Cancer Causes & Control

, Volume 5, Issue 3, pp 267–272 | Cite as

Risk factors for extrahepatic bile duct cancers: Los Angeles County, California (USA)

  • Wong-Ho Chow
  • Joseph K. McLaughlin
  • Herman R. Menck
  • Thomas M. Mack
Research Papers

Abstract

Extrahepatic bile duct (EBD) cancers are rare and their risk factors are poorly understood. Except for a history of gallbladder diseases, evidence for other potential risk factors, such as excess body weight and use of tobacco and alcohol, is scant. A case-control study was conducted to examine risk factors for EBD cancers, including ampulla of Vater tumors, among Los Angeles County (California, USA) residents. Included were 105 histologically confirmed cases diagnosed between 1 March 1985 and 31 October 1989, aged 30 to 84 years, and 255 population-based controls frequency-matched to cases by gender and age in five-year groups. Cases and controls were interviewed about their demographic background and potential risk factors, including tobacco, alcohol, and beverage consumption, diet, medical history, and reproductive factors among women. For deceased cases, their next-of-kin were interviewed. Risk of cancers of both subsites of extrahepatic duct and ampulla of Vater increased with smoking of cigars/pipes or cigarettes. For both men and women, risks increased twofold or more among those who smoked cigarettes for 50 or more pack-years. While a history of gallbladder diseases substantially increased the risk of cancers of both subsites, excess body mass index was associated only with cancer of extrahepatic duct subsite (odds ratio [OR]=4.0, 95 percent confidence interval [CI]=1.1–14.2 among men and OR=2.7; CI=0.8–9.4 among women in the highest quartile relative to those in the lowest quartile). Alcohol drinkers had lower risks compared with nondrinkers, but no consistent trend was observed with amount consumed. No consistent patterns of risks were found for coffee, tea, diet, occupation, or reproductive factors. These results suggest that lifestyle-related factors, such as use of tobacco and excess body weight, play a role in EBD cancer risk.

Key words

Alcohol body mass index extrahepatic bile duct cancers risk factors tobacco smoking USA 

