.31, p = 0.077). The relationship between gallstones and CRC among men was inverse but not significant (HR = 0.81, 95%CI 0.63-1.04, p = 0.10). Additional adjustment for details of reproductive history or waist circumference yielded minimal changes to the observed associations. Further research is required to confirm the nature of the association between gallstones and CRC by sex.

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“…In support of the potential role of secondary bile acids in colorectal cancer, a recent prospective cohort study found an elevated risk of proximal colon cancer among patients with ultrasound-detected gallstone disease and cholecystectomy. 72 These patients are expected to have higher concentrations of fecal secondary bile acids due to a continuous bile flow into the bowel and increased activity of secondary bile acid-producing bacteria. 73,74 The predominant association with proximal colon cancer may reflect a greater proximal colonic absorption of fecal secondary bile acids.…”

Section: Red and Processed Meat Bile Acid And Sulfurmentioning

confidence: 99%

Environmental Factors, Gut Microbiota, and Colorectal Cancer Prevention

Song

Chan

2019

Clinical Gastroenterology and Hepatology

207

150

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The substantial burden of colorectal cancer and increasing trend in young adults highlight the importance of lifestyle modification as a complement to screening for colorectal cancer prevention. Several dietary and lifestyle factors have been implicated in the development of colorectal cancer, possibly through the intricate metabolic and inflammatory mechanisms. Likewise, as a key metabolic and immune regulator, the gut microbiota has been recognized to play an important role in colorectal tumorigenesis. Increasing data support that environmental factors are crucial determinants for the gut microbial composition and function, whose alterations induce changes in the host gene expression, metabolic regulation, and local and systemic immune response, thereby influencing cancer development. Here, we review the epidemiologic and mechanistic evidence regarding the links between diet and lifestyle and the gut microbiota in the development of colorectal cancer. We focus on factors for which substantial data support their importance for colorectal cancer and their potential role in the gut microbiota, including overweight and obesity, physical activity, dietary patterns, fiber, red and processed meat, marine omega-3 fatty acid, alcohol, and smoking. We also briefly describe other colorectal cancer-preventive factors for which the links with the gut microbiota have been suggested but remain to be mechanistically characterized, including vitamin D status, dairy consumption, and metformin use. Given limitations in available evidence, we highlight the need for further investigations in the relationship between environmental factors, gut microbiota, and colorectal cancer, which may lead to development and clinical translation of potential microbiota-based strategies for cancer prevention.

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Association Between Screen-Detected Gallstone Disease and Cancer in a Cohort Study

Cited by 51 publications

References 56 publications

Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones

Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones

Gallstones and incident colorectal cancer in a large pan‐European cohort study

Environmental Factors, Gut Microbiota, and Colorectal Cancer Prevention

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