Skip to main content
SpringerLink
Log in

Gallstones and colorectal cancer—There is a relationship, but it is hardly due to cholecystectomy

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

The prevalence of gallstone disease in 145 consecutive patients with colorectal cancer was compared with gallstone prevalence in 4,159 subjects randomly selected from a population. The group of patients had a significantly higher prevalence of gallstone disease than the population (odds ratio=1.59,95 percent confidence limits 1.04–2.45), whereas cholecystectomies occurred with equal frequency in the two groups. There was a nonsignificant trend toward more right-sided cancers in patients with gallstones than in patients without. These results, together with available literature, give substantial evidence for an association between gallstones and colorectal cancer, an association which is not due to cholecystectomy being a predisposing factor to colorectal cancer. Sporadic findings of an association between cholecystectomy and colorectal cancer can be explained by the above relationship.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hill MJ, Drasar BS, Williams RE,et al. Faecal bile-acids and clostridia in patients with cancer of the large bowel. Lancet 1975;i:535–9.

    Google Scholar 

  2. Reddy BS, Wynder EL. Metabolic epidemiology of colon cancer. Fecal bile acids and neutral sterols in colon cancer patients and patients with adenomatous polyps. Cancer 1977;39:2533–9.

    PubMed  CAS  Google Scholar 

  3. Turunen MJ, Kivilaakso EO. Increased risk of colorectal cancer after cholecystectomy. Ann Surg 1981;194:639–41.

    PubMed  CAS  Google Scholar 

  4. Lowenfels AB, Domellöf L, Lindström CG, Bergman F, Monk MA, Sternby NH. Cholelithiasis, cholecystectomy, and cancer: a case-control study in Sweden. Gastroenterology 1982;83:672–6.

    PubMed  CAS  Google Scholar 

  5. Schmauss von AK, Ehrhardt U. Cholelitiasis—Cholezystektomie und kolonkarzinom. Zentralbl Chir 1983;108:449–56.

    PubMed  CAS  Google Scholar 

  6. Allende HD, Ona FV, Davis HT. Gallbladder disease: risk factor for colorectal carcinoma? J Clin Gastroenterol 1984;6:51–5.

    PubMed  CAS  Google Scholar 

  7. von Machnik G, Füller C, Füller J, Kunath H. Explorative Untersuchungen zum gemeinsamen Vorkommen von Cholelithiasis, Zustand nach Cholezystektomie und Kolonkarzinom. Dtsch Z Verdau Stoffwechselkr 1986;46:22–9.

    PubMed  CAS  Google Scholar 

  8. Gafà M, Sarli L, Sansebastiano G,et al. Prevention of colorectal cancer. Role of association between gallstones and colorectal cancer. Dis Colon Rectum 1987;30:692–6.

    PubMed  Google Scholar 

  9. Breuer NF, Katschinski B, Mörtl E, Leder L-D, Goebell H. Large bowel cancer risk in cholelithiasis and after cholecystectomy. Postmortem study. Digestion 1988;40:219–26.

    Article  PubMed  CAS  Google Scholar 

  10. Hoare AM. Carcinoma of the colon and cholecystectomy. Lancet 1974;ii:1395–6.

    Google Scholar 

  11. Caprilli R, Pietroiusti A, Chierchini P, Giuliano M, Andreoli A, Prantera C. Relationship between cholecystectomy and colorectal cancer. Gastroenterology 1981;80:1120.

    Google Scholar 

  12. Manousos ON, Gerovassilis F, Paradimitriou CH, Tzonou A, Polychronopoulou A, Trichopoulos D. Cholecystectomy and colon cancer. Lancet 1981;ii:810.

    Google Scholar 

  13. Turnbull PR, Smith AH, Isbister WH. Cholecystectomy and cancer of the large bowel. Br J Surg 1981;68:551–3.

    PubMed  CAS  Google Scholar 

  14. Vernick LJ, Kuller LH. Cholecystectomy and rightsided colon cancer: an epidemiological study. Lancet 1981;ii:381–3.

    Google Scholar 

  15. Markman M. Cholecystectomy and carcinoma of the colon. Lancet 1982;ii:47.

    Google Scholar 

  16. Weiss NS, Daling JR, Chow WH. Cholecystectomy and the incidence of cancer of the large bowel. Cancer 1982;49:1713–5.

    PubMed  CAS  Google Scholar 

  17. Alley PG, Lee SP. The increased risk of proximal colonic cancer after cholecystectomy. Dis Colon Rectum 1983;26:522–4.

