Screen-detected gallstone disease and risk of liver and pancreatic cancer: The Kailuan Cohort Study

Liver Int. 2020 Jul;40(7):1744-1755. doi: 10.1111/liv.14456. Epub 2020 May 25.

Abstract

Background: Few studies have examined the risk of gastrointestinal cancers in screen-detected gallstone disease. This study aimed to investigate the association between screen-detected gallstone disease and gastrointestinal cancers using the Kailuan cohort, a population-based prospective cohort initiated in 2006.

Methods: A total of 79 809 men who underwent gallbladder ultrasonography, were free of cancers in 2006 and did not have gastrointestinal cancers within one year were enrolled. A Cox proportional hazards model with age as the timescale was used to evaluate the association between screen-detected gallstone disease and gastrointestinal cancers.

Results: We identified 1264 cases with gastrointestinal cancers, including 303 cases with liver cancer and 94 cases with pancreatic cancer. Screen-detected gallstone disease increased the risk of liver cancer, with an HR of 2.28 [95% confidence interval (CI): 1.20-4.33, P = .012]. The association was modified by the hepatitis B surface antigen status. A non-significant positive association was observed between pancreatic cancer and gallstone disease (HR 2.19, 95% CI: 0.95-5.05, P = .065). However, the HR became significant after those individuals with diabetes were excluded (HR 2.60, 95% CI: 1.12-6.01, P = .026).

Conclusion: Screen-detected gallstone disease may predict the risk for liver and pancreatic cancer.

Keywords: cohort; gallstones; liver cancer; pancreatic cancer; screen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholecystectomy
  • Cohort Studies
  • Gallstones* / diagnostic imaging
  • Gallstones* / epidemiology
  • Gallstones* / surgery
  • Humans
  • Liver
  • Male
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors