Cancer Causes & Control

, Volume 25, Issue 11, pp 1543–1551 | Cite as

Cholelithiasis and risk of pancreatic cancer: systematic review and meta-analysis of 21 observational studies

  • Yuanfeng Gong
  • Siying Li
  • Yunqiang Tang
  • Cong Mai
  • Mingchen Ba
  • Peng Jiang
  • Hui Tang
Original paper



To investigate the association between cholelithiasis and risk of pancreatic cancer (PaC).


We identified eligible studies in MEDLINE and EMBASE up to August 1, 2013 and the reference lists of original studies and review articles on this topic. Summary relative risks (SRRs) with their 95 % confidence intervals (CIs) were calculated with a random-effects model.


Twenty-one studies (15 case–control studies, 6 cohort studies) met eligibility criteria. The current data suggest that cholelithiasis is associated with a 25 % excess risk of PaC (SRRs = 1.25, 95 % CI 1.10–1.41; test for heterogeneity p = 0.006, I 2 = 47.6 %). In subgroup analysis of timing of exposure, seven of eight studies in patients whose diagnosis of cholelithiasis made more than specified year (5, 3, 2, or 1 year) prior to cancer diagnosis showed no association for PaC, while all three studies in patients diagnosed less than specified year before cancer diagnosis showed a positive association. There was no publication bias in the present meta-analysis.


This meta-analysis supports the hypothesis that a history of cholelithiasis may significantly increase PaC risk, particularly in Asian countries. However, the positive association disappeared over time, suggesting that cholelithiasis may be the early symptoms of PaC.


Cholelithiasis Pancreatic cancer Systematic review Meta-analysis Relative risks 



Pancreatic cancer


Odds ratio


Relative risk


Hazard ratio


Summary relative risks


Confidence intervals


Body mass index


Diabetes mellitus



This work was supported by a grant from the Scientific Study Project Foundation of Guangzhou medical University (No. 2013A43).

Conflict of interest

The authors have declared that no competing interests exist.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Yuanfeng Gong
    • 1
  • Siying Li
    • 2
  • Yunqiang Tang
    • 1
  • Cong Mai
    • 1
  • Mingchen Ba
    • 1
  • Peng Jiang
    • 1
  • Hui Tang
    • 1
  1. 1.Department of Hepatobiliary SurgeryAffiliated Cancer Hospital of Guangzhou Medical UniversityGuangzhouChina
  2. 2.Department of NeurologyThird Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina

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