    PubMed  CAS  Google Scholar 

  18. Vobecky J, Caro J, Devroede G. A case-control study of risk factors for large bowel carcinoma. Cancer 1983;51:1958–63.

    PubMed  CAS  Google Scholar 

  19. Blanco D, Ross RK, Paganini-Hill A, Henderson BE. Cholecystectomy and colonic cancer. Dis Colon Rectum 1984;27:290–2.

    PubMed  CAS  Google Scholar 

  20. Erikson SG, Lindström CG. Lack of relationship between cholecystectomy and colorectal cancer. A case control autopsy study in a defined population. Scand J Gastroenterol 1984;19:977–82.

    Google Scholar 

  21. Fixa B, Komárková O, Zaydlar K, Bures T, Erben J. Is there an increased risk of colorectal cancer after cholecystectomy? Neoplasma 1985;32:513–7.

    PubMed  CAS  Google Scholar 

  22. Preitner J, Mosimann F, Chastonay PH. Le risque de cancer côlorectal après cholécystectomie. Helv Chir Acta 1985;52:127–30.

    PubMed  CAS  Google Scholar 

  23. Spitz MR, Russell NC, Guinee VF, Newell GR. Questionable relationship between cholecystectomy and colon cancer. J Surg Oncol 1985;30:6–9.

    PubMed  CAS  Google Scholar 

  24. Kaibara N, Wakatsuki T, Mizusawa K, Sugesawa A, Kimura O, Koga S. Negative correlation between cholecystectomy and the subsequent development of large bowel carcinoma in a low-risk Japanese population. Dis Colon Rectum 1986;29:644–6.

    PubMed  CAS  Google Scholar 

  25. Moorehead RJ, Kernohan RM, Patterson CC, McKelvey ST, Parks TG. Does cholecystectomy predispose to colorectal cancer? A case control study. Dis Colon Rectum 1986;29:36–8.

    PubMed  CAS  Google Scholar 

  26. Friedman GD, Goldhaber MK, Quesenberry CP Jr. Lancet 1987;i:906–8.

    Google Scholar 

  27. Hladík V, Nozicka Z, Maslowská H. Colorectal carcinoma and cholecystectomy. Neoplasma 1987;34:361–6.

    PubMed  Google Scholar 

  28. Hyvärinen H, Partanen S. Association of cholecystectomy with abdominal cancers. Hepatogastroenterology 1987;34:280–4.

    PubMed  Google Scholar 

  29. Kune GA, Kune S, Watson LF. Large bowel cancer after cholecystectomy. Am J Surg 1988;156:359–62.

    PubMed  CAS  Google Scholar 

  30. Mamianetti A, Cinto RO, Altolaguirre D, Bosicio OA, Heidenreich A, Salomón M. Relative risk of colorectal cancer after cholecystectomy. A multicentre casecontrol study. Int J Colorectal Dis 1988;3:215–8.

    PubMed  CAS  Google Scholar 

  31. Caprilli R, Ciarniello P, dePetris G, Giuliano M, Saltarelli P, Spagnolo A. Do colon and rectum exhibit an opposite cancer risk trend versus cholecystectomy? A case-double control study. Ital J Surg Sci 1989;19:29–35.

    PubMed  CAS  Google Scholar 

  32. Lee SS, Cha S, Lee RL. The relationship between cholecystectomy and colon cancer: an Iowa study. J Surg Oncol 1989;41:81–5.

    PubMed  CAS  Google Scholar 

  33. Berkel J, Hombergen DA, Hooymayers IE, Faber JAJ. Cholecystectomy and colon cancer. Am J Gastroenterol 1990;85:61–4.

    PubMed  CAS  Google Scholar 

  34. Linos DA, Beard CM, O'Fallon WM, Dockerty MB, Beart RW, Kurland LT. Cholecystectomy and carcinoma of the colon. Lancet 1981;ii:379–81.

    Google Scholar 

  35. Abrams JS, Anton JR, Dreyfuss DC. The absence of a relationship between cholecystectomy and the subsequent occurrence of cancer of the proximal colon. Dis Colon Rectum 1983;26:141–4.

    PubMed  CAS  Google Scholar 

  36. Rundgren Å, Mellström D. Cholecystectomy and colon cancer in the elderly. Age Ageing 1983;12:44–9.

    PubMed  CAS  Google Scholar 

  37. Raymond L, Egeli R, Obradovic M,et al. Cholécystectomie et cancers recto-coliques: résultats préliminaires d'une étude longitudinale. Med Soc Prev 1985;30:252–3.

