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Systematic Review
Association between gallstones and the risk of biliary tract cancer: a systematic review and meta-analysis
Dan Huang, Hyundeok Joo, Nan Song, Sooyoung Cho, Woosung Kim, Aesun Shin
Epidemiol Health. 2021;43:e2021011.   Published online February 3, 2021
DOI: https://doi.org/10.4178/epih.e2021011
  • 18,448 View
  • 413 Download
  • 21 Web of Science
  • 25 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Biliary tract cancers (BTCs) are rare but highly fatal. Although the etiology of BTC is poorly understood, gallstones are proposed to be a major risk factor. We conducted a systematic review and meta-analysis to examine the associations between gallstone characteristics and BTC risk.
METHODS
We searched the MEDLINE, Embase, and Cochrane Central databases and systematically reviewed cohort and case-control studies published before April 9, 2018. All the included studies reported appropriate risk estimates and confidence intervals (CIs) for associations between the presence, size, number, or duration of gallstones and the risk of BTC, including gallbladder cancer (GBC), extrahepatic bile duct cancer (EBDC), and ampulla of Vater cancer (AOVC). Summary odds ratios (ORs) and their 95% CIs were calculated using a random-effects model in the meta-analysis. Subgroup analyses were conducted to inspect sources of potential heterogeneity, and the Egger test was performed to assess publication bias.
RESULTS
Seven cohort studies and 23 case-control studies in Asian, European, and American populations were included. The presence of gallstones was associated with an increased risk of BTC (OR, 4.38; 95% CI, 3.23 to 5.93; I<sup>2</sup>=91.2%), GBC (OR, 7.26; 95% CI, 4.33 to 12.18), EBDC (OR, 3.17; 95% CI, 2.24 to 4.50), and AOVC (OR, 3.28; 95% CI, 1.33 to 8.11). Gallstone size (>1 vs. <1 cm; OR, 1.88; 95% CI, 1.10 to 3.22) was significantly associated with the risk of GBC.
CONCLUSIONS
Gallstone characteristics, such as presence, size, and number, are associated with an increased risk of BTC. However, significantly high heterogeneity in the meta-analyses is a limitation of this study.
Summary
Korean summary
The prevalence of APCT-detected sacroiliitis in CD patients was higher than that in controls, but the condition was asymptomatic. The clinical significance of asymptomatic sacroiliitis in Korean CD patients remains unclear.
Key Message
본 연구에서는 체계적 문헌고찰과 메타분석법을 활용하여 여러 선행연구에서 담도계암 전반과 담석의 다양한 특성사이에 연관성이 있는지 탐구하였다. 총 30개의 문헌을 분석한 결과 담석의 존재 여부가 담도계암과 각 하위 암의 위험을 모두 높이는 것으로 나타났고, 담석의 크기가 클수록 담낭암의 위험이 높은 것으로 드러났다. 본 연구는 담석과 담도계암 전반의 연관성에 대해 체계적으로 정리한 최초의 문헌으로서 담석과 담도계암의 관계에 대한 이해의 폭을 넓히고, 추후 해당 주제로 추가 연구를 수행하는 데에 있어 기준점이 될 수 있으리라 기대한다.

Citations

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Review
Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs
Hassan Ahmadi Gharaei, Mostafa Dianatinasab, Seyyed Mostafa Kouhestani, Mohammad Fararouei, Hossein Moameri, Reza Pakzad, Reza Ghaiasvand
Epidemiol Health. 2019;41:e2019030.   Published online July 4, 2019
DOI: https://doi.org/10.4178/epih.e2019030
  • 16,207 View
  • 303 Download
  • 14 Web of Science
  • 19 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients’ quality of life, disease progress, and survival.
METHODS
The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.
RESULTS
The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.
CONCLUSIONS
Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
Summary

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Original Articles
Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
Mohd Azri Mohd Suan, Wei Leong Tan, Shahrul Aiman Soelar, Ibtisam Ismail, Muhammad Radzi Abu Hassan
Epidemiol Health. 2015;37:e2015017.   Published online March 30, 2015
DOI: https://doi.org/10.4178/epih/e2015017
  • 62,145 View
  • 188 Download
  • 11 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma.
METHODS
Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer.
RESULTS
Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008).
CONCLUSIONS
The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
Summary

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Epidemiological Comparison of viral hepatitis-hepatocellular carcinoma(HCC) and non viral hepatitis-hepatocellular carcinoma(HCC).
Pae Gun Park, Song Gyu Yoon, Hee Sup Lee, Jin Kun Jang, Ju Hee Maeng, Gee Hyun Lee, Jong Soo Choi
Korean J Epidemiol. 2003;25(1):32-38.
  • 6,193 View
  • 45 Download
AbstractAbstract PDF
Abstract
BACKGROUND
Korea is one of high incidence areas of Hepatocellular carcinoma (HCC) and major etiologic factor is hepatitis B virus (HBV). In future incidence of HBV related HCC may decrease and non viral hepatitis HCC (Non-B,C HCC) relatively increase because of widely used vaccination for HBV. To evaluate epidemiological characters of Non-B,C HCC, We divided HCC by viral or non-viral feature and compared each others.
METHODS
185 patients firstly diagnosed HCC and 455 normal subjects included from January 1997 to December 2000 and divided into 3 groups, HBV group (positive HBsAg), HCV group (positive anti-HCV Ab) and Non-B,C group (both negative HBsAg and anti-HCV Ab).
RESULTS
136 cases were HBV group (73.5%), 19 cases were HCV group (10.3%) and 27 cases were Non-B,C group (14.6%). Mean age of Non-B,C group at diagnosis was higher than HBV group (64.1+/-7.1 vs 55.6+/-7.7). Non-B,C HCC were more associated with alcohol abuse and rural residence (p<0.01). There was no difference of family history of liver disease, coexistence rate of liver cirrhosis and occupation.
CONCLUSION
Non-B,C HCC tended to be older in mean age than HBV HCC and more associated with alcohol abuse and rural residence. This characteristics of Non-B,C HCC supposed to be from difference in alcohol consumption and environment.
Summary

Epidemiol Health : Epidemiology and Health
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