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People who carry the typhoid bacterium in their gallbladder long term have about four times the usual risk of gallbladder cancer. Two meta-analyses suggest offering them gallbladder removal or regular scans; no programme has tried it.
Chronic Salmonella Typhi carriage carried a pooled odds ratio of 4.28 across 17 studies (Nagaraja and Eslick 2014) and a summary relative risk of 4.6 to 5.0 in the Chilean case-control study and meta-analysis (Koshiol 2016), with the gallbladder as the reservoir of carriage. The carrier state is diagnosable by stool culture or Vi serology and cholecystectomy is also the treatment for carriage itself. A pragmatic programme in a typhoid-endemic, gallbladder-cancer-endemic region (northern India) could randomise identified carriers to cholecystectomy or annual ultrasound and measure cancer incidence, with the added public health benefit of removing a transmission reservoir.
Typhoid carriage is one of the few modifiable risk factors for gallbladder cancer. In the UK it is rare, but it matters for people who grew up where typhoid is endemic and for the question of whether chronic carriers should be offered cholecystectomy.
No trial has tested cholecystectomy or surveillance for chronic carriers; the recommendation is expert inference from a fourfold risk. It is one of the prevention ideas on this page.
Shares Prophylactic (preventive) cholecystectomy, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Most of the world has almost no cancer care, Gallbladder cancer and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Prevention we already have is not deployed and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Most of the world has almost no cancer care and the tag gallbladder-evidence.
Shares Prophylactic (preventive) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Inflammation, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.