Systematic review with meta-analysis: the relationship between chronic Salmonella typhi carrier status and gall-bladder cancer
Across 17 studies, mostly from India and China, people who carried the typhoid bacterium long term were about four times as likely to have gallbladder cancer, and the authors suggest offering them gallbladder removal or ultrasound checks.
Overview
Systematic review of MEDLINE, PubMed, EMBASE, Cochrane and other databases identifying 17 studies of chronic Salmonella Typhi carriage and gallbladder carcinoma. The pooled odds ratio for chronic carrier state was 4.28 (95 percent CI 1.84 to 9.96); most studies were from South Asia, especially India and China, and the South-East Asian subgroup odds ratio was 4.13 (2.87 to 5.94). The authors conclude chronic carriage is an important risk factor and that management should include elective cholecystectomy or careful ultrasound monitoring.
- Pooled odds ratio 4.28 (95 percent CI 1.84 to 9.96) for chronic S. Typhi carriage and gallbladder cancer across 17 studies.
- South-East Asian subgroup odds ratio 4.13 (2.87 to 5.94).
No trial has tested cholecystectomy or surveillance for chronic carriers; the recommendation is expert inference from a fourfold risk. It is one of the prevention ideas on this page.
- Heterogeneous case-control studies with varied carrier definitions.
- Publication bias likely in a literature dominated by small positive studies.
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