Association of chili pepper consumption, low socioeconomic status and longstanding gallstones with gallbladder cancer in a Chilean population

Abstract

We explored the risk factors for gallbladder cancer and explanations for its sharp and constant incidence increase in Chile since the 1970s. We compared 114 consecutive patients with verified gallbladder cancer, diagnosed 1992-1995, to 114 matched hospital patients with gallstones, using conditional logistic regression analysis. Low education showed a nonsignificant positive relationship with gallbladder cancer [odds ratio (OR) ‫؍‬ 2.3, 95% confidence interval (CI) 0.8 -6.2], and low socioeconomic level showed a significant relationship (OR ‫؍‬ 5.0, 95% CI 1.5-17.3). A very long history of gallstone disease was significantly more prevalent among cases (OR ‫؍‬ 11.0, 95% CI 1.4 -85.2). Significant red chili pepper consumption was observed in gallbladder cancer patients (OR ‫؍‬ 2.9, 95% CI 1.6 -5.2). Low intake of both fresh fruit and sugar as soft drinks was associated with gallbladder cancer, with ORs of 6.4 (95% CI 1.4 -30.3) and 3.6 (95% CI 1.3-10.1), respectively. Multivariate analysis kept only a very low socioeconomic status and red chili pepper consumption as significant independent risk factors for gallbladder cancer, ORs of 6.3 (95% CI 1.7-23.0) and 3.2 (95% CI 1.7-5.9). Longstanding gallstone cases were removed from the multivariate model because all were in the low and very low socioeconomic groups, reinforcing the association. Patients with gallbladder cancer differed from matched controls by exhibiting lower socioeconomic levels, having a much longer history of gallstone disease and presenting a dietary pattern characterized by high red chili pepper consumption and low fresh fruit intake.

Obesity and the risk of gallbladder cancer: a meta-analysis

“…The eight cohort studies Wolk et al, 2001;Calle et al, 2003;Samanic et al, 2004Samanic et al, , 2006Engeland et al, 2005;Kuriyama et al, 2005;Oh et al, 2005) and three case -control studies Zatonski et al, 1997;Serra et al, 2002) that were included in the meta-analysis involved a total of 3288 cases. Main characteristics of the studies are shown in Table 1.…”

“…Main characteristics of the studies are shown in Table 1. Weight and height were measured in three studies (Engeland et al, 2005;Oh et al, 2005;Samanic et al, 2006) and self-reported in five studies Zatonski et al, 1997;Serra et al, 2002;Calle et al, 2003;Kuriyama et al, 2005); in three studies, obesity was defined by a discharge diagnosis of obesity Wolk et al, 2001;Samanic et al, 2004). Among case -control studies, one used population-based controls (Zatonski et al, 1997) and two used hospital-based controls Serra et al, 2002).…”

“…Eight studies presented relative risk estimates for 'overweight' compared with 'normal weight' Zatonski et al, 1997;Serra et al, 2002;Calle et al, 2003;Engeland et al, 2005;Kuriyama et al, 2005;Oh et al, 2005;Samanic et al, 2006). Metaanalysis of these studies found those in the overweight category had a statistically significant 15% increased risk (RR, 1.15; 95% CI, 1.01 -1.30) compared to those of normal weight, with no statistically significant heterogeneity among studies (Q ¼ 14.93; P ¼ 0.19; I 2 ¼ 26.3).…”

“…First, because of the observational design of the included studies, we cannot rule out the possibility that the observed association between excess body weight and risk is owing to confounding from other risk factors. Second, five studies Zatonski et al, 1997;Serra et al, 2002;Calle et al, 2003;Kuriyama et al, 2005) in this meta-analysis relied on self-reported weight and height and it is possible that weight has been under-reported, particularly by overweight or obese individuals (IARC, 2002). The summary relative risk estimate was higher for studies that relied on selfreported weight and height.…”

“…We identified eight cohort studies Wolk et al, 2001;Calle et al, 2003;Samanic et al, 2004Samanic et al, , 2006Engeland et al, 2005;Kuriyama et al, 2005;Oh et al, 2005) and four case -control studies (Zatonski et al, 1992(Zatonski et al, , 1997Strom et al, 1995;Serra et al, 2002) that reported results on overweight/obesity and risk of gallbladder cancer. One case -control study (Zatonski et al, 1992) was excluded because this study was included in a multicentre case -control study (Zatonski et al, 1997); the multicentre casecontrol study was included in this meta-analysis.…”