Frequency of gallbladder cancer in chile, A high‐risk area

Abstract

We report an autopsy study of gallbladder cancer prevalence in Chile, where the risk of this disease is among the highest reported world-wide. In 14,768 autopsy protocols obtained from 3 university hospitals, 45% of women and 20% of men older than 20 years had gallstone disease (the major known risk factor for gallbladder cancer). The prevalence of gallbladder cancer in Chileans was compared to that found in a Swedish-Czechoslovakian autopsy study previously published. These countries were chosen because of their high frequency of gallstone disease. The comparison was performed by using logistic regression models adjusting for possible differences in the age-sex structure or the true incidence of gallstones in both populations. We found that the most important single risk factor for gallbladder cancer in Chile was gallstone disease, with an estimated effect on the logistic scale meaning that the cancer risk for subjects with gallstones is seven times higher than for those without the disease. Second in importance was the risk for sex, women being 2.8 times higher than for men. The estimated difference in the sex composition and the incidence of gallstones resulted in 17.9% higher odds of cancer in Chile than in Sweden and Czechoslovakia. However, this difference was not significant. This study suggests that the major etiologic factors of gallbladder cancer in Chileans, Swedes and Czechoslovakians are primarily related to gallstone disease.

hOGG1 Ser326Cys polymorphism and susceptibility to gallbladder cancer in a Chinese population

“…Nervi et al reported that the incidence of gallbladder cancer in patients with gallstones was 7 times higher than that in patients without gallstones. 46 physical trauma produced by the stone and carcinogenic substance in bile might result in epithelia dysplasia and ultimately progress to carcinoma. 47,48 If the induction by physical trauma hypothesis is correct, it may be that duration for trauma rather stone size itself is the critical factor.…”

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

“…Ethnic and familial predisposition suggests the role of genetic predisposition or shared metabolic and lifestyle factors, including obesity, insulin resistance, or high-fat, high-caloric diet. 1,[6][7][8] Familial aggregation of gallstones has been reported in several studies, [9][10][11] but only one assessed the role of family history of gallstones in biliary tract cancer etiology. A case-control study of gallbladder cancer in Bolivia and Mexico reported that a family history of gallstones was associated with a 3.6-fold risk of gallbladder cancer.…”

Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar

“…Las mujeres chilenas se encuentran entre las de más alto riesgo en el mundo, con una prevalencia que supera el 60% a partir de los 50 años de edad 3,4 .…”

“…El CVB es en general de diagnóstico tardío y de mal pronóstico. Sin embargo, los CVB incipientes diagnosticados en forma incidental en colecistectomías (CCT), tienen una sobrevida cercana al 90% a cinco años [7][8][9][10][11] . Dado que la CL sintomática es el principal factor de riesgo de CVB, la CCT oportuna ha sido propuesta como la principal estrategia de prevención primaria de CVB [11][12][13][14] .…”

“…Sin embargo, se ha demostrado una relación inversa entre las tasas de CCT y la incidencia o mortalidad por CVB, lo que ha proporcionado sustento a la propuesta de utilizar esta estrategia como medida de prevención primaria. Además, se han realizado estudios de costo-efectividad y modelos estadísticos que sugieren que la CCT profiláctica en grupos de mayor riesgo sería efectiva para disminuir la mortalidad por CVB en Chile 8,11,15,16 .…”