{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:02:32Z","timestamp":1779688952708,"version":"3.53.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1007\/s10620-025-09551-5","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T09:59:20Z","timestamp":1764151160000},"page":"2024-2045","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Global Associations Between Gallbladder-Biliary Diseases and Pancreatic Cancer: Evidence from 204 Countries and Territories Over 32\u00a0years"],"prefix":"10.1007","volume":"71","author":[{"given":"Xiaoyang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghong","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"9551_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","volume":"74","author":"RL Siegel","year":"2024","unstructured":"Siegel RL, Giaquinto AN, Jemal A. Cancer statistics 2024. CA A Cancer Journal for Clinicians 2024;74:12\u201349.","journal-title":"CA A Cancer Journal for Clinicians"},{"key":"9551_CR2","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","volume":"162","author":"AF Peery","year":"2022","unstructured":"Peery AF, Crockett SD, Murphy CC et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the united states: update 2021. Gastroenterology 2022;162:621\u2013644.","journal-title":"Gastroenterology"},{"key":"9551_CR3","doi-asserted-by":"publisher","first-page":"16891","DOI":"10.3748\/wjg.v20.i45.16891","volume":"20","author":"PA Testoni","year":"2014","unstructured":"Testoni PA. Acute recurrent pancreatitis: etiopathogenesis, diagnosis and treatment. World J Gastroenterol 2014;20:16891.","journal-title":"World J Gastroenterol"},{"key":"9551_CR4","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1038\/s41579-022-00805-x","volume":"21","author":"SL Collins","year":"2023","unstructured":"Collins SL, Stine JG, Bisanz JE, Okafor CD, Patterson AD. Bile acids and the gut microbiota: metabolic interactions and impacts on disease. Nat Rev Microbiol 2023;21:236\u2013247.","journal-title":"Nat Rev Microbiol"},{"key":"9551_CR5","doi-asserted-by":"publisher","first-page":"3329","DOI":"10.3748\/wjg.15.3329","volume":"15","author":"H Bernstein","year":"2009","unstructured":"Bernstein H, Bernstein C, Payne CM, Dvorak K. Bile acids as endogenous etiologic agents in gastrointestinal cancer. World J Gastroenterol 2009;15:3329\u20133340.","journal-title":"World J Gastroenterol"},{"key":"9551_CR6","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1111\/dom.12124","volume":"16","author":"SK Garg","year":"2014","unstructured":"Garg SK, Maurer H, Reed K, Selagamsetty R. Diabetes and cancer: two diseases with obesity as a common risk factor. Diabetes Obes Metab 2014;16:97\u2013110.","journal-title":"Diabetes Obes Metab"},{"key":"9551_CR7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.14740\/wjon1166","volume":"10","author":"P Rawla","year":"2019","unstructured":"Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol 2019;10:10\u201327.","journal-title":"World J Oncol"},{"key":"9551_CR8","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1016\/S0140-6736(25)00261-2","volume":"405","author":"TF Stoop","year":"2025","unstructured":"Stoop TF, Javed AA, Oba A et al. Pancreatic cancer. Lancet 2025;405:1182\u20131202.","journal-title":"Lancet"},{"key":"9551_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2024.115140","volume":"214","author":"C Radkiewicz","year":"2025","unstructured":"Radkiewicz C, Ludvigsson JF, Sparrelid E, Emilsson L. Pancreatic cancer risk after benign gallbladder disease: a swedish population-based cohort study. Eur J Cancer 2025;214:115140.","journal-title":"Eur J Cancer"},{"key":"9551_CR10","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00535-013-0846-6","volume":"49","author":"Y Chen","year":"2014","unstructured":"Chen Y, Yeh J, Lin C et al. Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study. J Gastroenterol 2014;49:923\u2013931.","journal-title":"J Gastroenterol"},{"key":"9551_CR11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1038\/s41598-024-84781-7","volume":"15","author":"YA Kim","year":"2025","unstructured":"Kim YA, Kim HJ, Kang MJ, Han S, Park HM, Park S. Increased diagnosis of hepato-biliary-pancreatic cancer after cholecystectomy: a population-based study. Sci Rep 2025;15:411.","journal-title":"Sci Rep"},{"key":"9551_CR12","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1146\/annurev.pu.16.050195.000425","volume":"16","author":"H Morgenstern","year":"1995","unstructured":"Morgenstern H. Ecologic studies in epidemiology: concepts, principles, and methods. Annu Rev Public Health 1995;16:61\u201381.","journal-title":"Annu Rev Public Health"},{"key":"9551_CR13","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","volume":"403","author":"GDAI Collaborators","year":"2024","unstructured":"Collaborators GDAI. Global incidence, prevalence, years lived with disability (ylds), disability-adjusted life-years (dalys), and healthy life expectancy (hale) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the global burden of disease study 2021. Lancet 2024;403:2133\u20132161.","journal-title":"Lancet"},{"key":"9551_CR14","first-page":"1223","volume":"396","author":"GRF Collaborators","year":"2020","unstructured":"Collaborators GRF. Global burden of 87 risk factors in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019. The Lancet (British