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000275425 041__ $$aEnglish
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000275425 1001_ $$0P:(DE-He78)e56510c7dedbff7a279ad76dad80eeda$$aKharazmi, Elhamalsadat$$b0$$eFirst author
000275425 245__ $$aGallstones, cholecystectomy and kidney cancer: observational and Mendelian randomisation results based on large cohorts.
000275425 260__ $$aPhiladelphia, Pa. [u.a.]$$bSaunders$$c2023
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000275425 520__ $$aGallstones (cholelithiasis) constitute a major health burden with high costs related to surgical removal of the gallbladder (cholecystectomy), generally indicated for symptomatic gallstones. The association between gallstones, cholecystectomy and kidney cancer is controversial. We comprehensively investigated this association, considering age at cholecystectomy and time from cholecystectomy to kidney cancer diagnosis, and assessing the causal effect of gallstones on kidney cancer risk by Mendelian randomisation (MR).We compared the risk of kidney cancer in cholecystectomised and non-cholecystectomised individuals (16.6 million in total) from the Swedish nationwide cancer, census, patient and death registries using hazard ratios (HRs). For two-sample and multivariable MR, we used summary statistics based on 408,567 UK Biobank participants.During a median follow-up of 13 years, 2,627 of 627,870 cholecystectomised Swedish patients developed kidney cancer (HR=1.17, 95% CI 1.12-1.22). Kidney cancer risk was particularly increased in the first 6 months after cholecystectomy (HR=3.79, 95% CI 3.18-4.52) and in patients cholecystectomised before age 40 (HR=1.55, 95% CI 1.39-1.72). MR results based on 18.417 gallstone and 1,788 kidney cancer patients from the UK revealed a causal effect of gallstones on kidney cancer risk (9.6% risk increase per doubling in gallstone prevalence, 95% CI 1.2%-18.8%).Both observational and causal MR estimates based on large prospective cohorts support an increased risk of kidney cancer in gallstone patients. Our findings provide solid evidence for the compelling need to diagnostically rule out kidney cancer before and during gallbladder removal, to prioritise kidney cancer screening in patients undergoing cholecystectomy in their 30s, and to investigate the underlying mechanisms linking gallstones and kidney cancer in future studies.
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000275425 650_7 $$2Other$$acancer prevention
000275425 650_7 $$2Other$$acausal inference
000275425 650_7 $$2Other$$alarge nation-wide cohorts
000275425 650_7 $$2Other$$arisk prediction
000275425 7001_ $$aScherer, Dominique$$b1
000275425 7001_ $$aBoekstegers, Felix$$b2
000275425 7001_ $$0P:(DE-He78)59bc83ea3f8c2a5ef6118233f87b5e68$$aLiang, Qunfeng$$b3$$udkfz
000275425 7001_ $$aSundquist, Kristina$$b4
000275425 7001_ $$aSundquist, Jan$$b5
000275425 7001_ $$0P:(DE-He78)b510b884502b619724039bf33fdae68a$$aFallah, Mahdi$$b6$$eLast author$$udkfz
000275425 7001_ $$aBermejo, Justo Lorenzo$$b7
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