title: Risk factors for gallbladder cancer and cholangiocarcinoma: similarities, differences and updates.
abstract: BACKGROUND
  Far-ranging variation in the incidence of gallbladder cancer (GBC) and cholangiocarcinoma (CCA) in different geographic regions on the globe may reflect the risk factor distribution for these tumors
  
  
  METHODS
  The authors give a comprehensive review on the known risk factors for GBC and CCA, and analyze both similarities and differences between the risk factors for the two main types of biliary cancer
  
  
  CONCLUSIONS
  Leading risk factors for GBC include gallstones, female gender, and advancing age. Primary sclerosing cholangitis, nitrosamine exposure, choledochal cysts, Clonorchis sinensis and Opisthorchis viverrini represent important risk factors for CCA, although a specific risk factor cannot be identified for many patients. While both cancers affect mostly individuals in their sixth decade or older, CCA has a male predominance and GBC--a predilection for females. Although the current level of understanding of the molecular pathogenesis of GBC and CCA at the interface with specific risk factors is significantly lower than for other gastrointestinal malignancies, it continues to evolve and may soon open new avenues for the therapy of biliary cancers.
authors: Department of Internal Medicine, University of Connecticut, Farmington, CT 06032, USA. trustagi@resident.uchc.edu
authors: Tarun
authors: T
authors: Rustagi
authors: Constantin A
authors: CA
authors: Dasanu
references: Int J Cancer. 2005 Dec 10;117(5):854-60
references: 15957169
references: J Surg Oncol. 2008 Dec 1;98(7):485-9
references: 18802958
references: Oncology (Williston Park). 2004 Jun;18(7):889-96
references: 15255172
references: Br J Surg. 2002 Aug;89(8):962-70
references: 12153620
references: Eur J Cancer Prev. 2002 Aug;11(4):365-8
references: 12195163
references: Dig Dis Sci. 2005 May;50(5):862-7
references: 15906758
references: Am J Gastroenterol. 1998 Oct;93(10):1996-8
references: 9772078
references: Ann Surg. 1982 Mar;195(3):270-3
references: 7059239
references: CA Cancer J Clin. 2001 Nov-Dec;51(6):349-64
references: 11760569
references: Hepatology. 2000 Jan;31(1):247-8
references: 10613754
references: Clin Gastroenterol Hepatol. 2007 Oct;5(10):1221-8
references: 17689296
references: Cancer. 1995 Jan 1;75(1 Suppl):171-90
references: 8000995
references: Ann Surg. 1991 Jan;213(1):21-5
references: 1845927
references: Cancer. 1992 Sep 15;70(6):1498-501
references: 1516001
references: Arch Surg. 1983 Aug;118(8):986-8
references: 6870530
references: Nat Rev Cancer. 2004 Sep;4(9):695-706
references: 15343276
references: J Hepatol. 2006 Jun;44(6):1066-73
references: 16480786
references: Hum Pathol. 1996 Apr;27(4):360-5
references: 8617479
references: J Gastroenterol Hepatol. 2002 Sep;17(9):1015-20
references: 12167124
references: Arch Surg. 2009 May;144(5):441-7; discussion 447
references: 19451486
references: Arch Pathol Lab Med. 1993 Sep;117(9):944-7
references: 8368911
references: Hum Pathol. 1999 Jan;30(1):21-5
references: 9923922
references: Hepatogastroenterology. 2002 May-Jun;49(45):604-8
references: 12063950
references: Eur J Cancer Prev. 2003 Aug;12(4):269-72
references: 12883378
references: World J Gastroenterol. 2008 Jan 28;14(4):632-5
references: 18203300
references: Endoscopy. 2001 Jul;33(7):614-9
references: 11473335
references: Br J Cancer. 2007 May 7;96(9):1457-61
references: 17375043
references: BMC Cancer. 2002 May 03;2:10
references: 11991810
references: Int J Cancer. 2006 Apr 1;118(7):1591-602
references: 16397865
references: Clin Cancer Res. 2001 Sep;7(9):2648-55
references: 11555575
references: Cancer Res. 1995 Jun 15;55(12):2511-5
references: 7780959
references: Dig Dis Sci. 1999 Aug;44(8):1619-25
references: 10492143
references: Am J Gastroenterol. 1999 Feb;94(2):446-50
references: 10022644
references: Gastrointest Radiol. 1983;8(1):41-3
references: 6299873
references: Hepatology. 2001 Jun;33(6):1353-7
references: 11391522
references: Dig Dis Sci. 2000 Feb;45(2):317-24
references: 10711445
references: Chin Med J (Engl). 2000 Dec;113(12):1138-41
references: 11776153
references: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references: 19474385
references: Gut. 2000 Nov;47(5):721-7
references: 11034592
