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Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: A systematic review and meta-analysis

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Title: Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: A systematic review and meta-analysis
Authors: Clements, O
Eliahoo, J
Kim, JU
Taylor-Robinson, SD
Khan, SA
Item Type: Journal Article
Abstract: Background & Aims Cholangiocarcinoma (CCA) carries a poor prognosis, is increasing in incidence and its causes are poorly understood. Although some risk factors are known, they vary globally and collectively account for a minority of cases. The aim of this study was to perform a comprehensive meta-analysis of risk factors for intrahepatic (iCCA) and extrahepatic cholangiocarcinoma (eCCA), from Eastern and Western world studies. Methods A literature search of case-control studies was performed to identify potential risk factors for iCCA and eCCA. Pooled odds ratios (ORs) with 95% CIs and heterogeneity were calculated. Funnel plots were used to assess publication bias, and meta-regression was used to select risk factors for comparison between Eastern and Western studies. Results A total of 13 risk factors were selected from 25 case-control studies in 7 geographically diverse countries. The strongest risk factors for both iCCA and eCCA were biliary cysts and stones, cirrhosis, hepatitis B and hepatitis C. Choledochal cysts conferred the greatest risk of both iCCA and eCCA with pooled ORs of 26.71 (95% CI 15.80–45.16) and 34.94 (24.36–50.12), respectively. No significant associations were found between hypertension and obesity for either iCCA or eCCA. Comparing Eastern and Western populations, there was a difference for the association of hepatitis B with iCCA (coefficient = −0.15195; 95% CI −0.278 to −0.025; p = 0.022). Conclusion This is the most comprehensive meta-analysis of CCA risk factors to date. Some risk factors, such as diabetes, although less strong, are increasing globally and may be contributing to rising rates of this cancer.
Issue Date: 1-Jan-2020
Date of Acceptance: 3-Sep-2019
URI: http://hdl.handle.net/10044/1/84684
DOI: 10.1016/j.jhep.2019.09.007
ISSN: 0168-8278
Publisher: Elsevier
Start Page: 95
End Page: 103
Journal / Book Title: Journal of Hepatology
Volume: 72
Issue: 1
Copyright Statement: © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Cholangiocarcinoma
Risk factors
Meta-analysis
HEPATITIS-B-VIRUS
BILIARY-TRACT CANCER
INFLAMMATORY-BOWEL-DISEASE
BILE-DUCT CANCERS
MORTALITY-RATES
UNITED-STATES
DIABETES-MELLITUS
ASPIRIN USE
LIVER
POPULATION
Cholangiocarcinoma
Meta-analysis
Risk factors
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Cholangiocarcinoma
Risk factors
Meta-analysis
HEPATITIS-B-VIRUS
BILIARY-TRACT CANCER
INFLAMMATORY-BOWEL-DISEASE
BILE-DUCT CANCERS
MORTALITY-RATES
UNITED-STATES
DIABETES-MELLITUS
ASPIRIN USE
LIVER
POPULATION
Gastroenterology & Hepatology
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2019-09-16
Appears in Collections:Electrical and Electronic Engineering



This item is licensed under a Creative Commons License Creative Commons