    Google Scholar 

  38. Adami H-O, Krusemo UB, Meirik O. Unaltered risk of colorectal cancer within 14–17 years of cholecystectomy: updating of a population-based cohort study. Br J Surg 1987;74:675–8.

    PubMed  CAS  Google Scholar 

  39. Maringhini A, Moreau JA, Melton LJ, Hench VS, Zinmeister AR, diMagno EP. Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota. Ann Intern Med 1987;107:30–5.

    PubMed  CAS  Google Scholar 

  40. Gudmundsson S, Möller TR, Olsson H. Cancer incidence after cholecystectomy—a cohort study with 30 years follow-up. Eur J Surg Oncol 1989;15:113–7.

    PubMed  CAS  Google Scholar 

  41. Moorehead RJ, McKelvey STD. Cholecystectomy and colorectal cancer. Br J Surg 1989;76:250–3.

    PubMed  CAS  Google Scholar 

  42. Jørgensen T. Prevalence of gallstones in a Danish population. Am J Epidemiol 1987;126:912–21.

    PubMed  Google Scholar 

  43. Jørgensen T, Kay L, Schultz-Larsen K. The epidemiology of gallstones in a 70-year-old Danish population. Scand J Gastroenterol 1990;25:335–40.

    PubMed  Google Scholar 

  44. Breslow NE, Day NE. Statistical methods in cancer research. Vol 1. The analysis of case-control studies. IARC Scientific Publication No. 32. Monogr Eval Carcinog Risk Chem Hum, 1980.

  45. Jørgensen T. Gallstones in a Danish population: familial occurrence and social factors. J Biosoc Sci 1988;20:111–20.

    PubMed  Google Scholar 

  46. Jørgensen T. Gallstones. An epidemiological investigation. (Thesis.) Dan Med Bull 1990;37:336–46.

    Google Scholar 

  47. Pomare EW, Heaton KW. The effect of cholecystectomy on bile salt metabolism. Gut 1973;14:753–62.

    PubMed  CAS  Google Scholar 

  48. Almond HR, Vlahcevic ZR, Bell CC Jr, Gregory DH, Swell L. Bile acid kinetics and biliary lipid composition before and after cholecystectomy. N Engl J Med 1973;289:1213–6.

    Article  PubMed  CAS  Google Scholar 

  49. Adler RD, Metzger AL, Grundy SM. Biliary lipid secretion before and after cholecystectomy in American Indians with cholesterol gallstones. Gastroenterology 1976;66:1212–7.

    Google Scholar 

  50. van der Linden W, Katzenstein B, Nakayama F. The possible carcinogenic effect of cholecystectomy. No postoperative increase in the proportion of secondary bile acids. Cancer 1983;52:1265–8.

    PubMed  Google Scholar 

  51. Berr F, Stellaard F, Pratschke E, Paumgartner G. Effects of cholecystectomy on the kinetics of primary and secondary bile acids. J Clin Invest 1989;83:1541–50.

    Article  PubMed  CAS  Google Scholar 

  52. Castleden WM, Detchon P, Misso NLA. Biliary bile acids in cholelithiasis and colon cancer. Gut 1989;30:860–5.

    PubMed  CAS  Google Scholar 

  53. Werner B, deHeer K, Mitschke H. Cholecystectomy and carcinoma of the colon. An experimental study. Z Krebsforsch 1977;88:223–30.

    CAS  Google Scholar 

  54. Bandettini L, Filipponi F, Romagnoli P. Increase of the mitotic index of colonic mucosa after cholecystectomy. Cancer 1986;58:685–7.

    PubMed  CAS  Google Scholar 

  55. Vernick LJ, Kuller LH, Lohsoonthorn P, Rycheck RR, Redmond CK. Relationship between cholecystectomy and ascending colon cancer. Cancer 1980;45:392–5.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Glostrup Population Studies, Medical Department C, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark

    Torben Jørgensen M.D.

  2. Surgical Department K, Odense Hospital, University of Odense, Odense, Denmark

    Søren Rafaelsen M.D.

Authors
  1. Torben Jørgensen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Søren Rafaelsen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Jørgensen, T., Rafaelsen, S. Gallstones and colorectal cancer—There is a relationship, but it is hardly due to cholecystectomy. Dis Colon Rectum 35, 24–28 (1992). https://doi.org/10.1007/BF02053334

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02053334

Key words

Search

Navigation