Salmonella entericaserovar Typhi and gallbladder cancer: a case–control study and meta‐analysis

In Chile, where gallbladder cancer (GBC) rates are high and typhoid fever was endemic until the 1990s, we evaluated the association betweenSalmonella entericaserovar Typhi (S. Typhi) antibodies andGBC. We tested 39GBCcases, 40 gallstone controls, and 39 population‐based controls forS. Typhi Vi antibodies and performed culture and quantitative polymerase chain reaction for the subset with bile, gallstone, tissue, and stool samples available. We calculated gender and education‐adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association withGBC. We also conducted a meta‐analysis of >1000GBCcases by combining our results with previous studies.GBCcases were more likely to have high Vi antibody titer levels than combined controls (OR: 4.0, 95%CI: 0.9–18.3), althoughS. Typhi was not recovered from bile, gallstone, tissue, or stool samples. In our meta‐analysis, the summary relative risk was 4.6 (95%CI: 3.1–6.8,Pheterogeneity=0.6) for anti‐Vi and 5.0 (95%CI: 2.7–9.3,Pheterogeneity = 0.2) for bile or stool culture. Our results are consistent with the meta‐analysis. Despite differences in study methods (e.g.,S. Typhi detection assay), most studies found a positive association betweenS. Typhi andGBC. However, the mechanism underlying this association requires further investigation