Association of cholecystectomy with abdominal cancers

Five hundred and eighty-five randomly selected patients with abdominal cancer were examined with respect to previous cholecystectomy in the following groups: upper gastrointestinal (gastric or esophageal) cancer; biliary or pancreatic cancer; colorectal cancer, and urologic (renal, pelvic or ureteral) cancer. The frequency of cholecystectomy in each of these cancer groups was compared with that of cholecystectomy in the general population of the region from which the cancer patients came; the latter frequency was estimated in a previous epidemiological autopsy study. In all the gastrointestinal cancer groups studied there was a statistically significantly higher frequency of cholecystectomy than in the general population. In addition, the time interval from cholecystectomy to diagnosis of the cancer was determined. A trimodal distribution of this time interval was observed. The apex of the first peak was about 5, the second about 15, and the third about 23 years after cholecystectomy. Within the first period there was a statistically significant accumulation of biliary, and especially pancreatic, cancer (p = 0.007), and within the second and third periods an accumulation, though not statistically significant, of colorectal cancers (p = 0.07). Of the patients operated on ten years or less before the diagnosis of cancer, 96% were operated on for organic gallbladder disease. It seems that symptoms of upper gastrointestinal cancer, and especially of biliary or pancreatic cancer, may be misinterpreted as symptoms of cholepathy, and this may occur even when organic gallbladder disease is present. Furthermore, cholecystectomy might be a predisposing factor for the development of colorectal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)