Meta-analysisindependent cross-checkabstract checked I-ORG-130 standard review
Gallbladder removal and bowel cancer: another pooled analysis
No association between cholecystectomy and risk of colorectal cancer: a meta-analysis of cohort studies.
Overview
Yu L et al.. Int J Colorectal Dis 2023 · PMID 37368048 · DOI 10.1007/s00384-023-04463-0
Overall, gallbladder removal was not linked to bowel cancer.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Pool cohorts on cholecystectomy and CRC
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
2.3 million people
- What was actually found?
No overall association
- How large was the observed effect?
RR 1.06 (0.75-1.51)
- What do the results mean in everyday life?
Needed gallbladder surgery should not be avoided for fear of bowel cancer
- What are the study's limitations?
Inconsistent subgroups
- What does it say about Elawady's specific claim?
Contradicts the general claim
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Cannot exclude small subsite effects
Scientific in-depth review
1. Full reference
- Authors
- Yu L et al.
- Journal
- Int J Colorectal Dis
- Year
- 2023
- Identifier
- PMID 37368048 DOI 10.1007/s00384-023-04463-0
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Not stated in abstract.
2. Research question
Quantify colorectal cancer risk after cholecystectomy.
3. Study design and population
- Study design
- Meta-analysis – Meta-analysis of cohort studies
- Population
Cohort studies
- Country
Multinational
- Period
Not stated in abstract
- Sample size
14 studies; 2,283,616 subjects
- Inclusion and exclusion criteria
Cohort studies; Newcastle-Ottawa quality
4. Methods and endpoints
- Exposure / intervention
Cholecystectomy
- Comparator
No cholecystectomy
- Endpoints
CRC, colon, rectal cancer; subgroups
- Statistical methods
Pooled RR, subgroup and sensitivity analyses, Egger's test
5. Actual results
- Results
CRC RR 1.06 (0.75-1.51); colon RR 1.30 (0.88-1.93); rectal RR 0.99 (0.74-1.32). Subgroups: sigmoid colon RR 1.42 (1.27-1.58); colon cancer in females RR 1.47 (1.01-2.14) and males 1.32 (1.07-1.63); right colon in females RR 1.99 (1.31-3.03).
- Absolute risks
Not reported
- Authors' conclusion
No clear evidence of an association between cholecystectomy and CRC; timely cholecystectomy can be performed when indicated.
6. Strengths
- Large pooled sample
7. Weaknesses
- Inconsistent subgroup results (sigmoid vs right colon)
- Multiple subgroup testing
- Overlaps with I-ORG-129
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Subgroup findings at risk of multiplicity.
9. Assessment of the statistical interpretation
Several significant subgroups amid a null overall estimate suggest multiplicity/heterogeneity rather than a robust effect.
10. Relevance to the specific claim
Overall null result contradicts a general cancer-causing effect.
11. Independent contrary findings
Mu 2023 found a right-sided signal.
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Contradicts a general CRC effect; subgroup signals inconsistent.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
n/a
15. Linked fact checks
- Cholecystectomy causes a persistent long-term excess of proximal small-bowel adenocarcinoma and right-sided colon cancer (Lagergren 2001). – Studies contradicting or limiting the claim