edition) 2020;396:1223\u20131249.","journal-title":"The Lancet (British edition)"},{"key":"9551_CR15","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1038\/nature09515","volume":"467","author":"S Yachida","year":"2010","unstructured":"Yachida S, Jones S, Bozic I et al. Distant metastasis occurs late during the genetic evolution of pancreatic cancer. Nature 2010;467:1114\u20131117.","journal-title":"Nature"},{"key":"9551_CR16","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1097\/JS9.0000000000001054","volume":"110","author":"Z Li","year":"2024","unstructured":"Li Z, Zhang X, Sun C, Li Z, Fei H, Zhao D. Global, regional, and national burdens of early onset pancreatic cancer in adolescents and adults aged 15\u201349 years from 1990 to 2019 based on the global burden of disease study 2019: a cross-sectional study. Int J Surg 2024;110:1929\u20131940.","journal-title":"Int J Surg"},{"key":"9551_CR17","unstructured":"Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: united states, 2003\u20132006. Natl Health Stat Report 2009:1\u20137"},{"key":"9551_CR18","doi-asserted-by":"publisher","first-page":"1116582","DOI":"10.3389\/fendo.2023.1116582","volume":"14","author":"L Zhong","year":"2023","unstructured":"Zhong L, Liu J, Liu S, Tan G. Correlation between pancreatic cancer and metabolic syndrome: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023;14:1116582.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"9551_CR19","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1038\/nrgastro.2017.119","volume":"15","author":"W Jia","year":"2018","unstructured":"Jia W, Xie G, Jia W. Bile acid\u2013microbiota crosstalk in gastrointestinal inflammation and carcinogenesis. Nat Rev Gastroenterol Hepatol 2018;15:111\u2013128.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"9551_CR20","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s00204-011-0648-7","volume":"85","author":"C Bernstein","year":"2011","unstructured":"Bernstein C, Holubec H, Bhattacharyya AK et al. Carcinogenicity of deoxycholate, a secondary bile acid. Arch Toxicol 2011;85:863\u2013871.","journal-title":"Arch Toxicol"},{"key":"9551_CR21","first-page":"389","volume":"75","author":"B Stanimirov","year":"2012","unstructured":"Stanimirov B, Stankov K, Mikov M. Pleiotropic functions of bile acids mediated by the farnesoid x receptor. Acta Gastroenterol Belg 2012;75:389.","journal-title":"Acta Gastroenterol Belg"},{"key":"9551_CR22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011775","volume":"18","author":"S Qureshi","year":"2024","unstructured":"Qureshi S, Maria N, Chawla T et al. The frequency and associated factors of typhoid carriage in patients undergoing cholecystectomy for gallbladder disease in pakistan: a cross-sectional study. PLoS Negl Trop Dis 2024;18:e11775.","journal-title":"PLoS Negl Trop Dis"},{"key":"9551_CR23","doi-asserted-by":"crossref","unstructured":"Di Domenico EG, Cavallo I, Pontone M, Toma L, Ensoli F. Biofilm producing salmonella typhi: chronic colonization and development of gallbladder cancer. Int J Mol Sci 2017;18","DOI":"10.3390\/ijms18091887"},{"key":"9551_CR24","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1534\/genetics.104.031062","volume":"168","author":"AI Prieto","year":"2004","unstructured":"Prieto AI, Ramos-Morales F, Casadesu\u0301s J. Bile-induced dna damage in salmonella enterica. Genetics 2004;168:1787\u201394.","journal-title":"Genetics"},{"key":"9551_CR25","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1038\/s41575-019-0242-7","volume":"17","author":"RM Thomas","year":"2020","unstructured":"Thomas RM, Jobin C. Microbiota in pancreatic health and disease: the next frontier in microbiome research. Nat Rev Gastroenterol Hepatol 2020;17:53\u201364.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"9551_CR26","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1001\/jama.2020.20317","volume":"325","author":"MA Mederos","year":"2021","unstructured":"Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. JAMA 2021;325:382\u2013390.","journal-title":"JAMA"},{"key":"9551_CR27","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1038\/s41591-019-0675-0","volume":"25","author":"D Furman","year":"2019","unstructured":"Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 2019;25:1822\u20131832.","journal-title":"Nat Med"},{"key":"9551_CR28","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1158\/2159-8290.CD-15-1177","volume":"6","author":"J Incio","year":"2016","unstructured":"Incio J, Liu H, Suboj P et al. Obesity-induced inflammation and desmoplasia promote pancreatic cancer progression and resistance to chemotherapy. Cancer Discov 2016;6:852\u2013869.","journal-title":"Cancer Discov"},{"key":"9551_CR29","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1016\/j.cell.2020.03.062","volume":"181","author":"KM Chung","year":"2020","unstructured":"Chung KM, Singh J, Lawres L et al. Endocrine-exocrine signaling drives obesity-associated pancreatic ductal adenocarcinoma. Cell 2020;181:832\u2013847.","journal-title":"Cell"},{"key":"9551_CR30","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1053\/j.gastro.2013.08.018","volume":"145","author":"B Philip","year":"2013","unstructured":"Philip B, Roland CL, Daniluk J et al. A high-fat diet activates oncogenic kras and cox2 to induce development of pancreatic ductal