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@ARTICLE{Kharazmi:179295,
      author       = {E. Kharazmi$^*$ and K. Sundquist and J. Sundquist and M.
                      Fallah$^*$ and J. L. Bermejo},
      title        = {{R}isk of {G}ynecological {C}ancers in {C}holecystectomized
                      {W}omen: {A} {L}arge {N}ationwide {C}ohort {S}tudy.},
      journal      = {Cancers},
      volume       = {14},
      number       = {6},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2022-00577},
      pages        = {1484},
      year         = {2022},
      note         = {#EA:C120#LA:C120#},
      abstract     = {Background: Gallstones affect women more frequently than
                      men, and symptomatic gallstones are increasingly treated
                      with surgical removal of the gallbladder (cholecystectomy).
                      Breast, endometrial, and ovarian cancer share several risk
                      factors with gallstones, including overweight, obesity, and
                      exposure to female sex hormones. We intended to assess the
                      association between cholecystectomy and female cancer risk,
                      which has not been comprehensively investigated. Methods: We
                      investigated the risk of female cancers after
                      cholecystectomy leveraging the Swedish Cancer, Population,
                      Patient, and Death registries. Standardized incidence ratios
                      (SIRs) adjusted for age, calendar period, socioeconomic
                      status, and residential area were used to compare cancer
                      risk in cholecystectomized and non-cholecystectomized women.
                      Results: During a median follow-up of 11 years, 325,106
                      cholecystectomized women developed 10,431 primary breast,
                      2888 endometrial, 1577 ovarian, and 705 cervical cancers.
                      The risk of ovarian cancer was increased by $35\%$ $(95\%$
                      confidence interval (CI) $2\%$ to $77\%)$ in the first 6
                      months after cholecystectomy. The exclusion of cancers
                      diagnosed in the first 6 months still resulted in an
                      increased risk of endometrial $(19\%,$ $95\%CI$ $14\%$ to
                      $23\%)$ and breast $(5\%,$ $95\%CI$ $3\%$ to $7\%)$ cancer,
                      especially in women cholecystectomized after age 50 years.
                      By contrast, cholecystectomized women showed decreased risks
                      of cervical $(-13\%,$ $95\%CI$ $-20\%$ to $-7\%)$ and
                      ovarian $(-6\%,$ $95\%CI$ $-10\%$ to $-1\%)$ cancer.
                      Conclusions: The risk of ovarian cancer increased by $35\%$
                      in a just short period of time (6 months) following the
                      surgery. Therefore, it is worth ruling out ovarian cancer
                      before cholecystectomy. Women undergoing cholecystectomy
                      showed an increased risk of breast and endometrial cancer up
                      to 30 years after surgery. Further evaluation of the
                      association between gallstones or gallbladder removal on
                      female cancer risk would allow for the assessment of the
                      need to intensify cancer screening in cholecystectomized
                      women.},
      keywords     = {breast cancer (Other) / cervical cancer (Other) /
                      cholecystectomy (Other) / endometrial cancer (Other) /
                      gallbladder surgery (Other) / large nationwide cohort
                      (Other) / ovarian cancer (Other)},
      cin          = {C120},
      ddc          = {610},
      cid          = {I:(DE-He78)C120-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35326635},
      pmc          = {pmc:PMC8946708},
      doi          = {10.3390/cancers14061484},
      url          = {https://inrepo02.dkfz.de/record/179295},
}