Gallstones May Be a Warning Sign of Pancreatic Cancer

A possible association between gallstones and the most common type of pancreatic cancer, “pancreatic ductal adenocarcinoma,” was suggested in a published study. Before diagnosis, patients with pancreatic cancer were found, compared with people without cancer, to be 6 times more likely to have gallstone disease.

On the Relationship Between Pancreatic Cancer and Gallstones

Dr Teviah Sachs of Boston Medical Center in Massachusetts said of their research:

“We cannot currently be sure whether gallstone disease is a warning sign of pancreatic cancer or whether it will lead to pancreatic cancer, but we know there is an association and plan to investigate further. We do not want people with gallstone disease to think they have or will develop pancreatic cancer, because clearly the vast majority of people with gallstone disease do not have pancreatic cancer. However, we can tell specialists that if they have a patient with gallstones who also has other symptoms, they should not attribute those symptoms only to gallstones. A diagnosis of pancreatic cancer should be kept in mind for symptomatic patients whose condition is not explained by typical gallstones .”

Pancreatic cancer is often a life-threatening disease because it frequently goes unnoticed until advanced stages and is not diagnosed early.

Early diagnosis is further complicated by the fact that pancreatic cancer symptoms often resemble those of gallstone disease and gallbladder infections. Both have been shown to be risk factors for pancreatic cancer.

• Related topic: Symptoms and Treatment of Bile Duct Stones: Choledocholithiasis

Annual Incidence of Pancreatic Cancer and Gallstones

The aim of the current study was to compare the annual incidence of pancreatic cancer in the general population with the incidence of cholelithiasis (formation of gallstones) and cholecystitis (inflammation of the gallbladder) in the year before a pancreatic cancer diagnosis.

The study included a total of 18,700 patients with pancreatic cancer, with a median age of 76, recorded in the US SEER-Medicare database between 2008 and 2015. The frequency of hospital visits for gallstone disease in the year before a pancreatic cancer diagnosis was compared with the frequency among people with gallstones but without cancer recorded in SEER-Medicare.

In the group without cancer, there were an average of 99,287 patients each year; 0.8% had gallstone disease, while 0.3% had undergone gallbladder removal. In contrast, in the year before diagnosis, 4.7% of those with PDAC had a gallstone diagnosis and 1.6% had undergone gallbladder removal.

In conclusion, gallstones do not cause pancreatic cancer; therefore, removing the gallbladder as a precaution is not a procedure that reduces pancreatic cancer risk. However, understanding the relationship between pancreatic cancer and gallstones and the shared causes of both conditions (obesity, metabolic syndrome, older age, etc.) may offer an opportunity for earlier diagnosis and treatment of pancreatic cancer, which has a high mortality (death) rate.