Family history of gallstones and the risk of biliary tract cancer and gallstones: A population‐based study in Shanghai, China

Hsing, Ann W.; Bai, Yan; Andreotti, Gabriella; Rashid, Asif; Deng, Jie; Chen, Jinbo; Goldstein, Alisa M.; Han, Tian; Shen, Ming; Fraumeni, Joseph F.; Gao, Yu Tang

doi:10.1002/ijc.22756

Cited by 106 publications

(88 citation statements)

References 29 publications

(33 reference statements)

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“…Details of the study have been reported elsewhere (Hsing et al, 1998(Hsing et al, , 2007a. Patients with primary biliary cancer 156) newly diagnosed between June 1997 and May 2001 were identified through a rapid-reporting system established between the Shanghai Cancer Institute and 42 collaborating hospitals in urban Shanghai.…”

Section: Methodsmentioning

confidence: 99%

Body size and the risk of biliary tract cancer: a population-based study in China

et al. 2008

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Though obesity is an established risk factor for gall bladder cancer, its role in cancers of the extrahepatic bile ducts and ampulla of Vater is less clear, as also is the role of abdominal obesity. In a population-based case -control study of biliary tract cancer in Shanghai, China, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for biliary tract cancer in relation to anthropometric measures, including body mass index (BMI) at various ages and waist-to-hip ratio (WHR), adjusting for age, sex, and education. The study included 627 patients with biliary tract cancer (368 gall bladder, 191 bile duct, 68 ampulla of Vater) and 959 healthy subjects randomly selected from the population. A higher BMI at all ages, including early adulthood (ages 20 -29 years), and a greater WHR were associated with an increased risk of gall bladder cancer. A high usual adult BMI (X25.0) was associated with a 1.6-fold risk of gall bladder cancer (95% CI 1.2 -2.1, P for trend o0.001). Among subjects without gallstones, BMI was also positively associated with gall bladder cancer risk. Regardless of BMI levels, increasing WHR was associated with an excess risk of gall bladder cancer risk, with those having a high BMI (X25) and a high WHR (40.90) having the highest risk of gall bladder cancer (OR ¼ 12.6, 95% CI 4.8 -33.2), relative to those with a low BMI and WHR. We found no clear risk patterns for cancers of the bile duct and ampulla of Vater. These results suggest that both overall and abdominal obesity, including obesity in early adulthood, are associated with an increased risk of gall bladder cancer. The increasing prevalence of obesity and cholesterol stones in Shanghai seems at least partly responsible for the rising incidence of gall bladder cancer in Shanghai.

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Section: Methodsmentioning

confidence: 99%

Body size and the risk of biliary tract cancer: a population-based study in China

et al. 2008

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“…3,9,10 Briefly, cancer cases were identified by a rapid reporting system established by the Shanghai Cancer Institute (SCI) and 42 collaborating hospitals in Shanghai. Through this system we identified more than 95% of all incident biliary tract cancer cases (ICD9 code 156) diagnosed among Shanghai residents between June 1997 and May 2001.…”

