Gallstone Disease May Predict Pancreatic Cancer

Gallstone disease may predict pancreatic ductal adenocarcinoma (PDAC), a new study suggests. 

Researchers found that PDAC patients were 3 times more likely to have gallstone disease in the year prior to their cancer diagnosis, when compared with non-cancer patients.

These findings were presented in a press briefing in advance of Digestive Disease Week 2022. The full results of this study are scheduled to be presented at the meeting later this month. 

“Pancreatic cancer is often fatal because it is frequently not diagnosed until its later stages, and what complicates the initial diagnosis is that early symptoms often mirror those associated with gallstone disease and gallbladder inflammation, both of which have been demonstrated to be risk factors for pancreatic cancer,” said presenter Teviah Sachs, MD, of Boston Medical Center in Massachusetts. 

“Unfortunately, there is little known about how often these conditions occur before the diagnosis of pancreatic cancer. We sought to add to this understanding. ”

Dr Sachs and colleagues assessed the incidence of gallstone disease and gallbladder inflammation in the year prior to PDAC diagnosis and compared these findings with the annual incidence in a non-cancer population.

Using data from the SEER-Medicare database spanning the period from 2008 to 2015, the researchers compared 14,643 PDAC patients and 14,605 non-cancer patients. 

In the PDAC cohort, the median age of the patients was 76 years (interquartile range, 71-82 years), 54.3% of patients were women, 84.6% were White, and 51.7% had stage IV disease.

The researchers found that 4.5% of PDAC patients had a diagnosis of gallstone disease, as did 1.8% of non-cancer control individuals (P <.0001). 

The proportion of patients with gallstones was similar between the cancer and non-cancer cohorts — 84.3% and 87.2%, respectively (P =.2644). 

However, the incidence of gallbladder inflammation was significantly higher in the cancer cohort (45.9% vs 35.7%; P =.0046), as was the incidence of gallbladder removal (36.3% vs 24.8%; P =.0008).  

Gallstone disease was predictive of early-stage PDAC (odds ratio [OR], 1.36; 95% CI, 1.16-1.60) and receipt of surgery (OR, 1.51; 95% CI, 1.24-1.83).

“Understanding this association between gallstone disease and pancreatic cancer might be a key to improving differential diagnosis strategies that help combat the high mortality rate, providing an opportunity for earlier diagnosis and treatment,” Dr Sachs concluded.

Reference

Papageorge M, de Geus S, Woods A, et al. Gallstone disease in the year prior to pancreatic cancer diagnosis: An opportunity for action. To be presented at Digestive Disease Week 2022; May 21-23, 2022. Abstract 761.