Gallstones and incident colorectal cancer in a large pan-European cohort study
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined the association between history of gallstones and CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a prospective cohort of over half a million participants from ten European countries. History of gallstones was assessed at baseline using a self-reported questionnaire. The analytic cohort included 334,986 participants; a history of gallstones was reported by 3,917 men and 19,836 women, and incident CRC was diagnosed among 1,832 men and 2,178 women (mean follow-up: 13.6 years). Hazard ratios (HR) and 95% confidence intervals (CI) for the association between gallstones and CRC were estimated using Cox proportional hazards regression models, stratified by sex, study centre and age at recruitment. The models were adjusted for body mass index, diabetes, alcohol intake and physical activity. A positive, marginally significant association was detected between gallstones and CRC among women in multivariable analyses (HR = 1.14, 95%CI 0.99-1.31, p = 0.077). The relationship between gallstones and CRC among men was inverse but not significant (HR = 0.81, 95%CI 0.63-1.04, p = 0.10). Additional adjustment for details of reproductive history or waist circumference yielded minimal changes to the observed associations. Further research is required to confirm the nature of the association between gallstones and CRC by sex.
Date Issued
2019-09-15
Date Acceptance
2018-10-26
Citation
International Journal of Cancer, 2019, 145 (6), pp.1510-1516
ISSN
0020-7136
Publisher
Wiley
Start Page
1510
End Page
1516
Journal / Book Title
International Journal of Cancer
Volume
145
Issue
6
Copyright Statement
© 2018 UICC. This is the pre-peer reviewed version of the following article: [Ward, H. A., Murphy, N. , Weiderpass, E. , Leitzmann, M. F., Aglago, E. , Gunter, M. J., Freisling, H. , Jenab, M. , Boutron‐Ruault, M. , Severi, G. , Carbonnel, F. , Kühn, T. , Kaaks, R. , Boeing, H. , Tjønneland, A. , Olsen, A. , Overvad, K. , Merino, S. , Zamora‐Ros, R. , Rodríguez‐Barranco, M. , Dorronsoro, M. , Chirlaque, M. , Barricarte, A. , Perez‐Cornago, A. , Trichopoulou, A. , Bamia, C. , Lagiou, P. , Masala, G. , Grioni, S. , Tumino, R. , Sacerdote, C. , Mattiello, A. , Bueno‐de‐Mesquita, B. , Vermeulen, R. , Van Gils, C. , Nyström, H. , Rutegård, M. , Aune, D. , Riboli, E. and Cross, A. J. (2019), Gallstones and incident colorectal cancer in a large pan‐European cohort study. Int. J. Cancer.], which has been published in final form at https://dx.doi.org/10.1002/ijc.32090
Sponsor
Imperial College Trust
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30585640
Grant Number
P47328
Subjects
EPIC
Gallstones
cohort
colorectal cancer
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2019-01-11