Gallstones and the risk of biliary tract cancer: a population-based study in China A W Hsing1, Y-T Gao2, T-Q Han3, A Rashid4, L C Sakoda5, B-S Wang6, M-C Shen7, B-H Zhang8, S Niwa9, J Chen10 and J F Fraumeni Jr1 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20852-7234, USA 2Shanghai Cancer Institute, Shanghai, China 3Ruijin Hospital, Shanghai Second Medical University, Shanghai, China 4Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA 5Department of Epidemiology, University of Washington, Seattle, WA 98195 6Zhongshan Hospital, Fudan University, Shanghai, China 7Shanghai Tumor Hospital, Shanghai, China 8Institute of Oriental Hepatobiliary Surgery, Second Military Medical University, Shanghai, China 9Westat Inc., Rockville, MD, USA 10University of Pennsylvania, Philadelphia, PA, USA Correspondence to: Dr AW Hsing, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 5024, MSC 7234, 6120 Executive Blvd., Bethesda, MD 20852-7234, USA. E-mail: hsinga@mail.nih.gov Received 10 September 2007; revised 26 September 2007; accepted 26 September 2007; published online 13 November 2007 We conducted a population-based study of 627 patients with biliary tract cancers (368 of gallbladder, 191 bile duct, and 68 ampulla of Vater), 1037 with biliary stones, and 959 healthy controls randomly selected from the Shanghai population, all personally interviewed. Gallstone status was based on information from self-reports, imaging procedures, surgical notes, and medical records. Among controls, a transabdominal ultrasound was performed to detect asymptomatic gallstones. Gallstones removed from cancer cases and gallstone patients were classified by size, weight, colour, pattern, and content of cholesterol, bilirubin, and bile acids. Of the cancer patients, 69% had gallstones compared with 23% of the population controls. Compared with subjects without gallstones, odds ratios associated with gallstones were 23.8 (95% confidence interval (CI), 17.0-33.4), 8.0 (95% CI 5.6-11.4), and 4.2 (95% CI 2.5-7.0) for cancers of the gallbladder, extrahepatic bile ducts, and ampulla of Vater, respectively, persisting when restricted to those with gallstones at least 10 years prior to cancer. Biliary cancer risks were higher among subjects with both gallstones and self-reported cholecystitis, particularly for gallbladder cancer (OR=34.3, 95% CI 19.9-59.2). Subjects with bile duct cancer were more likely to have pigment stones, and with gallbladder cancer to have cholesterol stones (P<0.001). Gallstone weight in gallbladder cancer was significantly higher than in gallstone patients (4.9 vs 2.8 grams; P=0.001). We estimate that in Shanghai 80% (95% CI 75-84%), 59% (56-61%), and 41% (29-59%) of gallbladder, bile duct, and ampulla of Vater cancers, respectively, could be attributed to gallstones. British Journal of Cancer (2007) 97, 1577-1582. doi:10.1038/sj.bjc.6604047 www.bjcancer.com Published online 13 November 2007 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.