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Body Mass Index and the Risk of Gallbladder Cancer: An Updated Meta-analysis of Epidemiologic Studies

Canfeng Cai, Bing Zeng, Yuanfeng Gong, Guoxing Chen, Xiang Chen, Wendong Huang, Min Liang, Jun Zeng, Chaoming Tang

Objectives: To provide a quantitative assessment of the association between excess bodyweight, expressed as increased body-mass index (BMI), and the risk of gallbladder cancer (GBC), we conducted an updated metaanalysis of epidemiologic studies. Methods: We searched the MEDLINE and EMBASE databases form1966 to February 2013, and the reference lists of retrieved articles. A random-effects model was used to combine study-specific results. A total of 12 cohort studies (involving 5,101 cases) and 8 case-control studies (1,013 cases and 43,591 controls) were included in the meta-analysis. Results: Overall, compared with normal weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04-1.25) for overweight populations (BMI 25-30 kg/m2) and 1.56 (95% CI, 1.41-1.73) for obese (BMI >30 kg/m2) ones. Obese women had a higher risk of GBC than men did (women: RR 1.67, 95% CI 1.38-2.02, men: RR 1.42, 95% CI 1.21-1.66), and there was a significant association between overweight and GBC risk for women (RR 1.26, 95% CI 1.13-1.40), but not for men (RR 1.06, 95% CI 0.94-1.20). In addition, subgroup analyses revealed that overweight people with smoking or alcohol consumption or in western countries were strongly associated GBC risk (RR 1.16, 95% CI 1.02-1.31 for smokers, RR 1.27, 95% CI 1.10-1.47 for drinkers, and RR 1.14, 95% CI 1.05-1.25). Conclusions: Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC in both men and women, and overweight is associated with GBC risk only in women.