Cholelithiasis and risk of pancreatic cancer: systematic review and meta-analysis of 21 observational studies
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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.
KeywordsCholelithiasis Pancreatic cancer Systematic review Meta-analysis Relative risks
Summary relative risks
Body mass index
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.
- 2.StatBite (2010) U.S. pancreatic cancer rates. J Natl Cancer Inst 102:1822Google Scholar
- 4.Yeo CJ, Abrams RA, Grochow LB, Sohn TA, Ord SE et al (1997) Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival: a prospective, single-institution experience. Ann Surg 225(621–633):633–636Google Scholar
- 11.Gupta S, Vittinghoff E, Bertenthal D, Corley D, Shen H et al (2006) New-onset diabetes and pancreatic cancer. Clin Gastroenterol Hepatol 4(1366–1372):1301Google Scholar
- 17.Chen YK, Yeh JH, Lin CL, Peng CL, Sung FC et al (2014) Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study. J Gastroenterol 49:923–931Google Scholar
- 23.Wells GA, Shea B, O’connel D (2010) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa, Ottawa Health Research InstituteGoogle Scholar
- 44.Agrawal S, Jonnalagadda S (2000) Gallstones, from gallbladder to gut. Management options for diverse complications. Postgrad Med 108(143–146):149–153Google Scholar