Cholecystectomy and large bowel cancer.

The records of 5898 patients with colorectal cancer and 27,687 controls were examined for previous cholecystectomy. The estimated relative risks (and 95% confidence intervals) of development of any cancer of the large bowel and cancer of the right colon after cholecystectomy were 1.0 (0.8-1.2) and 1.1 (0.8-1.5) in women and 1.1 (0.9-1.5) and 1.2 (0.8-1.9) in men, respectively. Although these data do not rule out a small increase in risk, it is proposed that the association found in some other studies is, at least in part, an artifact. Intense diagnostic effort and treatment aimed at mild abdominal symptoms, encouraged by some patients and some medical care settings, could increase the detection and removal of gallstones and the early detection of colorectal cancer.