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Am J Hum Genet. 1984 Nov; 36(6): 1259–1278.
PMCID: PMC1684666
PMID: 6517051

Genetics and epidemiology of gallbladder disease in New World native peoples.

Abstract

Native peoples of the New World, including Amerindians and admixed Latin Americans such as Mexican-Americans, are highly susceptible to diseases of the gallbladder. These include cholesterol cholelithiasis (gallstones) and its complications, as well as cancer of the gallbladder. Although there is clearly some necessary dietary or other environmental risk factor involved, the pattern of disease prevalence is geographically associated with the distribution of genes of aboriginal Amerindian origin, and levels of risk generally correspond to the degree of Amerindian admixture. This pattern differs from that generally associated with Westernization, which suggests a gene-environment interaction, and that within an admixed population there is a subset whose risk is underestimated when admixture is ignored. The risk that an individual of a susceptible New World genotype will undergo a cholecystectomy by age 85 can approach 40% in Mexican-American females, and their risk of gallbladder cancer can reach several percent. These are heretofore unrecognized levels of risk, especially of the latter, because previous studies have not accounted for admixture or for the loss of at-risk individuals due to cholecystectomy. A genetic susceptibility may, thus, be as "carcinogenic" in New World peoples as any known major environmental exposure; yet, while the risk has a genetic basis, its expression as gallbladder cancer is so delayed as to lead only very rarely to multiply-affected families. Estimates in this paper are derived in part from two studies of Mexican-Americans in Starr County and Laredo, Texas.

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  • Nakayama F, Miyake H. Changing state of gallstone disease in Japan. Composition of the stones and treatment of the condition. Am J Surg. 1970 Dec;120(6):794–799. [PubMed] [Google Scholar]
  • Sampliner RE, Bennett PH, Comess LJ, Rose FA, Burch TA. Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. N Engl J Med. 1970 Dec 17;283(25):1358–1364. [PubMed] [Google Scholar]
  • Comess LJ, Bennett PH, Burch TA. Clinical gallbladder disease in Pima Indians. Its high prevalence in contrast to Framingham, Massachusetts. N Engl J Med. 1967 Oct 26;277(17):894–898. [PubMed] [Google Scholar]
  • Thistle JL, Eckhart KL, Jr, Nensel RE, Nobrega FT, Poehling GG, Reimer M, Schoenfield LJ. Prevalence of gallbladder disease among Chippewa Indians. Mayo Clin Proc. 1971 Sep;46(9):603–608. [PubMed] [Google Scholar]
  • Boss LP, Lanier AP, Dohan PH, Bender TR. Cancers of the gallbladder and biliary tract in Alaskan natives: 1970--79. J Natl Cancer Inst. 1982 Nov;69(5):1005–1007. [PubMed] [Google Scholar]
  • Ríos-Dalenz J, Correa P, Haenszel W. Morbidity from cancer in La Paz, Bolivia. Int J Cancer. 1981 Sep 15;28(3):307–314. [PubMed] [Google Scholar]
  • Albores-Saavedra J, Altamirano-Dimas M. Algunas consideraciones sobre 9,412 autopsias realizadas en el Hospital General de México. Gac Med Mex. 1971 Aug;102(2):193–203. [PubMed] [Google Scholar]
