Carcinoma of the gall-bladder is the fifth commonest gastrointestinal tract cancer, and is endemic in several countries.
An association of chronic typhoid carriage and carcinoma of the gall-bladder has been reported.
Professor Eslick and colleagues from Australia clarified whether chronic Salmonella typhi carrier state is associated with carcinoma of the gall-bladder.
A systematic search was conducted using MEDLINE, PubMed, EMBASE, Current Contents, Cochrane library, Google Scholar, Science Direct and Web of Science.
Original data were abstracted from each study and used to calculate a pooled odds ratio (OR) and 95% confidence interval (95% CI).
|The overall odds ratio for chronic S. typhi carrier state was 4.28|
|Alimentary Pharmacology & Therapeutics|
Of the articles selected, the team found that only 17 studies met full criteria for analysis.
The researchers found that the overall odds ratio for chronic S. typhi carrier state was 4.28.
Most of the studies were from South Asia especially India and China.
When a subgroup analysis was performed according to region, a significant association was observed in South-East Asia.
The team observed that chronic S. typhi carrier state was associated with carcinoma of the gall-bladder based on detection methods of S. typhi antibody levels, and even more so on culture.
The team found that the association was prominent in controls without gallstones when compared with controls with gallstones.
Professor Eslick and colleague commented, "Chronic S. typhi carrier state is an important risk factor among patients with carcinoma of the gall-bladder."
"Given the high risk associated with this carrier state, management options should include either elective cholecystectomy or careful monitoring using ultrasound."