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Is gallstone disease a marker of pancreatic-cancer risk?

NEW YORK 23/05 - Adults with pancreatic ductal adenocarcinoma are nearly six times more likely to have gallstone disease (cholelithiasis or cholecystitis) in the year prior to their cancer diagnosis, compared with the general population, according to a study to be presented at Digestive Disease Week.

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death in the United States, Dr. Teviah Sachs of Boston Medical Center noted during a pre-conference media briefing.

Early symptoms of PDAC may mimic those associated with gallstone disease and gallbladder inflammation, both of which have been demonstrated to be risk factors for pancreatic cancer. What's unclear is how often these conditions occur before the diagnosis of pancreatic cancer, he explained.

Dr. Sachs and his colleagues analyzed data from the SEER-Medicare database from 2008 to 2015. They identified 18,700 adults with PDAC (median age, 76; 53% women, 85% white) and compared them with an average of 99,287 individuals per year from the same database.

They found that 4.7% of the PDAC patients had a diagnosis of gallstone disease and 1.6% had their gallbladders removed in the year prior to their cancer diagnosis. In contrast, among the cancer-free controls, only 0.8% had gallstones and only 0.3% had their gallbladders removed.

Gallstone disease was predictive of earlier stage disease at diagnosis (stage I or II) and receipt of surgery.

"Although most patients with gallstone disease do not go on to develop pancreatic cancer, improving follow-up care and differential diagnosis strategies may help combat the high mortality rate in PDAC by providing an opportunity for earlier stage of diagnosis and intervention," Dr. Sachs told the briefing.

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