Cholangiocarcinomas (Bile Duct Cancer)

Cholangiocarcinomas (bile duct cancer) - Causes and Risk Factors

Any cause of chronic inflammation and/or infection to the bile ducts can increase the risk of developing CCA due to prolonged and repeated damage. These include bile duct stones or parasites (e.g. liver flukes, recurrent pyogenic cholangitis).

These are some other inflammatory conditions that can increase the risk of developing CCA:

Ulcerative Colitis – This is chronic inflammation of the large intestine that is often associated with inflammation of the bile duct (a condition known as sclerosing cholangitis). Patients with primary sclerosing cholangitis (PSC) are at an increased risk for CCA.
Congenital Bile Duct Cysts (Choledochal Cysts) - These are abnormal dilated bile ducts; they are usually congenital in nature and are typically diagnosed in childhood but may develop or be detected in adulthood. The lining of these sacs often contains pre-cancerous cells that increase the risk of developing cancer later in life.
Parasite infestation - Liver fluke infections are not uncommon especially in Asia, it occurs when people eat raw or poorly cooked fish that are infected with these tiny parasite worms. In humans, these flukes live in the bile ducts and can cause bile duct cancer. The types most closely related to CCA are Clonorchis sinensis, Schistosomiasis japonica and Opisthorchis viverrine.
Chronic Hepatitis C infection – This is a risk factor for intrahepatic CCA.
Exposure to cancer-causing (carcinogenic) agents such as asbestos, thorotrast, dioxins, nitrosamines, and vinyl chloride has been linked to causing CCA.
Smoking – Studies suggests that intrahepatic CCA is more common among heavy smokers.
Diabetes and Obesity - These metabolic conditions are increasingly associated as risk factors for intrahepatic CCA.

What are the complications of Cholangiocarcinomas (Bile Duct Cancer)?

In some patients, CCA can lead to the formation of a tumour that blocks the bile duct, resulting in the bile drainage system (cholangitis) getting infected.

Additionally, CCA may lead to the development of cirrhosis and result in scarring and damage to the liver cells, particularly patients with primary sclerosing cholangitis.