Skip to main content
Log in

Does the Frequency of Cholecystectomy Affect the Ensuing Incidence of Gallbladder Cancer in Sweden? A Population-Based Study with a 16-Year Coverage

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

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.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. 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

    Article  PubMed  CAS  Google Scholar 

  2. Stinton LM, Shaffer EA (2012) Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 6:172–187

    Article  PubMed  PubMed Central  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. De Aretxabala X, Roa I, Hepp J et al (2009) Early gallbladder cancer: is further treatment necessary? J Surg Oncol 100:589–593

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. Lazcano-Ponce EC, Miquel JF, Muñoz N et al (2001) Epidemiology and Molecular Pathology of Gallbladder Cancer. CA Cancer J Clin 51:349–364

    Article  PubMed  CAS  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602

    Article  PubMed  CAS  Google Scholar 

  11. Cariati A, Piromalli E, Cetta F (2014) Gallbladder cancers: associated conditions, histological types, prognosis, and prevention. Eur J Gastroenterol Hepatol 26:562–569

    Article  PubMed  Google Scholar 

  12. 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

    Article  PubMed  CAS  Google Scholar 

  13. Diehl A (1983) Gallstone size and the risk of gallbladder cancer. JAMA 250:2323–2326

    Article  PubMed  CAS  Google Scholar 

  14. Randi G, Malvezzi M, Levi F et al (2009) Epidemiology of biliary tract cancers: an update. Ann Oncol 20:146–159

    Article  PubMed  CAS  Google Scholar 

  15. 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

    Article  PubMed  CAS  Google Scholar 

  16. 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

    Article  PubMed  CAS  Google Scholar 

  17. Urbach DR, Stukel TA (2005) Rate of elective cholecystectomy and the incidence of severe gallstone disease. Can Med Assoc J 172:1015–1019

    Article  Google Scholar 

  18. Diehl A, Beral V (1981) Cholecystectomy and changing mortality from gallbladder cancer. Lancet 2:187–189

    Article  PubMed  CAS  Google Scholar 

  19. 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

    PubMed  CAS  Google Scholar 

  20. 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

    Article  PubMed  PubMed Central  Google Scholar 

  21. 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

    Article  PubMed  CAS  Google Scholar 

  22. Shrikhande S, Barreto S, Singh S et al (2010) Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol 36:514–519

    Article  PubMed  CAS  Google Scholar 

  23. Sandblom G, Enochsson L (2015) 2014 annual report for the Swedish Register for gallstone and ERCP. Available at GallRiks.se

  24. 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

    Article  PubMed  CAS  Google Scholar 

  25. 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

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  26. 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

    Article  PubMed  Google Scholar 

  27. (1993) NIH Consensus conference. Gallstones and laparoscopic cholecystectomy. JAMA 269:1018–1024

  28. 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

    Article  PubMed  CAS  Google Scholar 

  29. 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

    Article  PubMed  Google Scholar 

  30. 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

    CAS  Google Scholar 

  31. Ransohoff D, Gracie W (1993) Treatment of gallstones. Ann Intern Med 119:606–619

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Noel.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest or financial support to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-015-3267-2

Keywords

Navigation