references: Hepatology. 1995 Sep;22(3):774-9
references: 7657282
references: Surgery. 2001 Jun;129(6):699-703
references: 11391368
references: Mayo Clin Proc. 1994 Oct;69(10):969-82
references: 7934194
references: J Natl Cancer Inst. 1996 Oct 16;88(20):1472-7
references: 8841022
references: Hepatobiliary Pancreat Dis Int. 2003 May;2(2):285-9
references: 14599986
references: Int J Cancer. 2007 Feb 1;120(3):638-41
references: 17109384
references: Gastroenterology. 1995 Nov;109(5):1612-7
references: 7557145
references: Br J Surg. 1996 Aug;83(8):1062-64
references: 8869303
references: Gut. 1996 Apr;38(4):610-5
references: 8707097
references: J Natl Cancer Inst. 1980 Dec;65(6):1209-14
references: 6933267
references: Lancet Infect Dis. 2005 Jan;5(1):31-41
references: 15620559
references: Gastroenterology. 2005 Mar;128(3):620-6
references: 15765398
references: J Am Geriatr Soc. 2008 May;56(5):960-1
references: 18454764
references: Gastroenterology. 2002 Oct;123(4):1090-8
references: 12360471
references: Scand J Gastroenterol. 1997 Oct;32(10):1042-5
references: 9361178
references: J Gastroenterol Hepatol. 2002 Oct;17(10):1049-55
references: 12201863
references: N Engl J Med. 1995 Apr 6;332(14):924-33
references: 7877651
references: Gastroenterology. 2005 May;128(6):1655-67
references: 15887157
references: Am J Gastroenterol. 1980 Feb;73(2):113-9
references: 6249119
references: J Hepatol. 2004 Mar;40(3):472-7
references: 15123362
references: Rev Epidemiol Sante Publique. 1993;41(2):107-12
references: 8493388
references: Br J Surg. 1988 Aug;75(8):799-801
references: 3167534
references: Eur J Gastroenterol Hepatol. 2007 Aug;19(8):615-7
references: 17625428
references: J Gastroenterol Hepatol. 1999 Dec;14(12):1144-9
references: 10634149
references: Int J Epidemiol. 1989 Jun;18(2):309-14
references: 2767843
references: Dig Dis Sci. 2000 May;45(5):900-3
references: 10795752
references: J Natl Cancer Inst. 2006 Jun 21;98(12):873-5
references: 16788161
references: Carcinogenesis. 2002 Nov;23(11):1927-31
references: 12419842
references: J Natl Cancer Inst. 1997 Sep 17;89(18):1360-5
references: 9308706
references: Cancer Causes Control. 2001 Dec;12(10):959-64
references: 11808716
references: Lancet Oncol. 2003 Mar;4(3):167-76
references: 12623362
references: Br J Surg. 1997 Jul;84(7):969-73
references: 9240138
references: Cancer. 2000 Jun 1;88(11):2471-7
references: 10861422
references: Histopathology. 2002 Mar;40(3):269-78
references: 11895493
references: Cancer. 1977 Jan;39(1):232-46
references: 64293
references: Int J Epidemiol. 1996 Oct;25(5):933-40
references: 8921477
references: Cancer. 2004 Feb 15;100(4):783-93
references: 14770435
references: Cancer Res. 2000 Feb 1;60(3):522-4
references: 10676628
references: Br J Cancer. 2009 Jun 2;100(11):1765-70
references: 19436294
references: J Natl Cancer Inst. 1995 Mar 1;87(5):378-84
references: 7853419
references: JAMA. 1965 Mar 8;191:829-37
references: 14250071
references: Contraception. 1991 Jun;43(6):667-93
references: 1868737
references: Int J Cancer. 2002 Dec 1;102(4):407-11
references: 12402311
references: Cancer Sci. 2010 Mar;101(3):579-85
references: 20085587
references: Arch Surg. 1995 Feb;130(2):194-7
references: 7848091
references: Hepatology. 1998 Oct;28(4):921-5
references: 9755226
references: Hepatogastroenterology. 2001 Mar-Apr;48(38):382-6
references: 11379314
references: Arch Surg. 1996 Sep;131(9):981-4; discussion 985
references: 8790169
references: Gastroenterology. 1998 Oct;115(4):937-46
references: 9753497
references: Am J Gastroenterol. 2007 May;102(5):1016-21
references: 17324130
references: Hepatology. 2000 Jan;31(1):7-11
references: 10613720
references: Am J Gastroenterol. 2000 Jun;95(6):1402-10
references: 10894571
references: JAMA. 1978 Aug 4;240(5):434-5
references: 660885
references: Gastroenterology. 1985 Jul;89(1):151-6
references: 2989071
references: Surg Gynecol Obstet. 1954 Nov;99(5):529-41
references: 13205425
references: Cancer. 1995 Nov 15;76(10):1747-56
references: 8625043
references: J Hepatol. 2009 Jan;50(1):158-64
references: 19012991
references: Am J Gastroenterol. 2004 Mar;99(3):523-6
references: 15056096
references: J Environ Pathol Toxicol Oncol. 2001;20(4):311-5
references: 11797840
references: Ann Intern Med. 1987 Jul;107(1):30-5
references: 3592446
