Anthropometric risk factors for cancers of the biliary tract in the biliary tract cancers pooling project

Sarah S. Jackson, Alison L. Van Dyke, Bin Zhu, Ruth M. Pfeiffer, Jessica L. Petrick, Hans Olov Adami, Demetrius Albanes, Gabriella Andreotti, Laura E. Beane Freeman, Amy Berrington De Gonzalez, Julie E. Buring, Andrew T. Chan, Yu Chen, Gary E. Fraser, Neal D. Freedman, Yu Tang Gao, Susan M. Gapstur, J. Michael Gaziano, Graham G. Giles, Eric J. GrantFrancine Grodstein, Patricia Hartge, Mazda Jenab, Cari M. Kitahara, Synnove F. Knutsen, Woon Puay Koh, Susanna C. Larsson, I. Min Lee, Linda M. Liao, Juhua Luo, Emma E. McGee, Roger L. Milne, Kristine R. Monroe, Marian L. Neuhouser, Katie M. O'Brien, Ulrike Peters, Jenny N. Poynter, Mark P. Purdue, Kim Robien, Dale P. Sandler, Norie Sawada, Catherine Schairer, Howard D. Sesso, Tracey G. Simon, Rashmi Sinha, Rachael Z. Stolzenberg-Solomon, Shoichiro Tsugane, Renwei Wang, Elisabete Weiderpass, Stephanie J. Weinstein, Emily White, Alicja Wolk, Jian Min Yuan, Anne Zeleniuch-Jacquotte, Xuehong Zhang, Katherine A. McGlynn, Peter T. Campbell, Jill Koshiol

Research output: Contribution to journalArticlepeer-review


Biliary tract cancers are rare but highly fatal with poorly understood etiology. Identifying potentially modifiable risk factors for these cancers is essential for prevention. Here we estimated the relationship between adiposity and cancer across the biliary tract, including cancers of the gallbladder (GBC), intrahepatic bile ducts (IHBDC), extrahepatic bile ducts (EHBDC), and the ampulla of Vater (AVC). We pooled data from 27 prospective cohorts with over 2.7 million adults. Adiposity was measured using baseline body mass index (BMI), waist circumference, hip circumference, waist-to-hip, and waist-to-height ratios. HRs and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards models adjusted for sex, education, race, smoking, and alcohol consumption with age as the time metric and the baseline hazard stratified by study. During 37,883,648 person-years of follow-up, 1,343 GBC cases, 1,194 EHBDC cases, 784 IHBDC cases, and 623 AVC cases occurred. For each 5 kg/m2 increase in BMI, there were risk increases for GBC (HR ¼ 1.27; 95% CI, 1.19-1.36), IHBDC (HR ¼ 1.32; 95% CI, 1.21-1.45), and EHBDC (HR ¼ 1.13; 95% CI, 1.03-1.23), but not AVC (HR ¼ 0.99; 95% CI, 0.88-1.11). Increasing waist circumference, hip circumference, waist-to-hip ratio, and waist-to-height ratio were associated with GBC and IHBDC but not EHBDC or AVC. These results indicate that adult adiposity is associated with an increased risk of biliary tract cancer, particularly GBC and IHBDC. Moreover, they provide evidence for recommending weight maintenance programs to reduce the risk of developing these cancers. Significance: These findings identify a correlation between adiposity and biliary tract cancers, indicating that weight management programs may help minimize the risk of these diseases.

Original languageEnglish (US)
Pages (from-to)3973-3982
Number of pages10
JournalCancer Research
Issue number15
StatePublished - Aug 1 2019

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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