The Uncertain Link Between Gallstone Disease and Colorectal Cancer

Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide and is a major cause of cancer-related mortality. While environmental and genetic factors have a major and well-known contribution in its pathogenesis, research has suggested that nutrition and lifestyle may also play a central role in the development of this neoplasm. Moreover, metabolic, hormonal and biochemical changes in the digestive tract can create a favorable ground for tumor development in the colonic epithelium.

Gallstone disease are a very common gastrointestinal disease that often remains asymptomatic, without being a major health problem. However, epidemiological studies have shown a link between the occurrence of right-sided colon cancers and the presence of gallstones which led to an increasing interest in the mechanisms that may underlie this association. Although the two pathologies share numerous risk factors (obesity, metabolic syndrome, hypercholesterolemia, diabetes, high-fat diet, sedentary lifestyle, old age), gallstones may be at the intersection of several CRC pathways. Whether it’s metabolic changes in bile acids and cholesterol, changes of the gut microbiota, or even inflammation, gallstones could independently promote the appearance of colorectal tumors.

In this review article, we aim to provide an assessment of the factors and mechanisms by which gallstones and cholecystectomy could influence the development of CRC. It is also important to consider whether the profile of the gallstone patient could be included in individualized screening programs for the early detection of CRC.