Association between gallstones or cholecystectomy and upper gastrointestinal cancers: a systematic review and meta-analysis
File(s)
Accepted version
Author(s)
Li, Fangqing
Murphy, Gwen A
Mortell, Gemma
Cross, Amanda
Harewood, Rhea
Type
Journal Article
Abstract
Background
Gallstones and cholecystectomy may be associated with upper gastrointestinal cancer risk but findings from individual studies are inconsistent. We undertook a systematic review and meta-analysis of available evidence.
Methods
PubMed/MEDLINE and Embase were searched through April 2026 to identify case-control and cohort studies investigating gallstones or cholecystectomy and oesophageal or gastric cancer risk. Random effects models estimated pooled relative risks (RRs) and 95% confidence intervals (CIs) for oesophageal and gastric cancer. Heterogeneity was evaluated using I2 and τ2 statistics.
Results
This meta-analysis included 17 studies. There was no association between gallstones [RR (95%CI) = 1.05 (0.97-1.14)] or cholecystectomy [RR (95% CI) = 0.98 (0.88-1.11)] and oesophageal cancer; however, both were positively associated with gastric cancer [RR (95% CI) = 1.25 (1.08-1.44); 1.11 (1.06-1.15), respectively]. In subgroup analyses, cholecystectomy was positively associated with non-cardia [RR (95%CI) = 1.17 (1.04-1.33)] but not cardia gastric cancer [RR (95% CI) = 0.89 (0.78-1.02)]; there were no other statistically significant associations by subtype/subsite, however data were limited for some subgroups.
Conclusions
Gallstones and cholecystectomy were positively associated with gastric cancer, cholecystectomy was specifically associated with non-cardia gastric cancer. Additional large-scale longitudinal studies are needed to clarify associations by cancer subtype and subsite.
PROSPERO registration: CRD42024563020
Gallstones and cholecystectomy may be associated with upper gastrointestinal cancer risk but findings from individual studies are inconsistent. We undertook a systematic review and meta-analysis of available evidence.
Methods
PubMed/MEDLINE and Embase were searched through April 2026 to identify case-control and cohort studies investigating gallstones or cholecystectomy and oesophageal or gastric cancer risk. Random effects models estimated pooled relative risks (RRs) and 95% confidence intervals (CIs) for oesophageal and gastric cancer. Heterogeneity was evaluated using I2 and τ2 statistics.
Results
This meta-analysis included 17 studies. There was no association between gallstones [RR (95%CI) = 1.05 (0.97-1.14)] or cholecystectomy [RR (95% CI) = 0.98 (0.88-1.11)] and oesophageal cancer; however, both were positively associated with gastric cancer [RR (95% CI) = 1.25 (1.08-1.44); 1.11 (1.06-1.15), respectively]. In subgroup analyses, cholecystectomy was positively associated with non-cardia [RR (95%CI) = 1.17 (1.04-1.33)] but not cardia gastric cancer [RR (95% CI) = 0.89 (0.78-1.02)]; there were no other statistically significant associations by subtype/subsite, however data were limited for some subgroups.
Conclusions
Gallstones and cholecystectomy were positively associated with gastric cancer, cholecystectomy was specifically associated with non-cardia gastric cancer. Additional large-scale longitudinal studies are needed to clarify associations by cancer subtype and subsite.
PROSPERO registration: CRD42024563020
Date Acceptance
2026-08-15
Citation
BMC Cancer
ISSN
1471-2407
Publisher
BMC
Journal / Book Title
BMC Cancer
Copyright Statement
Subject to copyright. This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
Publication Status
Accepted