Risk Factors for Bile Duct Cancer

A risk factor is anything that increases your chance of developing a disease. Most people with bile duct cancer do not have an obvious cause. Having a risk factor does not mean you will develop cancer, and people without known risk factors can still develop cholangiocarcinoma. Many established risk factors involve long-term inflammation or damage to the bile ducts.

Primary sclerosing cholangitis

Primary sclerosing cholangitis, or PSC, is a chronic disease that causes inflammation and scarring of the bile ducts. PSC significantly increases the risk of cholangiocarcinoma. People with PSC may undergo specialized monitoring because they have a much higher risk than the general population.

Inflammatory bowel disease

PSC frequently occurs in people with inflammatory bowel disease, particularly ulcerative colitis. Inflammatory bowel disease itself may be associated with bile duct cancer risk, especially when PSC is also present.

Bile duct cysts

People born with abnormal bile duct structures, including choledochal cysts, have an increased risk of developing bile duct cancer. These cysts can cause repeated inflammation and abnormal bile flow.

Caroli disease

Caroli disease is a rare inherited condition in which bile ducts inside the liver become abnormally enlarged. It can increase the risk of cholangiocarcinoma.

Liver fluke infection

Certain parasitic liver flukes can live in the bile ducts and cause long-term inflammation. These infections are uncommon in the United States but are important causes of bile duct cancer in parts of Southeast Asia.

Chronic liver disease

Some chronic liver diseases may increase the risk of intrahepatic cholangiocarcinoma. Examples can include:

• Cirrhosis

• Chronic hepatitis B

• Chronic hepatitis C

• Bile duct stones

Long-standing stones within the bile ducts inside the liver may cause chronic inflammation and increase risk.

Age

Bile duct cancer is primarily diagnosed in older adults. Risk generally increases with age.

Certain chemical exposures

Exposure to certain chemicals has historically been associated with bile duct cancer, although occupational causes are uncommon.

Can bile duct cancer be inherited?

Most bile duct cancers are not directly inherited. However, certain inherited syndromes may increase cancer risk, and some tumors develop genetic changes that affect treatment. If you have a strong personal or family history of cancer, ask your doctor whether genetic counseling or inherited genetic testing may be appropriate.