A meta-analysis of cholecystectomy and risk of colorectal cancer

Edward Giovannucci, Graham A. Colditz, Meir J. Stampfer

Research output: Contribution to journalArticlepeer-review

135 Scopus citations

Abstract

Background: Over 60 studies have addressed the hypothesis that the risk of colorectal cancer is increased following cholecystectomy; these studies have yielded inconsistent findings. The aim of the present study was to quantitatively summarize the results from the collective studies. Methods: A meta-analysis of the published studies addressing the relation between cholecystectomy and colorectal cancer was conducted. Results: The combined results from 33 case-control studies showed an association between Cholecystectomy and risk of colorectal cancer (pooled relative risk [RR] = 1.34; 95% confidence interval [CI] = 1.14-1.57), particularly when limited to the proximal colon (RR = 1.88; 95% CI = 1.54-2.30). In most studies, the risk was stronger when the first 5-15 years following the surgery were excluded. The results from 6 cohort studies, with follow-up to approximately 15 years postcholecystectomy, were generally null (RR = 0.97; 95% CI = 0.82-1.14). A more limited body of evidence suggests that cholelithiasis is related to an elevated risk of proximal colon cancer. Conclusions: Because the risks varied substantially by study design and because time since cholecystectomy or potentially confounding factors were often not considered, we could not firmly quantitate this risk. However, the findings are consistent with other evidence that suggests some characteristic of bile acid metabolism increases the risk of cancer of the proximal colon.

Original languageEnglish
Pages (from-to)130-141
Number of pages12
JournalGastroenterology
Volume105
Issue number1
DOIs
StatePublished - Jul 1993

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