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Cholelithiasis and the risk of liver cancer: results from cohort studies of 134 546 Chinese men and women
  1. Emily Vogtmann1,2,3,
  2. Xiao-Ou Shu2,
  3. Hong-Lan Li1,
  4. Wong-Ho Chow4,
  5. Gong Yang2,
  6. Bu-Tian Ji5,
  7. Hui Cai2,
  8. Chang Yu6,
  9. Yu-Tang Gao1,
  10. Wei Zheng2,
  11. Yong-Bing Xiang1
  1. 1State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P R China
  2. 2Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  3. 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
  4. 4Department of Epidemiology, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
  5. 5Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  6. 6Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  1. Correspondence to Dr Yong-Bing Xiang, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, No. 25, Lane 2200, Xie Tu Road, Shanghai 200032, P R China; ybxiang{at}


Background Cholelithiasis and cholecystectomy have been proposed as risk factors for liver cancer, but findings have been inconsistent. We assessed this association using data from the Shanghai Women's and Men's Health Studies.

Methods History of cholelithiasis and cholecystectomy were reported at baseline and follow-up interviews, and liver cancer diagnoses were ascertained from the Shanghai Cancer Registry and Vital Statistics Unit. Adjusted hazard ratios (aHRs) and 95% CIs were calculated after adjustment for potential confounders.

Results A history of cholelithiasis and cholecystectomy was reported by 9.5% and 3.6% of participants at baseline, respectively. After a total of 859 882 person-years of follow-up for women and 391 093 for men, incident liver cancer was detected in 160 women and 252 men. A positive association was observed between a history of cholelithiasis or cholecystectomy and liver cancer in men (aHR 1.46; 95% CI 1.02 to 2.07) and women (aHR 1.55; 95% CI 1.06 to 2.26). Similar results were observed for cholelithiasis only, but cholecystectomy did not reach statistical significance. There was no strong evidence for detection bias of liver cancer due to cholelithiasis or cholecystectomy.

Conclusions Our study suggests that cholelithiasis and possibly cholecystectomy may increase the risk of liver cancer.

  • Cancer epidemiology
  • Cohort studies
  • Epidemiology of chronic diseases

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