Gallbladder disease, cholecystectomy, and pancreatic cancer risk in the International Pancreatic Cancer Case-Control Consortium (PanC4)

Valentina Rosato, Eva Negri, Cristina Bosetti, Núria Malats, Paulina Gomez-Rubio, Pan Gen EU Consortium, Patrick Maisonneuve, Anthony B. Miller, H. Bas Bueno-De-Mesquita, Peter A. Baghurst, Witold Zatonski, Gloria M. Petersen, Ghislaine Scelo, Ivana Holcatova, Eleonora Fabianova, Diego Serraino, Sara H. Olson, Jesús Vioque, Pagona Lagiou, Eric J. DuellPaolo Boffetta, Carlo La Vecchia

Research output: Contribution to journalArticle

Abstract

Background The association among gallbladder disease, cholecystectomy, and pancreatic cancer is unclear. Moreover, time interval between gallbladder disease or cholecystectomy and pancreatic cancer diagnosis is not considered in most previous studies. Aim To quantify the association among gallbladder disease, cholecystectomy, and pancreatic cancer, considering time since first diagnosis of gallbladder disease or cholecystectomy. Methods We used data from nine case-control studies within the Pancreatic Cancer Case-Control Consortium, including 5760 cases of adenocarcinoma of the exocrine pancreas and 8437 controls. We estimated pooled odds ratios and the corresponding 95% confidence intervals by estimating study-specific odds ratios through multivariable unconditional logistic regression models, and then pooling the obtained estimates using fixed-effects models. Results Compared with patients with no history of gallbladder disease, the pooled odds ratio of pancreatic cancer was 1.69 (95% confidence interval, 1.51-1.88) for patients reporting a history of gallbladder disease. The odds ratio was 4.90 (95% confidence interval, 3.45-6.97) for gallbladder disease diagnosed <2 years before pancreatic cancer diagnosis and 1.11 (95% confidence interval, 0.96-1.29) when ≥2 years elapsed. The pooled odds ratio was 1.64 (95% confidence interval, 1.43-1.89) for patients who underwent cholecystectomy, as compared to those without cholecystectomy. The odds ratio was 7.00 (95% confidence interval, 4.13-11.86) for a surgery <2 years before pancreatic cancer diagnosis and 1.28 (95% confidence interval, 1.08-1.53) for a surgery ≥2 years before. Conclusions There appears to be no long-term effect of gallbladder disease on pancreatic cancer risk, and at most a modest one for cholecystectomy. The strong short-term association can be explained by diagnostic bias and reverse causation.

Original languageEnglish (US)
Pages (from-to)408-415
Number of pages8
JournalEuropean Journal of Cancer Prevention
Volume29
Issue number5
DOIs
StatePublished - Sep 1 2020

Keywords

  • case-control studies
  • cholecystectomy
  • gallbladder disease
  • pancreatic cancer
  • pooled analysis
  • risk factors

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

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  • Cite this

    Rosato, V., Negri, E., Bosetti, C., Malats, N., Gomez-Rubio, P., Consortium, P. G. EU., Maisonneuve, P., Miller, A. B., Bueno-De-Mesquita, H. B., Baghurst, P. A., Zatonski, W., Petersen, G. M., Scelo, G., Holcatova, I., Fabianova, E., Serraino, D., Olson, S. H., Vioque, J., Lagiou, P., ... La Vecchia, C. (2020). Gallbladder disease, cholecystectomy, and pancreatic cancer risk in the International Pancreatic Cancer Case-Control Consortium (PanC4). European Journal of Cancer Prevention, 29(5), 408-415. https://doi.org/10.1097/CEJ.0000000000000572