Project Details


Cancers of the biliary tract provide a unique opportunity to combine
biochemistry and epidemiology to shed light on the possible etiology of
cancers which are uncommon in the U.S. but of considerable international
importance. Different parts of the biliary tract are bathed in the same
material, bile. Yet, there are significant differences in the epidemiology
of cancers of these different parts of the biliary tract. In addition,
there are marked differences in the incidence of these diseases across
countries. These findings have led to many hypotheses about etiology,
including biochemical hypotheses arising out of preliminary work by the
investigators: marked differences have been demonstrated in the bile and
gallstone constituents of normal, cholelithiasis, and cancer patients in
Bolivia and the U.S. In order to further investigate the risk factors and etiology of biliary
tract cancers, a case-control study is proposed. Subjects will be
collected from two collaborating Latin American centers: La Paz, Bolivia
and Mexico City, Mexico. Three case groups will be recruited into the
study, patients undergoing abdominal surgery who have newly-diagnosed: 1)
cancer of the gallbladder, 2) cancer of the extra-hepatic biliary tract,
and 3) cancer of the ampulla of Vater. Each case will be compared to two
sets of controls: 1) abdominal surgery patients with cholelithiasis, and
2) abdominal surgery patients who have no biliary tract disease. Personal
interviews will be used to obtain: demographic characteristics, prior
medical history, family history, and exposure to agents presumed to be risk
factors for biliary cancer. Bile, blood, and, where appropriate, gallstone
specimens will be obtained from cases and controls during surgery and
analyzed for various biochemical parameters. Univariate analysis,
including calculation of odds ratios with confidence intervals, will be
followed by stratification and multiple logistic regression, enabling us to
evaluate the importance of each variable while adjusting for the others as
confounders, as well as the relative importance of each variable as a risk
Effective start/end date3/1/842/28/89


  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health


  • Medicine(all)

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