Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer

Together with thyroid cancer, cancer of the gallbladder is the only non-sex hormone-related cancer displaying a female preponderance, with incidence being 3-4 times more common among women. We carried out this study to evaluate the role of menstrual, reproductive and lifestyle factors in gallbladder carcinogenesis. A case-control study involving 64 newly diagnosed cases of gallbladder cancer and 101 cases of cholelithiasis was carried out. A detailed menstrual and reproductive history was illustrated beside detailed lifestyle history, in particular consumption of betel nut, tobacco and alcohol and smoking, odds ratio was calculated. Mean age of the patients with cancer was 51 +/- 1.2 years while it was 40.9 +/- 1.2 years for gallstones; 69% of cancer patients and 90% of gallstones patients were females. More than half of the cancer patients (53%) and 43% of the gallstone patients were illiterate. A past history of typhoid was present in 22% of cancer patients and 13% of gallstone patients, while 35% of cancer and 25% of gallstone patients were chewers, 18.1 and 9.9% were smokers, and 10% of cancer and 2% of gallstone patients consumed alcohol. Mean age of menarche was 13.4 +/- 1.2 years among female patients with cancer while it was 14.0 +/- 1.4 years for gallstone patients. Higher age at menarche (> 13 years, OR 2.48, 95% confidence interval (CI) 1.16-5.3), higher number of childbirths (>3 births, OR 3.92; 95% Cl 1.4-10.3), higher number of pregnancies (>3 pregnancies, OR 6.66, 95% Cl 1.8-23.4), and higher age at last childbirth (> 25 years, OR 2.97, 95% Cl 1.04-8.5) were found to have significantly higher risk of developing gallbladder cancer. In conclusion, tobacco chewing and smoking are associated with increased odds of gallbladder cancer. Similarly early menarche, late menopause, multiple pregnancies and childbirth increased the risk of gallbladder cancer. (C) 2003 Lippincott Williams Wilkins.