  • Henson DE. Conference and workshop on cancer epidemiology in Latin America. Opportunities for collaborative research. J Natl Cancer Inst. 1983 May;70(5):979–985. [PubMed] [Google Scholar]
  • Rios-Dalenz J, Takabayashi A, Henson DE, Strom BL, Soloway RD. The epidemiology of cancer of the extra-hepatic biliary tract in Bolivia. Int J Epidemiol. 1983 Jun;12(2):156–160. [PubMed] [Google Scholar]
  • Williams CN, Johnston JL, Weldon KL. Prevalence of gallstones and gallbladder disease in Canadian Micmac Indian women. Can Med Assoc J. 1977 Oct 8;117(7):758–760. [PMC free article] [PubMed] [Google Scholar]
  • LAM RC. Gallbladder diseases among the American Indians. J Lancet. 1954 Aug;74(8):305–309. [PubMed] [Google Scholar]
  • Erickson WG. Cholecystectomy and the American Indian. A ten-year comparative study. Rocky Mt Med J. 1972 Jul;69(7):33–35. [PubMed] [Google Scholar]
  • Danzinger RG, Gordon H, Schoenfield LJ, Thistle JL. Lithogenic bile in siblings of young women with cholelithiasis. Mayo Clin Proc. 1972 Oct;47(10):762–766. [PubMed] [Google Scholar]
  • SIEVERS ML, MARQUIS JR. The Southwestern American Indian's burden: biliary disease. JAMA. 1962 Nov 3;182:570–572. [PubMed] [Google Scholar]
  • Sampliner JE, O'Connell DJ. Biliary surgery in the Southwestern American Indian. Arch Surg. 1968 Jan;96(1):1–3. [PubMed] [Google Scholar]
  • KRAVETZ RE. ETIOLOGY OF BILIARY TRACT DISEASE IN SOUTHWESTERN AMERICAN INDIANS. ANALYSIS OF 105 CONSECUTIVE CHOLECYSTECTOMIES. Gastroenterology. 1964 Apr;46:392–398. [PubMed] [Google Scholar]
  • Reichenbach DD. Autopsy incidence of diseases among Southwestern American Indians. Arch Pathol. 1967 Jul;84(1):81–86. [PubMed] [Google Scholar]
  • West KM. Diabetes in American Indians and other native populations of the New World. Diabetes. 1974 Oct;23(10):841–855. [PubMed] [Google Scholar]
  • Szathmary EJ, Holt N. Hyperglycemia in Dogrib Indians of the Northwest Territories, Canada: association with age and a centripetal distribution of body fat. Hum Biol. 1983 May;55(2):493–515. [PubMed] [Google Scholar]
  • Thistle JL, Schoenfield LJ. Lithogenic bile among young Indian women. N Engl J Med. 1971 Jan 28;284(4):177–181. [PubMed] [Google Scholar]
  • Grundy SM, Metzger AL, Adler RD. Mechanisms of lithogenic bile formation in American Indian women with cholesterol gallstones. J Clin Invest. 1972 Dec;51(12):3026–3043. [PMC free article] [PubMed] [Google Scholar]
  • Morris DL, Buechley RW, Key CR, Morgan MV. Gallbladder disease and gallbladder cancer among American Indians in tricultural New Mexico. Cancer. 1978 Nov;42(5):2472–2477. [PubMed] [Google Scholar]
  • Diehl AK, Stern MP, Ostrower VS, Friedman PC. Prevalence of clinical gallbladder disease in Mexican-American, Anglo, and black women. South Med J. 1980 Apr;73(4):438–443. [PubMed] [Google Scholar]
  • Bainton D, Davies GT, Evans KT, Gravelle IH. Gallbladder disease. Prevalence in a South Wales industrial town. N Engl J Med. 1976 May 20;294(21):1147–1149. [PubMed] [Google Scholar]
  • Friedman GD, Kannel WB, Dawber TR. The epidemiology of gallbladder disease: observations in the Framingham Study. J Chronic Dis. 1966 Mar;19(3):273–292. [PubMed] [Google Scholar]
  • HANNA BL, DAHLBERG AA, STRANDSKOV HH. A preliminary study of the population history of the Pima Indians. Am J Hum Genet. 1953 Dec;5(4):377–388. [PMC free article] [PubMed] [Google Scholar]
  • BROWN KS, HANNA BL, DAHLBERG AA, STRANDSKOV HH. The distribution of blood group alleles among Indians of Southwest North America. Am J Hum Genet. 1958 Jun;10(2):175–195. [PMC free article] [PubMed] [Google Scholar]
  • Brown JE, Christensen C. Biliary tract disease among the Navajos. JAMA. 1967 Dec 11;202(11):1050–1052. [PubMed] [Google Scholar]
  • Sievers ML. Disease patterns among southwestern Indians. Public Health Rep. 1966 Dec;81(12):1075–1083. [PMC free article] [PubMed] [Google Scholar]
  • Diehl AK. Epidemiology of gallbladder cancer: a synthesis of recent data. J Natl Cancer Inst. 1980 Dec;65(6):1209–1214. [PubMed] [Google Scholar]
  • Lowenfels AB. Gallstones and the risk of cancer. Gut. 1980 Dec;21(12):1090–1092. [PMC free article] [PubMed] [Google Scholar]
  • Vernick LJ, Kuller LH, Lohsoonthorn P, Rycheck RR, Redmond CK. Relationship between cholecystectomy and ascending colon cancer. Cancer. 1980 Jan 15;45(2):392–395. [PubMed] [Google Scholar]
  • Hill MJ. Bile, bacteria and bowel cancer. Gut. 1983 Oct;24(10):871–875. [PMC free article] [PubMed] [Google Scholar]
  • Narisawa T, Sano M, Sato M, Takahashi T, Arakawa H. Relationship between cholecystectomy and colonic cancer in low-risk Japanese population. A preliminary study. Dis Colon Rectum. 1983 Aug;26(8):512–515. [PubMed] [Google Scholar]
  • Bismuth H, Malt RA. Current concepts in cancer: carcinoma of the biliary tract. N Engl J Med. 1979 Sep 27;301(13):704–706. [PubMed] [Google Scholar]
  • Albores-Saavedra J, Alcántra-Vazquez A, Cruz-Ortiz H, Herrera-Goepfert R. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer. 1980 Mar 1;45(5):919–927. [PubMed] [Google Scholar]
  • Alonso de Ruiz P, Albores-Saavedra J, Henson DE, Monroy MN. Cytopathology of precursor lesions of invasive carcinoma of the gallbladder: a study of bile aspirated from surgically excised gallbladders. Acta Cytol. 1982 Mar-Apr;26(2):144–152. [PubMed] [Google Scholar]
  • Black WC, Key CR, Carmany TB, Herman D. Carcinoma of the gallbladder in a population of Southwestern American Indians. Cancer. 1977 Mar;39(3):1267–1279. [PubMed] [Google Scholar]
  • Bagheri SA, Bolt MG, Boyer JL, Palmer RH. Stimulation of thymidine incorporation in mouse liver and biliary tract epithelium by lithocholate and deoxycholate. Gastroenterology. 1978 Feb;74(2 Pt 1):188–192. [PubMed] [Google Scholar]
  • Silverman SJ, Andrews AW. Bile acids: co-mutagenic activity in the Salmonella-mammalian-microsome mutagenicity test: brief communication. J Natl Cancer Inst. 1977 Nov;59(5):1557–1559. [PubMed] [Google Scholar]
  • Palmer RH, Ruban Z. Production of bile duct hyperplasia and gallstones by lithocholic acid. J Clin Invest. 1966 Aug;45(8):1255–1267. [PMC free article] [PubMed] [Google Scholar]
  • Reddy BS, Watanabe K. Effect of cholesterol metabolites and promoting effect of lithocholic acid in colon carcinogenesis in germ-free and conventional F344 rats. Cancer Res. 1979 May;39(5):1521–1524. [PubMed] [Google Scholar]
  • Young TK, Frank JW. Cancer surveillance in a remote Indian population in northwestern Ontario. Am J Public Health. 1983 May;73(5):515–520. [PMC free article] [PubMed] [Google Scholar]
  • HESSE FG. Incidence of cholecystitis and other diseases among Pima Indians of Southern Arizona. J Am Med Assoc. 1959 Aug 8;170(15):1789–1790. [PubMed] [Google Scholar]
  • GIBBS FA. WITHDRAWAL CONVULSIONS: EPILEPTIC OR NOT? JAMA. 1964 Dec 7;190:944–944. [PubMed] [Google Scholar]
  • MCLAUGHLIN CW., Jr CARCINOMA OF THE GALLBLADDER, AN ADDED HAZARD IN UNTREATED CALCULOUS CHOLECYSTITIS IN OLDER PATIENTS. Surgery. 1964 Oct;56:755–759. [PubMed] [Google Scholar]
  • Holmes SL, Mark JB. Carcinoma of the gallbladder. Surg Gynecol Obstet. 1971 Oct;133(4):561–564. [PubMed] [Google Scholar]
  • Rudolph R, Cohen JJ, Gascoigne RH. Biliary cancer among Southwestern American Indians. Ariz Med. 1970 Oct;27(10):1–4. [PubMed] [Google Scholar]
  • Weiss KM, Hanis GL. All "silent" gallstones are not silent. N Engl J Med. 1984 Mar 8;310(10):657–658. [PubMed] [Google Scholar]
  • Gracie WA, Ransohoff DF. The natural history of silent gallstones: the innocent gallstone is not a myth. N Engl J Med. 1982 Sep 23;307(13):798–800. [PubMed] [Google Scholar]
  • Reed TE. Ethnic classification of Mexican-Americans. Science. 1974 Jul 19;185(4147):283–283. [PubMed] [Google Scholar]
  • Relethford JH, Stern MP, Gaskill SP, Hazuda HP. Social class, admixture, and skin color variation in Mexican-Americans and Anglo-Americans living in San Antonio, Texas. Am J Phys Anthropol. 1983 May;61(1):97–102. [PubMed] [Google Scholar]
  • Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. [PMC free article] [PubMed] [Google Scholar]
  • Vernick LJ, Kuller LH, Lohsoonthorn P, Rycheck RR, Redmond CK. Relationship between cholecystectomy and ascending colon cancer. Cancer. 1980 Jan 15;45(2):392–395. [PubMed] [Google Scholar]
  • Narisawa T, Sano M, Sato M, Takahashi T, Arakawa H. Relationship between cholecystectomy and colonic cancer in low-risk Japanese population. A preliminary study. Dis Colon Rectum. 1983 Aug;26(8):512–515. [PubMed] [Google Scholar]
  • Abrams JS, Anton JR, Dreyfuss DC. The absence of a relationship between cholecystectomy and the subsequent occurrence of cancer of the proximal colon. Dis Colon Rectum. 1983 Mar;26(3):141–144. [PubMed] [Google Scholar]
  • Lowenfels AB, Domellöf L, Lindström CG, Bergman F, Monk MA, Sternby NH. Cholelithiasis, cholecystectomy, and cancer: a case-control study in Sweden. Gastroenterology. 1982 Sep;83(3):672–676. [PubMed] [Google Scholar]
  • Lanier AP, Blot WJ, Bender TR, Fraumeni JF., Jr Cancer in Alaskan Indians, Eskimos, and Aleuts. J Natl Cancer Inst. 1980 Nov;65(5):1157–1159. [PubMed] [Google Scholar]
  • Lanier AP, Bender TR, Blot WJ, Fraumeni JF., Jr Cancer in Alaskan Natives: 1974-78. Natl Cancer Inst Monogr. 1982;62:79–81. [PubMed] [Google Scholar]
  • NEEL JV. Diabetes mellitus: a "thrifty" genotype rendered detrimental by "progress"? Am J Hum Genet. 1962 Dec;14:353–362. [PMC free article] [PubMed] [Google Scholar]
  • Locke FB, King H. Cancer mortality risk among Japanese in the United States. J Natl Cancer Inst. 1980 Nov;65(5):1149–1156. [PubMed] [Google Scholar]
  • King H, Locke FB. Cancer mortality among Chinese in the United States. J Natl Cancer Inst. 1980 Nov;65(5):1141–1148. [PubMed] [Google Scholar]
  • Kolonel LN. Cancer patterns of four ethnic groups in Hawaii. J Natl Cancer Inst. 1980 Nov;65(5):1127–1139. [PubMed] [Google Scholar]

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