Risk factors for cholangiocarcinoma in a low risk Caucasian population

Objectives: Little is known about the etiology of cholangiocarcinoma, apart from its association with liver fluke infestation. Methods: A case-control study was conducted in Athens and included six chol angiocarcinoma cases, 333 hepatocellular carcinoma cases and 360 controls w ith minor ailments or injuries. All subjects were interviewed and tested fo r hepatitis 8 and C infection. For all six cholangiocarcinomas, 97 hepatoce llular carcinomas and 129 controls, sex steroids were determined in the blo od. Results: Hepatitis B or C viruses, tobacco smoking, alcohol drinking and di abetes mellitus were not related to cholangiocarcinoma, but history of thyr oid disease was. Estradiol levels were higher among cholangiocarcinoma case s than among the other two groups. Conclusions: This study provides evidence that endocrine and autoimmune fac tors are important in the etiology of cholangiocarcinoma.