{
  "abstract": "Background/Objectives: Gallbladder cancer (GBC) remains a leading cause of cancer death in Chilean women. Gallstones are present in >90% of GBC cases, but few individuals with gallstones develop cancer, suggesting additional factors are needed. Methods: To determine whether obesity increases the risk of progression from gallstones to high-grade dysplasia (HGD) and GBC, we used data from the Chile Biliary Longitudinal Study, 2016–2025, comprising women with ultrasound-detected gallstones in high-incidence regions of Chile.We measured body mass index (BMI) and waist-to-height ratio (WHtR) at baseline and up to two follow-up visits. We used Cox proportional-hazards models with age as the time scale to quantify associations of time-varying BMI and WHtR with HGD/GBC risk. Results: During a median follow-up of 4.8 years, 116 of 4711 women developed HGD/GBC. Time-varying BMI was not significantly associated with HGD/GBC risk (p-overall = 0.11; p-nonlinearity = 0.20). In contrast, time-varying WHtR showed a non-linear association with HGD/GBC (p-overall = 0.02; p-nonlinearity = 0.02). Baseline WHtR and BMI models showed similar patterns of associations. Based on longitudinal WHtR trajectories among cases and lag sensitivity analyses, preclinical disease-related weight loss is unlikely to fully explain the observed associations. Conclusions: In conclusion, central obesity measured by WHtR was non-linearly associated with HGD/GBC risk in this population, suggesting that central adiposity may impact the progression from gallstones to HGD/GBC.",
  "abstract_shown": true,
  "affiliations": [
    "Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA",
    "Escuela de Salud Pública, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile",
    "Center for Cancer Prevention and Control (CECAN), Santiago 8331150, Chile",
    "Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA",
    "Hospital Dr. Hernán Henríquez Aravena, Temuco 4781151, Chile",
    "Facultad de Medicina, Universidad de La Frontera, Temuco 4781218, Chile",
    "Facultad de Medicina, Universidad Católica del Maule, Talca 3480112, Chile",
    "Independent Researcher, Willis, VA 24380, USA",
    "Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile",
    "Instituto de Salud Pública, Santiago 7780050, Chile"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Paz Cook"
    },
    {
      "affs": [
        3
      ],
      "name": "Ruth M. Pfeiffer"
    },
    {
      "affs": [
        0
      ],
      "name": "Jennifer S. Smith"
    },
    {
      "affs": [
        2,
        4,
        5
      ],
      "name": "Juan Carlos Araya",
      "orcid": "0000-0003-3501-8203"
    },
    {
      "affs": [
        4
      ],
      "name": "Noldy Mardones"
    },
    {
      "affs": [
        6
      ],
      "name": "Laura Huidobro",
      "orcid": "0000-0001-6179-6688"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Hector Losada",
      "orcid": "0000-0002-8684-9675"
    },
    {
      "affs": [
        7
      ],
      "name": "Allan Hildesheim",
      "orcid": "0000-0003-0257-2363"
    },
    {
      "affs": [
        2,
        8
      ],
      "name": "Juan Carlos Roa",
      "orcid": "0000-0001-8313-8774"
    },
    {
      "affs": [
        1
      ],
      "name": "Claudia Marco",
      "orcid": "0000-0002-3631-8817"
    },
    {
      "affs": [
        1
      ],
      "name": "Ian Reyes",
      "orcid": "0009-0006-8439-0350"
    },
    {
      "affs": [
        1
      ],
      "name": "Matias Pozo",
      "orcid": "0009-0001-5940-075X"
    },
    {
      "affs": [
        1,
        9
      ],
      "name": "Catterina Ferreccio",
      "orcid": "0000-0001-6331-5534"
    },
    {
      "affs": [
        3
      ],
      "name": "Jill Koshiol",
      "orcid": "0000-0002-3832-6204"
    },
    {
      "name": "the Chile BiLS Study Group"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ayf3b2zpmj9sw.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18203356",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13702334/?tool=EBI",
  "id": "ayf3b2zpmj9sw",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://www.mdpi.com/2072-6694/18/20/3356",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Cholangiocarcinoma and Gallbladder Cancer Studies"
    ]
  ],
  "openalex": "W7222954048",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13702334/pdf/?tool=EBI",
  "pmcid": "PMC13702334",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/ayf3b2zpmj9sw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:58Z",
      "native_id": "10.3390/cancers18203356",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/20/3356"
    },
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "PMC:PMC13702334",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13702334"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Cholangiocarcinoma and Gallbladder Cancer Studies",
      "subfield": "surgery"
    }
  ],
  "title": "Obesity and Risk of High-Grade Dysplasia and Gallbladder Cancer Among Women with Gallstones in the Chile Biliary Longitudinal Study",
  "title_text": "Obesity and Risk of High-Grade Dysplasia and Gallbladder Cancer Among Women with Gallstones in the Chile Biliary Longitudinal Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:34Z",
  "url": "https://research.draconitic.com/paper/ayf3b2zpmj9sw",
  "venue": "Cancers",
  "versions": []
}