adenocarcinoma in mice. Gastroenterology 2013;145:1449\u20131458.","journal-title":"Gastroenterology"},{"key":"9551_CR31","doi-asserted-by":"crossref","unstructured":"Fahrmann JF, Bantis LE, Capello M et al. A plasma-derived protein-metabolite multiplexed panel for early-stage pancreatic cancer. JNCI: Journal of the National Cancer Institute 2019 111:372\u20139","DOI":"10.1093\/jnci\/djy126"},{"key":"9551_CR32","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1038\/s41591-023-02332-5","volume":"29","author":"D Placido","year":"2023","unstructured":"Placido D, Yuan B, Hjaltelin JX et al. A deep learning algorithm to predict risk of pancreatic cancer from disease trajectories. Nat Med 2023;29:1113\u20131122.","journal-title":"Nat Med"},{"key":"9551_CR33","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1097\/MEG.0000000000002652","volume":"35","author":"N Sun","year":"2023","unstructured":"Sun N, Wang X, Wei J. Gallstones, cholecystectomy and the risk of pancreatic cancer: an updated systematic review and meta-analysis of cohort studies. Eur J Gastroenterol Hepatol 2023;35:1313.","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"9551_CR34","doi-asserted-by":"publisher","first-page":"5101","DOI":"10.1038\/s41467-018-07460-y","volume":"9","author":"E Ferkingstad","year":"2018","unstructured":"Ferkingstad E, Oddsson A, Gretarsdottir S et al. Genome-wide association meta-analysis yields 20 loci associated with gallstone disease. Nat Commun 2018;9:5101.","journal-title":"Nat Commun"},{"key":"9551_CR35","doi-asserted-by":"publisher","first-page":"000","DOI":"10.14218\/JCTH.2023.00563","volume":"000","author":"CJ Costa","year":"2024","unstructured":"Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of gallstone disease and their clinical significance: a narrative review. J Clin Transl Hepatol 2024;000:000\u2013000.","journal-title":"J Clin Transl Hepatol"},{"key":"9551_CR36","doi-asserted-by":"publisher","first-page":"e609","DOI":"10.1016\/S2214-109X(16)30143-7","volume":"4","author":"M Plummer","year":"2016","unstructured":"Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. The Lancet Global Health 2016;4:e609\u2013e616.","journal-title":"The Lancet Global Health"},{"key":"9551_CR37","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12885-025-13597-z","volume":"25","author":"T Li","year":"2025","unstructured":"Li T, Lin C, Wang W. Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021. BMC Cancer 2025;25:189.","journal-title":"BMC Cancer"},{"key":"9551_CR38","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1038\/s41698-025-00820-0","volume":"9","author":"Z Tan","year":"2025","unstructured":"Tan Z, Meng Y, Wu Y et al. The burden and temporal trend of early onset pancreatic cancer based on the gbd 2021. NPJ Precis Oncol 2025;9:32.","journal-title":"NPJ Precis Oncol"},{"key":"9551_CR39","first-page":"295","volume":"58","author":"HILL Ab","year":"1965","unstructured":"Ab HILL. The environment and disease: association or causation? Proc R Soc Med 1965;58:295\u2013300.","journal-title":"Proc R Soc Med"},{"key":"9551_CR40","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1007\/s10654-020-00703-7","volume":"36","author":"M Shimonovich","year":"2021","unstructured":"Shimonovich M, Pearce A, Thomson H, Keyes K, Katikireddi SV. Assessing causality in epidemiology: revisiting bradford hill to incorporate developments in causal thinking. Eur J Epidemiol 2021;36:873\u2013887.","journal-title":"Eur J Epidemiol"},{"key":"9551_CR41","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1111\/add.16329","volume":"119","author":"W Hall","year":"2024","unstructured":"Hall W. Austin bradford hill\u2019s \u2018environment and disease: association or causation.\u2019 Addiction 2024;119:386\u2013390.","journal-title":"Addiction"},{"key":"9551_CR42","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12982-015-0037-4","volume":"12","author":"KM Fedak","year":"2015","unstructured":"Fedak KM, Bernal A, Capshaw ZA, Gross S. Applying the bradford hill criteria in the 21st century: how data integration has changed causal inference in molecular epidemiology. Emerg Themes Epidemiol 2015;12:14.","journal-title":"Emerg Themes Epidemiol"}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09551-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-025-09551-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09551-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:06:09Z","timestamp":1779685569000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-025-09551-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["9551"],"URL":"https:\/\/doi.org\/10.1007\/s10620-025-09551-5","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"assertion":[{"value":"24 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Throughout manuscript preparation, the authors employed artificial intelligence tools solely for linguistic refinement and editorial support. All research design, data analysis, and scientific interpretations were conducted independently by our team. The intellectual contributions, analytical frameworks, and conclusions represent original scholarly work\u2014AI assistance was restricted to grammar enhancement and formatting optimization.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of generative AI and AI-assisted technologies in the writing process"}}]}}