Body Size Indicators and Risk of Gallbladder Cancer: Pooled Analysis of Individual-Level Data from 19 Prospective Cohort Studies

Abstract

Background There are few established risk factors for gallbladder cancer beyond gallstones. Recent studies suggest a higher risk with high body mass index (BMI), an indicator of general heaviness, but evidence from other body size measures is lacking. Methods Associations of adult BMI, young adult BMI, height, adult weight gain, waist circumference (WC), waist-height ratio (WHtR), hip circumference (HC), and waist-hip ratio (WHR) with gallbladder cancer risk were evaluated. Individual-level data from 1,878,801 participants in 19 prospective cohort studies (14 studies had circumference measures) were harmonized and included in this analysis. Multivariable Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI). Results After enrollment, 567 gallbladder cancer cases were identified during 20.1 million person-years of observation, including 361 cases with WC measures. Higher adult BMI (per 5 kg/m2, HR: 1.24; 95%CI: 1.13–1.35), young adult BMI (per 5 kg/m2, HR: 1.12; 95%CI: 1.00–1.26), adult weight gain (per 5 kg, HR: 1.07; 95%CI: 1.02–1.12), height (per 5cm, HR: 1.10; 95%CI: 1.03–1.17), WC (per 5cm, HR: 1.09; 95%CI: 1.02–1.17), WHtR (per 0.1 unit, HR: 1.24; 95%CI: 1.00–1.54), and HC (per 5cm, HR: 1.13; 95%CI: 1.04–1.22), but not WHR (per 0.1 unit, HR: 1.03; 95%CI: 0.87–1.22), were associated with higher risks of gallbladder cancer and results did not differ meaningfully by sex or other demographic/lifestyle factors. Conclusions These findings indicate that measures of overall and central excess body weight are associated with higher gallbladder cancer risks. Impact Excess body weight is an important, and potentially preventable, gallbladder cancer risk factor.

Anthropometric Risk Factors for Cancers of the Biliary Tract in the Biliary Tract Cancers Pooling Project

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