references: J Natl Cancer Inst. 1997 Aug 6;89(15):1132-8
references: 9262251
references: Lancet. 2005 Oct 8;366(9493):1303-14
references: 16214602
references: Int Surg. 1995 Jan-Mar;80(1):61-4
references: 7657495
references: Keio J Med. 1997 Dec;46(4):169-72
references: 9444927
references: Nihon Shokakibyo Gakkai Zasshi. 1991 Jun;88(6):1369-74
references: 1653864
references: J Hepatol. 2002 Mar;36(3):321-7
references: 11867174
references: Carcinogenesis. 1999 Jan;20(1):133-7
references: 9934860
references: Lancet. 1978 Jan 28;1(8057):207
references: 74629
references: Arzneimittelforschung. 1984;34(9B):1121-6
references: 6095876
references: J Pediatr Surg. 2002 Nov;37(11):1568-73
references: 12407541
references: Hum Pathol. 1998 Feb;29(2):175-80
references: 9490278
references: Abdom Imaging. 2003 Jan-Feb;28(1):72-4
references: 12483389
references: Korean J Intern Med. 1999 Jul;14(2):1-8
references: 10461418
references: Indian J Cancer. 2004 Oct-Dec;41(4):147-51
references: 15659866
references: Gastrointest Endosc. 2003 Apr;57(4):541-5
references: 12665766
references: Br J Cancer. 2009 Jan 13;100(1):178-80
references: 19018260
references: Eur J Cancer Prev. 2006 Apr;15(2):134-7
references: 16523010
references: J Hepatobiliary Pancreat Surg. 2000;7(4):426-31
references: 11180865
references: J Hepatobiliary Pancreat Surg. 2000;7(2):198-205
references: 10982614
references: Br J Cancer. 1999 Feb;79(3-4):640-4
references: 10027343
references: Rev Med Chil. 1999 Sep;127(9):1049-55
references: 10752267
references: Ann R Coll Surg Engl. 1992 May;74(3):222-4
references: 1616267
references: Acta Chir Scand Suppl. 1980;500:7-12
references: 6939199
references: Br J Cancer. 2006 Jun 5;94(11):1751-8
references: 16736026
references: Eur J Gastroenterol Hepatol. 2007 Aug;19(8):623-30
references: 17625430
references: Am J Gastroenterol. 2000 Mar;95(3):784-7
references: 10710075
references: Am J Trop Med Hyg. 2006 Jul;75(1):93-6
references: 16837714
references: Hepatology. 1998 Feb;27(2):311-6
references: 9462625
references: J Natl Cancer Inst. 2007 Jun 6;99(11):895-7
references: 17551150
references: Semin Liver Dis. 2004 May;24(2):139-54
references: 15192787
references: Br J Surg. 1998 Jul;85(7):911-6
references: 9692562
references: Int J Cancer. 1994 Nov 15;59(4):505-9
references: 7960220
references: CA Cancer J Clin. 2006 Mar-Apr;56(2):106-30
references: 16514137
references: Southeast Asian J Trop Med Public Health. 2009 Jul;40(4):701-12
references: 19842402
references: Aliment Pharmacol Ther. 2004 Jul;20 Suppl 1:90-4
references: 15298612
references: Health Phys. 1991 Sep;61(3):337-47
references: 1880023
references: Eur J Surg Oncol. 1997 Apr;23(2):188-9
references: 9158199
references: Trop Med Int Health. 2004 May;9(5):588-94
references: 15117303
references: Gut. 1996 Feb;38(2):265-8
references: 8801209
references: Cancer Sci. 2004 Jul;95(7):592-5
references: 15245596
references: N Engl J Med. 1999 Oct 28;341(18):1368-78
references: 10536130
references: Aust N Z J Surg. 1991 Nov;61(11):855-7
references: 1661112
references: Jpn J Cancer Res. 2002 Jul;93(7):842-7
references: 12149151
references: N Engl J Med. 1991 Apr 18;324(16):1073-8
references: 1826143
references: Int J Cancer. 2008 Apr 15;122(8):1849-53
references: 18076042
references: J Hepatol. 2002 Dec;37(6):806-13
references: 12445422
references: J Clin Gastroenterol. 2008 Feb;42(2):178-90
references: 18209589
references: Hepatology. 2009 Jan;49(1):116-23
references: 19085911
references: Br J Cancer. 1984 Sep;50(3):389-97
references: 6087869
references: Eur J Cancer Prev. 1997 Dec;6(6):557-9
references: 9496458
references: Int J Cancer. 1991 May 30;48(3):323-8
references: 1645697
references: Ann Oncol. 1999;10 Suppl 4:308-11
references: 10436847
references: Am Surg. 2001 Jan;67(1):7-10
references: 11206901
references: Semin Liver Dis. 1994 May;14(2):109-14
references: 8047893
references: Am J Gastroenterol. 2008 Jul;103(7):1716-20
references: 18557716
references: Ann Surg. 1994 Nov;220(5):644-52
references: 7979612
references: Br J Cancer. 2007 Dec 3;97(11):1577-82
references: 18000509
references: Ann Surg. 1968 Dec;168(6):1088-93
references: 4301820
references: Am J Gastroenterol. 1999 Jun;94(6):1638-42
references: 10364037
references: Cancer. 1998 Jan 1;82(1):86-95
references: 9428483