Background-The occurrence of gall stones has repeatedly been associate
d with an increased risk for cancer of the colon, but risk associated
with cholecystectomy remains unclear. Aims-To evaluate the hypothesis
in a nationwide cohort of more than 40 000 gall stone patients with co
mplete follow up including information of cholecystectomy and obesity.
Patients-in the population based study described here, 42 098 patient
s with gall stones in 1977-1989 were identified in the Danish Hospital
Discharge Register. Methods-These patients were linked to the Danish
Cancer Registry to assess their risks for colorectal and other cancers
during follow up to the end of 1992.Results-The analysis showed a mod
est increase in the number of cancers at all sites combined (n=3940; R
R, 1.07; 95% confidence intervals (CI), 1.0 to 1.1). A weak associatio
n was found for cancer of the colon (n=360; RR, 1.09; 95% CI 1.0 to 1.
2), which remained unchanged when analysed by sex, anatomical subsite,
and duration of follow up. Multivariate analysis with adjustment for
cholecystectomy and clinically defined obesity did not change these es
timates to any significant extent. Excess risks were found for cancers
of the pancreas and the small intestine. A non-significant increased
risk for breast cancer was seen in women five years after initial disc
harge for gall stones. Conclusion-A borderline significant association
was seen between gall stones and cancer of the colon, and for cancer
of pancreas and small intestine as well as for breast cancer in women.