Do Gallstones Predict Biliary Tract Cancers?

Some characteristics of gallstones appear to be associated with an increased risk of biliary tract cancers (BTC), but questions remain, according to investigators.

The etiology of BTCs, which are rare but often fatal, is not well understood, the authors noted in their article in Epidemiology and Health. Gallstones have been targeted as a major risk factor.

To shed some light on the true predictive value of gallstones, the investigators reviewed cohort and case-control studies published before April 9, 2018, from the MEDLINE, Embase, and Cochrane Central databases.

Each of the 7 cohort and 23 case-control studies conducted among Asian, European, and American populations included “appropriate risk estimates and confidence intervals for associations between the presence, size, number, or duration of gallstones and the risk of BTC, including gallbladder cancer (GBC), extrahepatic bile duct cancer (EBDC), and ampulla of Vater cancer (AOVC).”

The authors reported, “The presence of gallstones was associated with an increased risk of BTC (OR, 4.38; 95% CI, 3.23 to 5.93; I2=91.2%), GBC (OR, 7.26; 95% CI, 4.33 to 12.18), EBDC (OR, 3.17; 95% CI, 2.24 to 4.50), and AOVC (OR, 3.28; 95% CI, 1.33 to 8.11). Gallstone size (>1 vs. <1 cm; OR, 1.88; 95% CI, 1.10 to 3.22) was significantly associated with the risk of GBC.”

However, the investigators noted, “significantly high heterogeneity in the meta-analyses is a limitation of this study.”

—Rebecca Mashaw

Reference:

Huang D, Joo H, Song N, Cho S, Kim W, Shin A. Association between gallstones and the risk of biliary tract cancer: a systematic review and meta-analysis. Epidemiol Health. 2021;43:e2021011.  DOI: 10.4178/epih.e2021011