Cholecystectomy Not Likely to Cause Gastric Cancer

A new study has found that cholecystectomy (surgical removal of the gallbladder) is in all probability not causally related to gastric cancer.

Researchers at the Karolinska Institutet (Stockholm, Sweden) evaluated the risk of gastric cancer within a cohort of 251,672 individuals in the Swedish national inpatient register, who had undergone cholecystectomy between 1970 and 1997. All incident cases of gastric cancer were identified through linkage to the Swedish cancer registry. Standardized incidence ratios (SIRs) were calculated for comparisons with cancer rates of the general population in Sweden.

The study found that the risk of distal gastric cancer was 41% higher the first year after cholecystectomy than in the general population, but this excess risk fell to 11% higher during the ensuing 10 years. Beyond 10 years, the excess risk of distal gastric cancer almost completely disappeared. The excess risk of distal gastric cancer was apparent only among men and only among patients with more extensive surgery (cholecystectomy with choledocholithotomy). Similarly, the risk of gastric cardia cancer was twice as high during the first year after cholecystectomy as in the general population, but this excess risk completely disappeared thereafter, and there was no difference in risk according to sex or extent of surgery. The study findings were published in the June 2007 edition of the American Journal of Gastroenterology.

"Assuming a long latency time between initiation of gastric carcinogenesis and clinical presentation of gastric cancer and a continuous exposure, we would, contrary to our finding, have anticipated a trend of increasing risk with longer follow-up,” said lead author Dr. Katja Fall and colleagues. "Also, even with a delayed onset of disease among women, we would have expected some excess risk among women in the oldest age category and/or with the longest follow-up.”


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