Gallbladder stones and gallbladder polyps associated with
increased risk of colorectal adenoma in men
Yen-Ling Liu,* Jin-Shang Wu,*
Chih-Ting Lee,* Wan-Ju Lin* and
*Department of Family Medicine, National Cheng Kung University Hospital, and
Department of Family Medicine, College of Medicine, National Cheng
Kung University, Tainan, Taiwan
colorectal adenoma, colorectal non-neoplastic
polyps, gallbladder polyps, gallbladder stones.
Accepted for publication 13 September 2017.
Dr Chih-Jen Chang and Dr Feng-Hwa Lu,
Department of Family Medicine, National
Cheng Kung University Hospital, No.138, Sheng
Li Road, Tainan 704, Taiwan.
Declaration of conflict of interest: None.
Background and Aims: Most cases of colorectal cancer develop via an adenoma to
carcinoma sequence. Gallbladder polyps share some risk factors with colorectal polyps.
Little is known about the relationship between gallbladder diseases and different status
of colorectal polyps by gender. This study was to investigate the association of gallbladder
stones and polyps with colorectal adenomas by gender in a Taiwanese population.
Methods: A total of 7066 eligible subjects who underwent a total colonoscopy as a part of
health check-up between January 2001 and August 2009 were recruited. Colonoscopic
ﬁndings were classiﬁed into polyp-free, non-neoplastic polyps and colorectal adenomas.
Gallbladder stones and gallbladder polyps were diagnosed based on ultrasonographic
Results: There was a signiﬁcant difference in the status of colon polyps between subjects
with and without gallbladder polyps. However, the status of colon polyps was not
signiﬁcantly different between subjects with or without gallbladder stones. After adjusting
obesity, fasting plasma glucose, and other variables, there was a positive relationship
between gallbladder polyps and colorectal adenomas (odds ratio [OR]: 1.396, 95%
conﬁdence interval [CI]: 1.115–1.747) but not non-neoplastic polyps in all subjects. In
men, gallbladder polyps (OR: 1.560, 95% CI: 1.204–2.019) and gallbladder stones (OR:
1.465, 95% CI 1.081–1.984) were positively associated with colorectal adenomas. In
women, neither gallbladder polyps nor gallbladder stones were signiﬁcantly related to co-
Conclusions: Both gallbladder polyps and gallbladder stones were associated with an
increased risk of colorectal adenomas in men but not in women. Gender difference was sig-
niﬁcant for the association between gallbladder lesions and colorectal polyps.
Colorectal cancer is one of the most common cancers worldwide,
especially in developed countries.
Most cases of colorectal
cancer develop via an adenoma to carcinoma sequence.
fore, early detection and removal of colorectal adenomas during
colonoscopy may potentially prevent colorectal cancer.
purpose, the etiologies and risk factors of colorectal adenomas,
such as male gender, older age, obesity, metabolic syndrome,
glucose intolerance, and hyperlipidemia, have taken on broader
Similarly, gallbladder polyps share some risk
factors, including metabolic syndrome, male gender, age, and
Moreover, there is a common epitope found on the
epithelium of gallbladder and that of colorectal mucosa.
addition, gallbladder stones also appear to be associated with
age, obesity, blood glucose, and blood pressure,
are more prevalent in women.
Gallbladder polyps and gallbladder stones share some risk
factors, such as age, obesity, and metabolic abnormalities, with
However, little is known about the
association of gallbladder polyps
with colorectal polyps. Although two studies showed
a positive association between gallbladder polyps and colorectal
adenomas or adenocarcinoma,
only one study revealed that
gallbladder polyps were risk factors for colorectal adenomas.
Yamaji et al. showed strong association between gallbladder
stones and colorectal adenomas.
Furthermore, there is a signiﬁ-
cant gender impact on the prevalence of gallbladder polyps and
gallbladder stones, which complicates the relationships among
gallbladder polyps, gallbladder stones, and colorectal polyps.
The aim of this study was thus to investigate the association of
gallbladder stones and polyps with colorectal adenomas by gender
in a Taiwanese population.
Study participants. In this cross-sectional study, we
recruited 9591 subjects who underwent a total colonoscopic
examination as a part of health check-ups at National Cheng Kung
Journal of Gastroenterology and Hepatology 33 (2018) 800–806
© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd