Jill Koshiol

NCI, DCEG, IIB

Earl Stadtman Investigator

PLCO (Learn more about this study)

PLCO-17

Mar 5, 2013

Biliary Tract Cancers Pooling Project

Gallbladder cancer, the fifth most common gastrointestinal tract malignancy in the United States, is highly fatal with a 5-yr survival rate of only ~10-15%. The disease is relatively rare in the U.S., Canada, and most of Western Europe whereas it is somewhat more common in Japan, China, Latin America and Eastern Europe. Cancers of the gallbladder, extrahepatic bile duct, and ampulla of Vater (collectively referred to as biliary tract cancers) are expected to account for almost 10,000 incident cancers in the U.S. in 2012. Biliary tract cancers display distinct demographic patterns and molecular profiles, suggesting that they are separate disease entities. For example, gallbladder cancer occurs about two-to-five fold more often in women than in men, while the other biliary tract cancers tend to be slightly more common in men than in women. Given the rarity and exceptionally poor prognosis of these cancers, little is known about their etiology beyond a positive association with history of cholesterol gallstones, which is associated with higher risk of gallbladder cancer (relative risks are in the range of 4 to 24) and also associated with a more modest higher risk of other biliary tract cancers.

The rarity of biliary tract cancer underscores the need for combining data from multiple well-characterized studies to better understand its etiology. In this context, the NCI Cohort Consortium is unique in its ability to prospectively evaluate risk factors for individual types of biliary tract cancers. To this end, we have established an approved NCI Cohort Consortium project named the Biliary Tract Cancer Pooling Project (BTCPP). A key advantage of this resource is that most of the necessary data have been already collected and harmonized from earlier projects, and resources are available to add in new cohorts entirely de novo.

The purpose of this proposal is to prospectively evaluate risk factors for biliary tract cancer. Given the rarity of cancers of the gallbladder, extrahepatic bile ducts, and ampulla of Vater, it is necessary to establish large pooling projects to study their risk factors. This would be the largest prospective analysis to date for biliary tract cancers and could provide critical information toward establishing whether hypothesized risk factors are associated with risk and how those associations vary by site.

Peter Campbell, peter.campbell@cancer.org, American Cancer Society, Epidemiology Research Program, Atlanta GA, p.404-327-6460

Katherine McGlynn, mcglynnk@mail.nih.gov, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, p.301-435-4919