Abstract:
BACKGROUND:Over 60 studies have addressed the hypothesis that the risk of colorectal cancer is increased following cholecystectomy; these studies have yielded inconsistent findings. The aim of the present study was to quantitatively summarize the results from the collective studies. METHODS:A meta-analysis of the published studies addressing the relation between cholecystectomy and colorectal cancer was conducted. RESULTS:The combined results from 33 case-control studies showed an association between cholecystectomy and risk of colorectal cancer (pooled relative risk [RR] = 1.34; 95% confidence interval [CI] = 1.14-1.57), particularly when limited to the proximal colon (RR = 1.88; 95% CI = 1.54-2.30). In most studies, the risk was stronger when the first 5-15 years following the surgery were excluded. The results from 6 cohort studies, with follow-up to approximately 15 years postcholecystectomy, were generally null (RR = 0.97; 95% CI = 0.82-1.14). A more limited body of evidence suggests that cholelithiasis is related to an elevated risk of proximal colon cancer. CONCLUSIONS:Because the risks varied substantially by study design and because time since cholecystectomy or potentially confounding factors were often not considered, we could not firmly quantitate this risk. However, the findings are consistent with other evidence that suggests some characteristic of bile acid metabolism increases the risk of cancer of the proximal colon.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Giovannucci E,Colditz GA,Stampfer MJdoi
10.1016/0016-5085(93)90018-8subject
Has Abstractpub_date
1993-07-01 00:00:00pages
130-41issue
1eissn
0016-5085issn
1528-0012pii
0016-5085(93)90018-8journal_volume
105pub_type
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