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Journal of Gastroenterology
Published in: Journal of Gastroenterology 5/2014

01-05-2014 | Original Article—Liver, Pancreas, and Biliary Tract

Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study

Authors: Yen-Kung Chen, Jiann-Horng Yeh, Cheng-Li Lin, Chiao-Ling Peng, Fung-Chang Sung, Ing-Ming Hwang, Chia-Hung Kao

Published in: Journal of Gastroenterology | Issue 5/2014

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Abstract

Background

This study examined the association of cholelithiasis post-cholecystectomy with subsequent cancers and evaluated the risk of cancer in patients with both cholelithiasis and cholecystectomy.

Methods

The Taiwanese National Health Insurance Research Database was used to identify 15545 newly diagnosed cholelithiasis patients from 2000 to 2010, and 62180 frequency-matched non-cholelithiasis patients. A total of 5850 (37.6 %) with cholelithiasis patients received a cholecystectomy. The risk of developing cancer after cholecystectomy was measured using the Cox proportional-hazards model.

Results

The incidence of developing cancer in the cholelithiasis cohort was 1.52-fold higher than that in the comparison cohort (p < 0.001). Compared with patients aged 20–34 years, patients in older age groups had a higher risk of developing cancer. The hazard ratio (HR) for developing gallbladder, extrahepatic bile duct, pancreatic, liver, stomach, and colorectal cancer was 59.3, 10.7, 3.12, 1.90, 1.71, and 1.36-fold higher for patients with cholelithiasis, respectively. After a cholecystectomy, the HR for developing stomach and colorectal cancer was 1.81-fold and 1.56-fold, respectively. The incidence rate ratio was higher for the first 5 years and over 5 years (5.05 and 4.46, respectively) (95 % confidence interval 4.73–5.39 and 4.11–4.84, respectively) in proximal colon and stomach cancer patients with cholecystectomies.

Conclusions

Cholelithiasis patients have a higher risk of gastrointestinal cancer, particularly of gallbladder and extrahepatic bile duct cancer. Post-cholecystectomy patients have a risk of colorectal and stomach cancer within the first 5 years and persisting after 5 years, respectively. This paper proposes strategies for preventing gastrointestinal cancer.
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Metadata
Title
Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study
Authors
Yen-Kung Chen
Jiann-Horng Yeh
Cheng-Li Lin
Chiao-Ling Peng
Fung-Chang Sung
Ing-Ming Hwang
Chia-Hung Kao
Publication date
01-05-2014
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 5/2014
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-013-0846-6

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