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A risk factor is anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.
But having a risk factor, or even many risk factors, does not mean that a person will get the disease. And many people who get the disease have few or no known risk factors.
Researchers have found some risk factors that make a person more likely to develop bile duct cancer.
People who have chronic (long-standing) inflammation of the bile ducts have an increased risk of developing bile duct cancer. Certain conditions of the liver or bile ducts can cause this, these include:
Other rare diseases of the liver and bile duct that may increase the risk of developing bile duct cancer include polycystic liver disease and Caroli syndrome (a dilation of the intrahepatic bile ducts present at birth).
Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease. People with these diseases have an increased risk of bile duct cancer.
Older people are more likely than younger people to get bile duct cancer. Most people diagnosed with bile duct cancer are in their 60s or 70s.
In the US, the risk of bile duct cancer is highest among Hispanic Americans. Worldwide, bile duct cancer is much more common in Southeast Asia and China, largely because of the high rate of infection with liver flukes in these areas.
Being overweight or obese can increase the risk of cancers of the gallbladder and bile ducts. This could be because obesity increases the risk of gallstones and bile duct stones, as well as the risk of non-alcoholic fatty liver disease. But there may be other ways that being overweight can lead to bile duct cancers, such as changes in certain hormones.
Non-alcoholic fatty liver disease is the build-up of extra fat in the liver cells that's not caused by alcohol. Over time, this can cause swelling and scarring that can progress to cancer.
A radioactive substance called Thorotrast (thorium dioxide) was used as a contrast agent for x-rays until the 1950s. It was found to increase the risk for bile duct cancer, as well as some types of liver cancer, and is no longer used.
A history of bile duct cancer in the family seems to increase a person’s chances of developing this cancer, but the risk is still low because this is a rare disease. Most bile duct cancers are not found in people with a family history of the disease.
People with diabetes (type 1 or type 2) have a higher risk of bile duct cancer. This increase in risk is not high, and the overall risk of bile duct cancer in someone with diabetes is still low.
People who drink alcohol are more likely to get intrahepatic bile duct cancer. The risk is higher in those who have liver problems from drinking alcohol.
Studies have found other factors that might increase the risk of bile duct cancer, but the links are not as clear. These include:
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Abou-Alfa GK, Jarnagin W, Lowery M, D’Angelica M, Brown K, Ludwig E, Covey A, Kemeny N, Goodman KA, Shia J, O’Reilly EM. Liver and bile duct cancer. In: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, PA. Elsevier; 2014:1373-1395.
American Liver Foundation. Non-Alcoholic Fatty Liver Disease. Accessed at https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/non-alcoholic-fatty-liver-disease/#information-for-the-newly-diagnosed on June 18, 2018.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. v.1.2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf on June 19, 2018.
Patel T, Borad MJ. Carcinoma of the biliary tree. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA. Lippincott Williams & Wilkins; 2015:715-735.
Petrick JL, Campbell PT, Koshiol J, et al. Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project. Br J Cancer. 2018;118(7):1005-1012.
Petrick JL, Yang B, Altekruse SF, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: A population-based study in SEER-Medicare. PLoS One. 2017:12(10).
Welzel TM, Graubard BI, El-Serag HB, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol. 2007;5(10):1221-1228.
Last Revised: July 3, 2018