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The association between biliary tract inflammation and risk of digestive system cancers: A population-based cohort study.

Tsai TY, Lin CC, Peng CY, Huang WH, Su WP, Lai SW, Chen HJ, Lai HC - Medicine (Baltimore) (2016)

Bottom Line: The aHR of stomach cancer was also found to be increased (2.73; 95% CI: 1.28-5.81) in patients with gallbladder inflammation only.There were no differences in esophageal cancer (aHR: 0.82; 95% CI: 0.23-2.87) and colorectal cancer (aHR: 0.92; 95% CI: 0.59-1.45).The aHR for digestive system cancers increased by 3.66 times (95% CI: 2.50-5.35) and 12.20 times (95% CI: 8.66-17.17) in BTI visits frequency averaged 2 to 4 visits per year and frequency averaged ≥5 visits per year, respectively.Patients with BTI have significantly higher risk of digestive system cancers, particularly biliary tract, pancreatic, and primary liver cancers, compared with those who are without it.

View Article: PubMed Central - PubMed

Affiliation: aGraduate Institute of Clinical Medical Science bSchool of Medicine cDivision of Hepato-gastroenterology, Department of Internal Medicine dManagement Office for Health Data eDepartment of Public Health fDepartment of Family Medicine gSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT
The relationship between biliary tract inflammation (BTI) and digestive system cancers is unclear. This study aimed to evaluate the association between BTI and the risks of digestive system cancers.Using the Taiwan National Health Insurance claims data, information on a cohort of patients diagnosed with BTI (n = 4398) between 2000 and 2009 was collected. A comparison cohort of sex-, age-, and index year-matched persons without BTI (n = 17,592) was selected from the same database. The disease was defined by the ICD-9-CM. Both cohorts were followed until the end of 2010 and incidences of digestive system cancers were calculated.The results revealed an increase in adjusted hazard ratio (aHR) of biliary tract cancer (24.45; 95% confidence interval [CI]: 9.20-65.02), primary liver cancer (1.53; 95% CI: 1.07-2.18), and pancreatic cancer (3.10; 95% CI: 1.20-8.03) in patients with both gallbladder and BTI. The aHR of stomach cancer was also found to be increased (2.73; 95% CI: 1.28-5.81) in patients with gallbladder inflammation only. There were no differences in esophageal cancer (aHR: 0.82; 95% CI: 0.23-2.87) and colorectal cancer (aHR: 0.92; 95% CI: 0.59-1.45). The aHR for digestive system cancers increased by 3.66 times (95% CI: 2.50-5.35) and 12.20 times (95% CI: 8.66-17.17) in BTI visits frequency averaged 2 to 4 visits per year and frequency averaged ≥5 visits per year, respectively.Patients with BTI have significantly higher risk of digestive system cancers, particularly biliary tract, pancreatic, and primary liver cancers, compared with those who are without it.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of digestive system cancer in the study population.
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Figure 2: Cumulative incidence of digestive system cancer in the study population.

Mentions: The cumulative incidence of developing digestive system cancers in the BTI cohort was 72.99 per 10,000 person-years and 34.40 per 10,000 person-years in the comparison cohort (Table 2). The cumulative incidence curve of developing digestive system cancer in individuals with BTI was significantly greater than the incidence curve in those without BTI (P <0.0001, by the log-rank test) (Fig. 2). After adjustments for age, sex, occupational status, DM, PLA, pancreatitis, hepatitis B infection, hepatitis C infection, unspecified chronic hepatitis, alcoholic liver disease, cirrhosis, and cholelithiasis, individuals with BTI had a 1.68-fold increased risk than those without BTI (adjusted hazard ratio [aHR]: 1.68, 95% CI: 1.35–2.09). Individuals with only gallbladder inflammation might have a trend of increasing risk of developing digestive system cancers but did not reach statistical significance (aHR: 1.14, 95% CI: 0.84–1.57). However, individuals with only biliary inflammation or with both subtypes of BTI were still significantly associated with increased risk of developing digestive system cancers. (aHR: 2.13 and 2.37, respectively).