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References

  1. 1.
    Miller BA, Ries LAG, Hankey BF, Kosary CL, Edwards BK, eds.Cancer Statistics Review: 1973–1989. Rockville, MD, USA: National Cancer Institute, 1992; NIH Pub. No. 92-2789.Google Scholar
  2. 2.
    Mack TM, Menck HR. Epidemiology of cancer of the gallbladder and extrahepatic biliary passages. In: Correa P, Haenszel W, eds.Epidemiology of Cancer of the Digestive Tract. Boston, MA, USA: Martinus Nijhoff Publishers, 1982.Google Scholar
  3. 3.
    Fraumeni JF Jr, Kantor AF. Biliary tract: In: Schottenfeld D, Fraumeni JF Jr, eds.Cancer Epidemiology and Prevention. Philadelphia, PA, USA: WB Saunders, 1982.Google Scholar
  4. 4.
    Menck HR, Mack TM. Incidence of biliary tract cancer in Los Angeles.Natl Cancer Inst Monogr 1982;62: 95–9.PubMedGoogle Scholar
  5. 5.
    Strom BL, Hibberd PL, Soper KA, Stolley PD, Nelson WL. International variations in epidemiology of cancers of the extrahepatic biliary tract.Cancer Res 1985;45: 5165–8.PubMedGoogle Scholar
  6. 6.
    Yen S, Hsieh C-c, MacMahon B. Extrahepatic bile duct cancer and smoking, beverage consumption, past modical history, and oral-contraceptive use.Cancer 1987;59: 2112–6.PubMedGoogle Scholar
  7. 7.
    Renard P, Boutron MC, Faivre J, et al. Biliary tract cancers in Cote-d'Or (France): incidence and natural history.J Epidemiol Comm Health 1987;41: 344–8.Google Scholar
  8. 8.
    Kato K, Akai S, Tominaga S, Kato I. A case-control study of biliary tract cancer in Niigata Prefecture, Japan.Jpn J Cancer Res 1989;80: 932–8.PubMedGoogle Scholar
  9. 9.
    Ekbom A, Hsieh C-c, Yuen J, et al. Risk of extrahepatic bileduct cancer after cholecystectomy.Lancet 1993;342: 1262–5.PubMedGoogle Scholar
  10. 10.
    Bedikian AY, Valdivieso M, De La Cruz A, et al. Cancer of the extrahepatic bile duct.Med Pediat Oncol 1980;8: 53–61.Google Scholar
  11. 11.
    Lambe M, Trichopoulos D, Hsieh C-c, Ekbom A, Adami HO, Pavia M. Parity and cancers of the gall bladder and the extrahepatic bile ducts.Int J Cancer 1993;54: 941–4.PubMedGoogle Scholar
  12. 12.
    World Health Organization.International Classification of Diseases for Oncology, First Edition. Geneva, Switzerland: WHO, 1976.Google Scholar
  13. 13.
    Waksberg J. Sampling methods for random digit dialing.J Am Stat Assoc 1978;73: 40–6.Google Scholar
  14. 14.
    Hatten J. Medicare's common denominator: the covered population.Health Care Finance Rev 1980;2: 53–64.Google Scholar
  15. 15.
    Breslow NE, Day NE.Statistical Methods in Cancer Research. Volume I. The Analysis of Case-Control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.Google Scholar
  16. 16.
    McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF Jr. Stomach cancer and cigarette smoking among US veterans, 1954–1980.Cancer Res 1990;50: 3804.PubMedGoogle Scholar
  17. 17.
    Brinton LA.Epidemiology of Cervical Cancer-Review. Lyon, France: International Agency for Research on Cancer, 1992; IARC Sci. Pub. No. 119: 3–23.Google Scholar
  18. 18.
    McLaughlin JK, Mandel JS, Mehl ES, Blot WJ. Rehability of next-of-kin and self-respondents for cigarette, coffee, and alcohol consumption.Epidemiology 1990;1: 408–12.PubMedGoogle Scholar
  19. 19.
    Howe GR, Jain M, Burch JD, Miller AB. Cigarette smoking and cancer of the pancreas: evidence from a population-based case-control study in Toronto, Canada.Int J Cancer 1991;47: 323–8.PubMedGoogle Scholar
  20. 20.
    Hsing AW, McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF Jr. Cigarette smoking and liver cancer among US veterans.Cancer Causes Control 1990;1: 217–21.PubMedGoogle Scholar
  21. 21.
    Lew EA, Garfinkel L. Variations in mortality by weight among 750,000 men and women.J Chron Dis 1979;32: 563–76.PubMedGoogle Scholar
  22. 22.
    Zatonski W, La Vecchia C, Przewozniak K, Maisonneuve P, Lowenfels AB, Boyle P. Risk factors for gall-bladder cancer: a Polish case-control study.Int J Cancer 1992;51: 707–11.PubMedGoogle Scholar
  23. 23.
    Scragg RKR, McMichael AJ, Baghurst PA. Diet, alcohol, and relative weight in gall stone disease: a case-control study.Brit Med J 1984;288: 1113–9.Google Scholar
  24. 24.
    Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Speizer FE, Willett WC. Weight, diet, and the risk of symptomatic gallstones in middle-aged women.N Engl J Med 1989;321: 563–9.PubMedGoogle Scholar
  25. 25.
    Kato I, Nomura A, Stemmermann GN, Chyou P-H. Prospective study of clinical gallbladder disease and its association with obesity, physical activity, and other factors.Dig Dis Sci 1992;37: 784–90.PubMedGoogle Scholar
  26. 26.
    Diehl AK. Epidemiology of gallbladder cancer: a synthesis of recent data.JNCI 1980;65: 1209–13.PubMedGoogle Scholar
  27. 27.
    Mack TM. Pancreas. In: Schottenfeld D, Fraumeni JF Jr, eds.Cancer Epidemiology and Prevention. Philadelphia, PA, USA: WB Saunders, 1982.Google Scholar
  28. 28.
    Friedman GD, Van Den Eeden SK. Risk factors for pancreatic cancer: an exploratory study.Int J Epidemiol 1993;22: 30–7.PubMedGoogle Scholar
  29. 29.
    La Vecchia C, Negri E, D'Avanzo B, Franceschi S, Boyle P. Risk factors for gallstone disease requiring surgery.Int J Epidemiol 1991;20: 209–15.PubMedGoogle Scholar
  30. 30.
    Kato I, Kato K, Akai S, Tominaga S. A case-control study of gallstones: a major risk factor for biliary tract cancer.Jpn J Cancer Res 1990;81: 578–83.PubMedGoogle Scholar
  31. 31.
    Thornton J, Symes C, Heaton K. Moderate alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol.Lancet 1983;2: 819–22.PubMedGoogle Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • Wong-Ho Chow
    • 1
  • Joseph K. McLaughlin
    • 1
  • Herman R. Menck
    • 2
  • Thomas M. Mack
    • 3
  1. 1.Epidemiology and Biostatistics Program, Division of Cancer EtiologyNational Cancer Institute, EPN 415BethesdaUSA
  2. 2.the University of Southern CaliforniaLos Angeles
  3. 3.University of Southern CaliforniaLos AngelesUSA

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