title: Salmonella enterica serovar Typhi and gallbladder cancer: a case-control study and meta-analysis.
abstract: In Chile, where gallbladder cancer (GBC) rates are high and typhoid fever was endemic until the 1990s, we evaluated the association between Salmonella enterica serovar Typhi (S. Typhi) antibodies and GBC. We tested 39 GBC cases, 40 gallstone controls, and 39 population-based controls for S. Typhi Vi antibodies and performed culture and quantitative polymerase chain reaction for the subset with bile, gallstone, tissue, and stool samples available. We calculated gender and education-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association with GBC. We also conducted a meta-analysis of >1000 GBC cases by combining our results with previous studies. GBC cases were more likely to have high Vi antibody titer levels than combined controls (OR: 4.0, 95% CI: 0.9-18.3), although S. Typhi was not recovered from bile, gallstone, tissue, or stool samples. In our meta-analysis, the summary relative risk was 4.6 (95% CI: 3.1-6.8, Pheterogeneity=0.6) for anti-Vi and 5.0 (95% CI: 2.7-9.3, Pheterogeneity= 0.2) for bile or stool culture. Our results are consistent with the meta-analysis. Despite differences in study methods (e.g., S. Typhi detection assay), most studies found a positive association between S. Typhi and GBC. However, the mechanism underlying this association requires further investigation.
authors.affiliation: Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, MD.
authors.forename: Jill
authors.initials: J
authors.lastname: Koshiol
authors.affiliation: Laboratory of Microbiology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Aniela
authors.initials: A
authors.lastname: Wozniak
authors.affiliation: Escuela de Medicina, Advanced Center for Chronic Diseases, ACCDiS, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Paz
authors.initials: P
authors.lastname: Cook
authors.affiliation: Laboratory of Microbiology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Christina
authors.initials: C
authors.lastname: Adaniel
authors.affiliation: Escuela de Medicina, Advanced Center for Chronic Diseases, ACCDiS, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Johanna
authors.initials: J
authors.lastname: Acevedo
authors.affiliation: Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Lorena
authors.initials: L
authors.lastname: Azócar
authors.affiliation: Stanford Cancer Institute, Palo Alto, CA.|Department of Health Research and Policy, Stanford School of Medicine, Palo Alto, CA.
authors.forename: Ann W
authors.initials: AW
authors.lastname: Hsing
authors.affiliation: Department of Pathology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Roa
authors.affiliation: Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Marcela F
authors.initials: MF
authors.lastname: Pasetti
authors.affiliation: Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Miquel
authors.affiliation: Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Myron M
authors.initials: MM
authors.lastname: Levine
authors.affiliation: Escuela de Medicina, Advanced Center for Chronic Diseases, ACCDiS, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012485:Salmonella typhi / Q000276:immunology; D014435:Typhoid Fever / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*
keywords: Chile; Salmonella enterica serovar Typhi; Vi antibodies; epidemiology; gallbladder cancer; meta-analysis