Acute cholecystitis, an inflammatory disease of the gallbladder, is a known risk factor for gastrointestinal cancers, say researchers from Taipei Veterans General Hospital in Taiwan. Many studies have shown that the risk rises with cholelithiasis or after cholecystectomy. But they note that most studies have had limited adjustment for the potential risk factors for each specific cancer. Until their study, they say, no other study had focused on the general and specific cancer risks in patients with cholecystitis.
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In their retrospective study of 20,431 patients with cholecystitis, the researchers documented 1,541 cancers (mostly liver, colorectal, lung, extrahepatic biliary, and gastric) over a follow-up period of a median 5.4 years. Significantly higher hazard ratios (HRs) were found among patients with cholecystitis in liver cancer (95% confidence interval [CI], 1.73-2.34), biliary tract cancer (95% CI, 2.23-4.18), and pancreatic cancer (95% CI, 1.38-2.88). But after adjusting for other demographic characteristics and comorbidities, cholecystitis was an independent risk factor for biliary tract cancer, which doubled the risk for extrahepatic biliary cancer. Men aged < 60 years had the greatest risk of developing cancer. The increased risk of cancer persisted after 5 years of follow-up.
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Though the study findings supported the elevated risk for biliary tract cancer in patients who had had cholecystectomy, that risk was reduced after the researchers controlled for other risk factors. Their results suggested that, in fact, cholecystectomy markedly lowered the risk (HR dropped from 2.34 to 1.28), perhaps because it alleviated inflammation.
Source
Lee P-C, Hu Y-W, Hu L-Y, et al. Am J Med. 2015;128(2):185-191.
doi: 10.1016/j.amjmed.2014.08.036.
