Risk Factors for Cholangiocarcinoma

Hi,
Below are the risk factors for CC;in the United States and Europe, the main risk factors are PSC and choledochal cysts;and the incidence of cholangiocarcinoma is slightly higher in men.

1.General risk factors
Age>65years(age 30-50 if patient with PSC-primary sclerosing cholangitis)
Smoking?(?=questionable)
Obesity
Diabetes
Hyperlipidemia?
2.Post surgical
Biliary-enteric anastomosis.
3.Chronic inflammatory disease
Primary sclerosing cholangitis with or without ulcerative colitis(30%)
Biliary tract stone disease
Hepatitis B(south east Asia)
Hepatitis C
HIV
Liver cirrhosis
Hepatolithiasis(highest in Taiwan,50-70% CC patient associated with this Dx.)
Liver flukes (highest in Thailand)
4.Drugs,toxins or chemicals
Alcohol?
Thorotrast
Dioxin
Vinyl chloride
Nitrosamines
Asbestos
Oral contraceptive (esp.the first generation of oral contraceptive pills)
Isoniazid
Phenytoin?
5.Congenital/Genetic disorder
Choledochal cysts
Caroli’s disease
Congenital hepatic fibrosis
Lynch syndrome
Multiple billary papillomatosis.

References
1.CC controversies and challenges -Tushar Patel vol.8 ,April 2011 Gast.&Hep.
2.Evidence-Based ….Review of CC.-Murad Aljiffry etc. ISSN1072-7515/09
3.Epidemiology;pathogenesis & classification of CC-uptodate.com 19.2:May2011
God bless.