Abstract
OBJECTIVES: To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI), and the risk of gallbladder cancer (GBC). METHODS: We identified eligible studies in Medline and EMBASE up to 1 February 2015, and reference lists of retrieved articles. Summary relative risks with their 95% confidence intervals were calculated in a random-effects model. Subgroup analyses were performed according to study design, gender, geographic location, ascertainment of exposure and adjustment for confounders. RESUITS: A total of 12 cohort studies and 8 case-control studies were included in the meta-analysis. Overall, compared with “normal” weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04–1.25) for overweight individuals (BMI 25–30 kg/m2) and 1.56 (95% CI, 1.41–1.73) for obese individuals (BMI > 30 kg/m2). Obese women had a higher risk of GBC than men did (women: SRRs 1.67, 95% CI 1.38–2.02; men: SRRs 1.42, 95% CI 1.21–1.66), and there was significant association between overweight and GBC risk in women (SRRs 1.26, 95% CI 1.13–1.40), but not in men (SRRs 1.06, 95% CI 0.94–1.20). CONCLUSIONS: Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC, especially in women. Overweight is associated with GBC risk only in women.
Highlights
Gallbladder cancer (GBC) is a highly fatal malignancy that differs from other cancers of the biliary tract, as being approximately two to five times more common in women than in men [1]
Study Selection Criteria Published articles were included according to the following criteria: (1) the outcome of interest was GBC incidence or mortality; (2) the exposure of interest was overweight or obesity defined by body mass index (BMI); (3) estimates of odds ratio (OR) or relative risk (RR) with corresponding 95% confidence intervals (CIs) were reported
Among the 34 full text articles, eight studies were not associated with GBC risk, three studies were excluded because gallbladder cancer was not distinguished from extra-hepatic bile duct cancer, and three studies did not provide RR with corresponding CI
Summary
Gallbladder cancer (GBC) is a highly fatal malignancy that differs from other cancers of the biliary tract, as being approximately two to five times more common in women than in men [1]. It has been established that history of gallstone is the leading cause of gallbladder cancer worldwide [3]. Genetic susceptibility, lifestyle factors, smoking, alcohol consumption and diabetes mellitus (DM) increase the risk of GBC [4,5,6,7]. Excess body weight, interpreted as overweight (BMI 25–30 kg/m2) or obesity (BMI > 30 kg/m2), is increasingly recognized as an important risk factor for various cancer types. Evidence from clinical studies has addressed the possible link between excess body weight and risk of GBC, but the findings have been somewhat contradictory. Studies found no statistically significant results [8,9,10], whereas recent studies did observe a significantly increased risk [11,12]
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