Large bowel cancer risk in cholelithiasis and after cholecystectomy. Postmortem study

To assess the large bowel cancer risk in cholelithiasis (CL) and after cholecystectomy (CE), the results of 11,828 autopsies were analyzed. 1,705 cases with CL and 380 with CE could be identified. Randomly selected cases matched for sex and age were used as controls. In CL and CE 61 cancers were observed compared with 53 in controls, the relative risk (RR) being 1.2. The risk ratio for the subgroups (CL, CE) was also 1.2. In contrast to women, there was a positive association (RR 1.7) between cancer and CL in men, in whom no risk increase was found after CE. In cases with CL and CE an elevated risk of developing proximal large bowel cancer was observed for both sexes (RR 1.7 in males and 1.4 in females). As regards distal cancer, no such relationship was observed in women (RR 0.83) whereas an increased risk was found in men (RR 2.3). The results of this study are in favor of a positive association between CL and CE and the risk of developing large bowel cancer.