The association between biliary tract inflammation and risk of digestive system cancers: A population-based cohort study.

Tsai TY, Lin CC, Peng CY, Huang WH, Su WP, Lai SW, Chen HJ, Lai HC - Medicine (Baltimore) (2016)

Cumulative incidence of digestive system cancer in the study population.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979819&req=5

Figure 2: Cumulative incidence of digestive system cancer in the study population.
Mentions: The cumulative incidence of developing digestive system cancers in the BTI cohort was 72.99 per 10,000 person-years and 34.40 per 10,000 person-years in the comparison cohort (Table 2). The cumulative incidence curve of developing digestive system cancer in individuals with BTI was significantly greater than the incidence curve in those without BTI (P <0.0001, by the log-rank test) (Fig. 2). After adjustments for age, sex, occupational status, DM, PLA, pancreatitis, hepatitis B infection, hepatitis C infection, unspecified chronic hepatitis, alcoholic liver disease, cirrhosis, and cholelithiasis, individuals with BTI had a 1.68-fold increased risk than those without BTI (adjusted hazard ratio [aHR]: 1.68, 95% CI: 1.35–2.09). Individuals with only gallbladder inflammation might have a trend of increasing risk of developing digestive system cancers but did not reach statistical significance (aHR: 1.14, 95% CI: 0.84–1.57). However, individuals with only biliary inflammation or with both subtypes of BTI were still significantly associated with increased risk of developing digestive system cancers. (aHR: 2.13 and 2.37, respectively).

Bottom Line: The aHR of stomach cancer was also found to be increased (2.73; 95% CI: 1.28-5.81) in patients with gallbladder inflammation only.There were no differences in esophageal cancer (aHR: 0.82; 95% CI: 0.23-2.87) and colorectal cancer (aHR: 0.92; 95% CI: 0.59-1.45).The aHR for digestive system cancers increased by 3.66 times (95% CI: 2.50-5.35) and 12.20 times (95% CI: 8.66-17.17) in BTI visits frequency averaged 2 to 4 visits per year and frequency averaged ≥5 visits per year, respectively.Patients with BTI have significantly higher risk of digestive system cancers, particularly biliary tract, pancreatic, and primary liver cancers, compared with those who are without it.

View Article: PubMed Central - PubMed

Affiliation: aGraduate Institute of Clinical Medical Science bSchool of Medicine cDivision of Hepato-gastroenterology, Department of Internal Medicine dManagement Office for Health Data eDepartment of Public Health fDepartment of Family Medicine gSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT
The relationship between biliary tract inflammation (BTI) and digestive system cancers is unclear. This study aimed to evaluate the association between BTI and the risks of digestive system cancers.Using the Taiwan National Health Insurance claims data, information on a cohort of patients diagnosed with BTI (n = 4398) between 2000 and 2009 was collected. A comparison cohort of sex-, age-, and index year-matched persons without BTI (n = 17,592) was selected from the same database. The disease was defined by the ICD-9-CM. Both cohorts were followed until the end of 2010 and incidences of digestive system cancers were calculated.The results revealed an increase in adjusted hazard ratio (aHR) of biliary tract cancer (24.45; 95% confidence interval [CI]: 9.20-65.02), primary liver cancer (1.53; 95% CI: 1.07-2.18), and pancreatic cancer (3.10; 95% CI: 1.20-8.03) in patients with both gallbladder and BTI. The aHR of stomach cancer was also found to be increased (2.73; 95% CI: 1.28-5.81) in patients with gallbladder inflammation only. There were no differences in esophageal cancer (aHR: 0.82; 95% CI: 0.23-2.87) and colorectal cancer (aHR: 0.92; 95% CI: 0.59-1.45). The aHR for digestive system cancers increased by 3.66 times (95% CI: 2.50-5.35) and 12.20 times (95% CI: 8.66-17.17) in BTI visits frequency averaged 2 to 4 visits per year and frequency averaged ≥5 visits per year, respectively.Patients with BTI have significantly higher risk of digestive system cancers, particularly biliary tract, pancreatic, and primary liver cancers, compared with those who are without it.

No MeSH data available.


Related in: MedlinePlus