Section: Study Subjectsmentioning

confidence: 99%

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Andreotti

Chen

Gao

et al. 2007

Intl Journal of Cancer

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Biliary tract cancers, encompassing the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. Gallstones, the predominant risk factor for biliary cancers, are linked with hyperlipidemia. As part of a populationbased case-control study conducted in Shanghai, China, we examined the associations of serum lipid levels with biliary stones and cancers. We included 460 biliary cancer cases (264 gallbladder, 141 extrahepatic bile duct, and 55 ampulla of Vater), 981 biliary stone cases and 858 healthy individuals randomly selected from the population. Participants completed an in-person interview and gave overnight fasting blood samples. Participants in the highest quintile of triglycerides (≥160 mg/dl) had a 1.4-fold risk of biliary stones (95% CI 5 1.1-1.9), a 1.9-fold risk of gallbladder cancer (95% CI 5 1.3-2.8), and a 4.8-fold risk of bile duct cancer (95% CI 5 2.8-8.1), compared to the reference group (third quintile: 90-124 mg/dl). Participants in the lowest quintile of high-density lipoprotein (HDL) (<30 mg/dl) had a 4.2-fold risk of biliary stones (95% CI 5 3.0-6.0), an 11.6-fold risk of gallbladder cancer (95% CI 5 7.3-18.5), and a 16.8-fold risk of bile duct cancer (95% CI 5 9.1-30.9), relative to the reference group (third quintile: 40-49 mg/dl). In addition, total cholesterol, low-density lipoprotein (LDL) and apolipoprotein A (apo A) were inversely associated with biliary stones; whereas low levels as well as high levels of total cholesterol, LDL, apo A and apolipoprotein B (apo B) were associated with excess risks of biliary tract cancers. Our findings support a role for serum lipids in gallstone development and biliary carcinogenesis. ' 2007 Wiley-Liss, Inc.Key words: serum lipid levels; gallstones; biliary tract cancer Biliary tract cancers, consisting of tumors of the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. 1,2 Gallstones are the most important known risk factor for all three biliary tract cancer subsites. Specifically, cholesterol gallstones (composed mainly of cholesterol) and mixed gallstones (composed of both cholesterol and bilirubin) are most strongly associated with gallbladder cancer. 2,3 Furthermore, cholesterol gallstones and gallbladder cancer share a number of putative risk factors, including obesity, high fat diet and hyperlipidemia. 2,4 Hyperlipidemia is generally characterized by high serum levels of total cholesterol, triglycerides, low-density-lipoprotein (LDL), and low levels of high-density-lipoprotein (HDL). High triglycerides and low HDL have been most consistently associated with gallstones, whereas the associations of total cholesterol and LDL with gallstones are less consistent. [5][6][7] Cholesterol gallstone pathogenesis involves cholesterol saturation of the bile duct due to the hypersecretion of cholesterol from the liver 8 ; however, the exact role of individual lipids, lipoproteins and apolipoproteins is less clear.Given the relationship between hyperlipidemia and gallsto...

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“…The role of genetic factors in biliary tract cancers and stones has been suggested by reports of ethnic and familial predisposition, but the genetic pathways are unclear (1,15). Although some gene variants in the lipid metabolism pathway have been linked to gallstones (16,17), few studies have examined their role in biliary tract cancers.…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms of Genes in the Lipid Metabolism Pathway and Risk of Biliary Tract Cancers and Stones: A Population-Based Case-Control Study in Shanghai, China

Andreotti

Chen

Gao

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Biliary tract cancers, encompassing the gallbladder, extrahepatic bile duct, and ampulla of Vater, are uncommon yet highly fatal malignancies. Gallstones, the primary risk factor for biliary cancers, are linked with hyperlipidemia. We examined the associations of 12 single nucleotide polymorphisms of five genes in the lipid metabolism pathway with the risks of biliary cancers and stones in a population-based case-control study in Shanghai, China. We included 235 gallbladder, 125 extrahepatic bile duct, and 46 ampulla of Vater cancer cases, 880 biliary stone cases, and 779 population controls. Subjects completed an in-person interview and gave blood. Genotyping was conducted by TaqMan assay using DNA from buffy coats. The effects of APOE IVS1+69 (rs440446) and APOB IVS6+360C>T (rs520354) markers were limited to men. Men carrying the G allele of APOE IVS1+69 had a 1.7-fold risk of stones [95% confidence interval (95% CI), 1.2-2.4], a 1.8-fold risk of gallbladder cancer (95% CI, 1.0-3.3), a 3.7-fold risk of bile duct cancer (95% CI, 2.0-7.0), and a 4-fold risk of ampullary cancer (95% CI, 1.4-12.4). Male carriers of the T allele of APOB IVS6+360C>T had a 2-fold risk of bile duct cancer (95% CI, 1.2-3.4). The APOB T-T haplotype (APOB IVS6+360C>T, EX4+56C>T) was associated with a 1.6-fold risk of bile duct cancer (95% CI, 1.1-2.3). Male and female carriers of the T allele of LDLR IVS9-30C>T (rs1003723) had a 1.5-fold risk of bile duct cancer. Our findings suggest that gene variants in the lipid metabolism pathway contribute to the risk of biliary tract stones and cancers, particularly of the bile duct. (Cancer Epidemiol Biomarkers Prev 2008;17(3):525 -34)

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Family history of gallstones and the risk of biliary tract cancer and gallstones: A population‐based study in Shanghai, China

Cited by 106 publications

References 29 publications

Body size and the risk of biliary tract cancer: a population-based study in China

Body size and the risk of biliary tract cancer: a population-based study in China

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Polymorphisms of Genes in the Lipid Metabolism Pathway and Risk of Biliary Tract Cancers and Stones: A Population-Based Case-Control Study in Shanghai, China

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