Meta-analysis of observational studies on cholecystectomy and the risk of colorectal adenoma

Zhao, Chengjin; Ge, Zhenming; Wang, Yamin; Qian, Jingjing

doi:10.1097/meg.0b013e328350f86b

Cited by 10 publications

(13 citation statements)

References 41 publications

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“…In addition, an analysis by Lin et al of 18 studies found that cholecystectomy was associated with a 23% excess risk of pancreatic cancer [6] . In contrast, other studies found no effect of cholecystectomy on the risk of colorectal adenoma [42] , esophageal and gastric cancer [44] , rectal cancer [7] and colonic adenoma [43] . However, Chiong et al reported a statistically significant risk of rectal cancer (OR = 1.33) [5] and colonic adenoma (OR = 2.26) [43] if gallstones were present.…”

Section: Discussionmentioning

confidence: 81%

“…There is a long-standing debate about the risk of cancer in patients who have gallstones and undergo cholecystectomy. Several review studies have discussed the potential risk of gallstones or cholecystectomy in various tumors, such as colorectal [42] and colonic adenomas [43] , and in several types of cancer, such as colorectal [5] , [7] , [8] , pancreatic [6] , esophageal, and gastric [44] . In 1993, Giovannucci et al found a 34% increased risk of colorectal cancer following cholecystectomy based on combined results from 33 case-control studies [8] .…”

Section: Discussionmentioning

confidence: 99%

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Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis

Liu

et al. 2014

PLoS ONE

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BackgroundRecent epidemiological evidence points to an association between gallstones or cholecystectomy and the incidence risk of liver cancer, but the results are inconsistent. We present a meta-analysis of observational studies to explore this association.MethodsWe identified studies by a literature search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and relevant conference proceedings up to March 2014. A random-effects model was used to generate pooled multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Between-study heterogeneity was assessed using Cochran’s Q statistic and the I2. ResultsFifteen studies (five case-control and 10 cohort studies) were included in this analysis. There were 4,487,662 subjects in total, 17,945 diagnoses of liver cancer, 328,420 exposed to gallstones, and 884,507 exposed to cholecystectomy. Pooled results indicated a significant increased risk of liver cancer in patients with a history of gallstones (OR = 2.54; 95% CI, 1.71–3.79; n = 11 studies), as well as cholecystectomy (OR = 1.62; 95% CI, 1.29–2.02; n = 12 studies), but there was considerable heterogeneity among these studies. The effects estimates did not vary markedly when stratified by gender, study design, study region, and study quality. The multivariate meta-regression analysis suggested that study region and study quality appeared to explain the heterogeneity observed in the cholecystectomy analysis.ConclusionsOur results suggest that individuals with a history of gallstones and cholecystectomy may have an increased risk of liver cancer.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis

Liu

et al. 2014

PLoS ONE

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“…Although a few studies have reported a positive association between cholecystectomy and CRC risk [12] [13], previous meta-analyses have reported that cholecystectomy was not associated with the risk of proximal colon cancer [7], rectal cancer [8] or colorectal adenoma [9]. However, most of the previous studies adjusted only for age and sex [10].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported conflicting results on associations between gallstones and/or cholecystectomy and CRC [7,8] or colorectal adenoma [9]. Further, risks may be differentially associated with cancer at different anatomical locations within the colon [10].…”

Section: Introductionmentioning

confidence: 99%

Cholecystectomy and the risk of colorectal cancer by tumor mismatch repair deficiency status

Jie

Reece

Buchanan

et al. 2016

Int J Colorectal Dis

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Purpose Gallbladder diseases and cholecystectomy may play a role in the development of colorectal cancer (CRC). Our aim was to investigate the association between cholecystectomy and CRC risk overall and by sex, family history, anatomical location, and tumor mismatch repair (MMR) status. Methods This study comprised 5,847 incident CRC cases recruited from population cancer registries in Australia, Canada and USA into the Colon Cancer Family Registry between 1997 and 2012, and 4,970 controls with no personal history of CRC who were either randomly selected from the general population or were spouses of the cases. The association between cholecystectomy and CRC was estimated using logistic regression, after adjusting for confounding factors. Results Overall, there was no evidence for an association between cholecystectomy and CRC (odds ratio [OR] = 0.88, 95% confidence interval: 0.73, 1.08). In the stratified analyses, there was no evidence for a difference in the association between women and men (P=.54), between individuals with and without family history of CRC in first-degree relative (P=.64), between tumor anatomical locations (P=.45), or between MMR-proficient and MMR-deficient cases (P=.54). Conclusion Cholecystectomy is not a substantial risk factor for CRC, regardless of sex, family history, anatomical location, or tumor MMR status.

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“…Cholecystectomy is thought to increase CRC risk by increasing bile salt exposure to the GI mucosa, particularly the proximal colon that may increase the rate of adenoma formation or the rate of transformation to invasive carcinoma. Several large metaanalyses have reported an association, though more recent studies have not demonstrated this effect [41][42][43]. To explore this association, a large cohort population study of patients undergoing colonoscopy were evaluated for lifestyle and dietary conditions that might be associated with adenoma formation.…”

Section: Inflammatory Bowel Disease (Ibd) Either Ulcerative Colitis Ormentioning

confidence: 99%

Risk Factors for Colorectal Cancer

Peterson¹

2015

MOJS

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In this review, modifiable and non-modifiable risk factors that contribute to development of colorectal cancer are discussed, exploring the role of genetics and heritable colon cancer syndromes along with medical comorbidities that influence risk. Socioeconomic factors that contribute to colorectal cancer risk are explored along with various health-related behavioral patterns such as obesity, smoking, and diet. Recent data suggesting changes in the incidence of colorectal cancer in the last decade is also reviewed. The rationale for a long-term population-based exploration of these issues is laid out to identify areas in which intervention can promote healthy behaviors, avoid disease, and optimize treatments.

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Meta-analysis of observational studies on cholecystectomy and the risk of colorectal adenoma

Cited by 10 publications

References 41 publications

Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis

Risk of Primary Liver Cancer Associated with Gallstones and Cholecystectomy: A Meta-Analysis

Cholecystectomy and the risk of colorectal cancer by tumor mismatch repair deficiency status

Risk Factors for Colorectal Cancer

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