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@ARTICLE{Kharazmi:275425,
      author       = {E. Kharazmi$^*$ and D. Scherer and F. Boekstegers and Q.
                      Liang$^*$ and K. Sundquist and J. Sundquist and M.
                      Fallah$^*$ and J. L. Bermejo},
      title        = {{G}allstones, cholecystectomy and kidney cancer:
                      observational and {M}endelian randomisation results based on
                      large cohorts.},
      journal      = {Gastroenterology},
      volume       = {165},
      number       = {1},
      issn         = {0016-5085},
      address      = {Philadelphia, Pa. [u.a.]},
      publisher    = {Saunders},
      reportid     = {DKFZ-2023-00748},
      pages        = {218-227.e8},
      year         = {2023},
      note         = {#LA:C120# / 165(1), pp. 218-227.e8},
      abstract     = {Gallstones (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.},
      keywords     = {cancer prevention (Other) / causal inference (Other) /
                      large nation-wide cohorts (Other) / risk prediction (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:37054756},
      doi          = {10.1053/j.gastro.2023.03.227},
      url          = {https://inrepo02.dkfz.de/record/275425},
}