Bacterial Gastroenteritis and the Risk of Biliary Tract Cancer: A Population-Based Study

Abstract

Background: Salmonella has shown to have oncogenic transformative effects and thereby increase the risk of certain cancers. For Campylobacter, no comparable effects have been demonstrated. Risk factor identification may allow for timely diagnosis and preventive treatment. To substantiate the oncogenic potential of Salmonella, this epidemiological study compared the incidence of extrahepatic biliary tract cancer (ehBTC) in patients with diagnosed Salmonella or Campylobacter infection with the ehBTC incidence in the general population. Methods: National infectious diseases surveillance records for patients aged ≥20 years when diagnosed with Salmonella or Campylobacter infection during 1999-2016 in the Netherlands were linked to the Netherlands Cancer Registry. All infections were clinically severe infections confirmed by laboratory testing. Incidence of ehBTC in Salmonella and Campylobacter patients ≥1 year post-infection was compared to the incidence of ehBTC in the Dutch general population using Standardized Incidence Ratios (SIRs). Results: 16.252 patients were diagnosed with Salmonella and 27.668 with Campylobacter infection. Of those, nine developed ehBTC at a median of 46 months (range 13-67) after Salmonella infection and seven at median 60 months (range 18-138) after Campylobacter infection. Compared to the general population, the SIR of ehBTC in Salmonella patients was 1.53 (95%CI 0.70-2.91). In patients aged < 60 years, SIR was 1.74 (95%CI 0.36-5.04). For Campylobacter patients, SIR was 0.97 (95%CI 0.39-2.00). Conclusion: Although statistical significance was not reached, there was a tendency towards increased occurrence of ehBTC among salmonellosis patients, but not among campylobacteriosis patients. Further research is necessary to uncover putative oncogenic transformative effects of other enteropathogens.Tabled 1PB06-05: Incidence of biliary tract cancer in patients ≥1 year after confirmed infection with Salmonella or Campylobacter, stratified by age and genderObserved incidenceExpected incidenceSIR95% CIP-valueSalmonella, all patients95.881.530.70-2.910.28020-6031.741.720.36-5.040.507Male52.6651.880.61-4.380.264Female43.291.220.33-3.110.835Campylo-bacter, all patients77.220.970.39-2.000.86820-6022.130.940.11-3.400.715Male34.030.750.15-2.180.857Female42.231.240.34-3.170.810 Open table in a new tab