Association between biliary tract cancers and family history of cancers in the Biliary Tract Cancers Pooling Project (BiTCaPP) Open Access

Abstract

Background: Biliary tract cancer (BTC) has a varied geographic and racial distribution, which differs by sex and site within the biliary tract. The established association of family history of gallstones with BTC, and the increased incidence of BTC among those with hereditary cancer syndromes, suggests a genetic component to BTC risk. We examined associations of family history of cancers with site-specific BTC risk and investigated whether these associations differ by sex and age.

Methods: This pooled analysis of seven prospective cohorts participating in the Biliary Tract Cancers Pooling Project (BiTCaPP) included individual-level data on 1,619 BTC cases and 1,185,000 non-cases from the United States and Finland. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Multivariable models were adjusted for sex, self-reported race, and calendar year at baseline. Study-specific estimates were pooled using a fixed effects model.

Results: A family history of cancer was not statistically significantly associated with independent risk of cancers of the gallbladder (HR = 0.88, 95% CI = 0.71-1.08), intrahepatic bile duct (HR = 0.99, 95% CI = 0.81-1.18), extrahepatic bile duct (HR = 0.99, 95% CI = 0.79-1.24), or ampulla of Vater (HR = 0.89, 95% CI = 0.72-1.00).

Conclusion: In the largest study to date of BTC risk, we found that family history of cancer may not be associated with risk of developing BTC.

Table of Contents

Chapter I: Background

Epidemiology of Biliary Tract Cancers……………………...……………………………1

Risk Factor Epidemiology of Biliary Tract Cancers………………………………………1

Genetic Associations………………………………………………………………………6

Significance of Thesis …………………………………………………………………….8

Chapter II: Manuscript Introduction………………………………………………………………………………10 Methods…………………………………………………………………………………..11 Results ……………………………………………………………………………………16 Discussion………………………………………………………………………………..19 Chapter III: Future Directions Summary…………………………………………………………………………………24

Future Directions………………………………………………………………………...25

Public Health Implications………………………………………………………………26

References………………………………………………………………………………..28

Tables…………………………………………………………………………………….34

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Extrahepatic Bile Duct Gallbladder Family History Ampulla of Vater Cancer Intrahepatic Bile Duct Epidemiology Biliary Tract
Committee Chair / Thesis Advisor	McCullough, Lauren, Emory University
Committee Members	Koshiol, Jill, National Cancer Institute
Partnering Agencies	US (Federal) agency other than CDC

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Association between biliary tract cancers and family history of cancers in the Biliary Tract Cancers Pooling Project (BiTCaPP) ()	2018-08-28 16:01:51 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions