A case-control assessment of risk factors for gallbladder carcinoma

Gallbladder carcinoma is an uncommon, but highly fatal disease. Its symptom s frequently mirror those of gallstone disease, and in most instances, diag nosis is an incidental finding at surgery. While risk factors have been sug gested for this cancer, many may in reality simply be a consequence of the older age of the population. This study is one of the few to approach this question by using a case-control study design comparing gallbladder carcino ma patients with a gallstone population, coupled with multivariate analysis to determine age-independent risk factors. Univariate analyses showed gall bladder carcinoma patients to be older than gallstone patients and to have many age-associated diseases. Following multiple regression adjustment for age, this disease was associated with female gender and with a previous his tory of gallstone symptoms. Carcinoma patients were less likely to have cho lesterol gallstones in their gallbladders at surgery. A previous history of smoking was a substantial risk but of borderline statistical significance. Previous studies report associations that may be due to the older age of t he gallbladder carcinoma patient. Our results show that after adjusting for age with multivariate analysis, gallbladder cancer subjects were predomina ntly female, more likely to report previous gallstone symptomology, and to smoke. While gallstones were not universally isolated from carcinoma patien ts at cholecystectomy, when present, they were less frequently classified a s cholesterol gallstones based on visual inspection. Further cohort studies which target these populations will allow us to gain a more solid consensu s on the risk factors for this disease.