Kim M, Han KD, Ko SH, Woo Y, Han JH. Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study. World J Gastrointest Surg 2024; 16(9): 2796-2807 [PMID: 39351570 DOI: 10.4240/wjgs.v16.i9.2796]
Corresponding Author of This Article
Jae Hyun Han, MD, PhD, Associate Professor, Division of Hepatobiliary-Pancreas Surgery and Liver Transplantation, Department of Surgery, St Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Joongbudae-ro 93, Paldal-gu, Suwon 16247, South Korea. gelasius@catholic.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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Kim M, Han KD, Ko SH, Woo Y, Han JH. Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study. World J Gastrointest Surg 2024; 16(9): 2796-2807 [PMID: 39351570 DOI: 10.4240/wjgs.v16.i9.2796]
Minseob Kim, Department of Surgery, Graduate School of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Kyung-Do Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Seung-Hyun Ko, Division of Endocrinology and Metabolism, Department of Internal Medicine, St Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, South Korea
Yoonkyung Woo, Jae Hyun Han, Division of Hepatobiliary-Pancreas Surgery and Liver Transplantation, Department of Surgery, St Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, South Korea
Co-first authors: Minseob Kim and Kyung-Do Han.
Author contributions: Kim M, Han KD, Ko SH, Woo Y, and Han JH contributed to the conception and design of the study, acquisition of data, drafting of the article, and making critical revisions related to the important intellectual content of the manuscript; All authors approved the final version of the article to be published; Kim M and Han KD are designated as co-first authors in recognition of their equal and substantial contributions to the study; They both played key roles in conception of the study, data acquisition and analysis, and drafting the article.
Supported bythe Clinical Research Invigoration Project of the St Vincent’s Hospital, The Catholic University of Korea, No. VC22ZASI0080.
Institutional review board statement: The study was approved by both the Korean National Health Insurance Service and the Institutional Review Board of the Catholic University of Korea (Approval No. VIRB-20220420-001).
Informed consent statement: Because this was a retrospective analysis of medical claims data, the need for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at gelasius@catholic.ac.kr.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Corresponding author: Jae Hyun Han, MD, PhD, Associate Professor, Division of Hepatobiliary-Pancreas Surgery and Liver Transplantation, Department of Surgery, St Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Joongbudae-ro 93, Paldal-gu, Suwon 16247, South Korea. gelasius@catholic.ac.kr
Received: April 1, 2024 Revised: July 4, 2024 Accepted: July 31, 2024 Published online: September 27, 2024 Processing time: 170 Days and 3.1 Hours
Abstract
BACKGROUND
The role of smoking in the incidence of colorectal cancer (CRC) or gastric cancer (GC) in populations undergoing cholecystectomy has not been investigated.
AIM
To evaluate the effect of smoking on CRC or GC development in cholecystectomy patients.
METHODS
A total of 174874 patients who underwent cholecystectomy between January 1, 2010 and December 31, 2017 were identified using the Korean National Health Insurance Service claims database. These patients were matched 1:1 with members of a healthy population according to age and sex. CRC or GC risk after cholecystectomy and the association between smoking and CRC or GC risk in cholecystectomy patients were evaluated using adjusted hazard ratios (HRs) and 95%CIs.
RESULTS
The risks of CRC (adjusted HR: 1.15; 95%CI: 1.06-1.25; P = 0.0013) and GC (adjusted HR: 1.11; 95%CI: 1.01-1.22; P = 0.0027) were significantly higher in cholecystectomy patients. In the population who underwent cholecystectomy, both CRC and GC risk were higher in those who had smoked compared to those who had never smoked. For both cancers, the risk tended to increase in the order of non-smokers, ex-smokers, and current smokers. In addition, a positive correlation was observed between the amount of smoking and the risks of both CRC and GC.
CONCLUSION
Careful follow-up and screening should be performed, focusing on the increased risk of gastrointestinal cancer in the cholecystectomy group, particularly considering the individual smoking habits.
Core Tip: The study found that patients who underwent cholecystectomy, especially those who were smokers, had a higher risk of developing colorectal and gastric cancers. The analysis of Korean National Health Insurance data revealed increased risks of gastrointestinal cancer following cholecystectomy, with an association with smoking habits. This emphasizes the need for thorough screening and follow-up in these patients.
