Abstract
Background
Gallbladder cancer (GBC) is rare among the different gastrointestinal cancers with a significant global variation in incidence. High cholecystectomy rates on benign indications have been assumed to prevent the development of gallbladder cancer. The aim of the present study was to explore the relationship between the rate of cholecystectomy at different time periods and regions of the country and the annual incidence of GBC.
Methods
Standardized cholecystectomy and GBC incidences for Swedish counties have been obtained from the Swedish national inpatient and National Cancer registries for the years 1998–2013. The incidences have been calculated for ages over 15 years and per 100,000 population. The relationships between cholecystectomy and GBC incidences have been analyzed using regression models. Correlation analyses were performed for the total cumulative incidence rates as well as the incidence rates calculated for the first and last 8 years of the entire study period.
Results
Cholecystectomy rates ranged from 99 to 205 per 100,000 and year, and the GBC incidence from 2.3 to 5.1. Overall, we observed a slow but steady decline in cholecystectomy rates—as well as GBC incidences during the 16-year period. No significant correlation between the cholecystectomy rates and GBC incidences was seen.
Conclusions
This nationwide population-based study demonstrates substantial geographic differences in annual cholecystectomy rates without any significant inverse co-variation between cholecystectomy rates and the ensuing GBC incidence which would have supported the idea that frequent cholecystectomy affects the incidence of GBC.
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References
Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386
Stinton LM, Shaffer EA (2012) Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 6:172–187
Witjes CD, van den Akker SA, Visser O et al (2012) Gallbladder cancer in the Netherlands: incidence, treatment and survival patterns since 1989. Dig Surg 29:92–98
Mayo SC, Shore AD, Nathan H et al (2010) National trends in the management and survival of surgically managed gallbladder adenocarcinoma over 15 years: a population-based analysis. J Gastrointest Surg 14:1578–1591
De Aretxabala X, Roa I, Hepp J et al (2009) Early gallbladder cancer: is further treatment necessary? J Surg Oncol 100:589–593
Butte JM, Matsuo K, Gönen M et al (2011) Gallbladder cancer: differences in presentation, surgical treatment, and survival in patients treated at centers in three countries. J Am Coll Surg 212:50–61
Pawlik TM, Gleisner AL, Vigano L et al (2007) Incidence of finding residual disease for incidental gallbladder carcinoma: implications for re-resection. J Gastrointest Surg 11:1478–1486 discussion 1486
Lazcano-Ponce EC, Miquel JF, Muñoz N et al (2001) Epidemiology and Molecular Pathology of Gallbladder Cancer. CA Cancer J Clin 51:349–364
Jain K, Mohapatra T, Das P et al (2014) Sequential occurrence of preneoplastic lesions and accumulation of loss of heterozygosity in patients with gallbladder stones suggest causal association with gallbladder cancer. Ann Surg 260:1073–1080
Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602
Cariati A, Piromalli E, Cetta F (2014) Gallbladder cancers: associated conditions, histological types, prognosis, and prevention. Eur J Gastroenterol Hepatol 26:562–569
Nervi F, Duarte I, Gómez G et al (1988) Frequency of gallbladder cancer in Chile, a high-risk area. Int J Cancer 41:657–660
Diehl A (1983) Gallstone size and the risk of gallbladder cancer. JAMA 250:2323–2326
Randi G, Malvezzi M, Levi F et al (2009) Epidemiology of biliary tract cancers: an update. Ann Oncol 20:146–159
Moerman C, Lagerwaard F, Bueno de Mesquita H et al (1993) Gallstone size and the risk of gallbladder cancer. Scand J Gastroenterol 28:482–486
Halldestam I, Enell E-L, Kullman E, Borch K (2004) Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 91:734–738
Urbach DR, Stukel TA (2005) Rate of elective cholecystectomy and the incidence of severe gallstone disease. Can Med Assoc J 172:1015–1019
Diehl A, Beral V (1981) Cholecystectomy and changing mortality from gallbladder cancer. Lancet 2:187–189
Ahlberg J, Ewerth S, Hellers G, Holmström B (1978) Decreasing frequency of cholecystectomies in the counties of Stockholm and Uppsala, Sweden. Acta Chir Scand Suppl 482:21–23
Ludvigsson JF, Andersson E, Ekbom A et al (2011) External review and validation of the Swedish national inpatient register. BMC Public Health 11(1):450
Sheth S, Bedford A, Chopra S (2000) Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy. Am J Gastroenterol 95:1402–1410
Shrikhande S, Barreto S, Singh S et al (2010) Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol 36:514–519
Sandblom G, Enochsson L (2015) 2014 annual report for the Swedish Register for gallstone and ERCP. Available at GallRiks.se
Maringhini A, Moreau J, Melton L et al (1987) Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota. Ann Intern Med 107:30–35
Chow W, Johansen C, Gridley G et al (1999) Gallstones, cholecystectomy and risk of cancers of the liver, biliary tract and pancreas. Br J Cancer 79:640–644
Enochsson L, Thulin A, Österberg J et al (2013) The swedish registry of gallstone surgery and endoscopic retrograde cholangiopancreatography (gallriks): a nationwide registry for quality assurance of gallstone surgery. JAMA Surg 148:471–478
(1993) NIH Consensus conference. Gallstones and laparoscopic cholecystectomy. JAMA 269:1018–1024
Persson GE (1996) Expectant management of patients with gallbladder stones diagnosed at planned investigation. A prospective 5- to 7-year follow-up study of 153 patients. Scand J Gastroenterol 31:191–199
Wanjura V, Lundström P, Osterberg J et al (2014) Gastrointestinal quality-of-life after cholecystectomy: indication predicts gastrointestinal symptoms and abdominal pain. World J Surg 38:3075–3081. doi:10.1007/s00268-014-2736-3
Attili A, De Santis A, Capri R et al (1995) The natural history of gallstones: the GREPCO experience. The GREPCO Group. Hepatol Baltim Md 21:655–660
Ransohoff D, Gracie W (1993) Treatment of gallstones. Ann Intern Med 119:606–619
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Noel, R., Arnelo, U., Lundell, L. et al. Does the Frequency of Cholecystectomy Affect the Ensuing Incidence of Gallbladder Cancer in Sweden? A Population-Based Study with a 16-Year Coverage. World J Surg 40, 66–72 (2016). https://doi.org/10.1007/s00268-015-3267-2
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DOI: https://doi.org/10.1007/s00268-015-3267-2