Screening for Biliary Cancers

Like many cancer types, we don’t know exactly why a person develops the disease. However, knowing whether you have risk factors, and taking steps to reduce the factors that are modifiable is important. For example, you can:

  • Maintain a healthy weight to avoid obesity-related gallstones
  • Avoid excessive drinking
  • Get vaccinated against Hepatitis B virus
  • Learn whether you have Hepatitis C virus infection; seek treatment if necessary
  • Avoid smoking
  • See your primary care provider regularly.
  • Know your family cancer history.
  • Consider genetic screening

About genetic screening

One genetic condition — Lynch Syndrome — is associated with a risk for many cancers, including gallbladder and bile duct cancer. If you have multiple blood relatives who have been diagnosed with cancer, especially rare types like pancreatic, ovarian, male breast cancer and metastatic breast or prostate cancer, you may want to take our Family History Questionnaire to learn whether you should consider genetic screening.

Am I high risk?

Two risk factors for cholangiocarcinoma may warrant increased surveillance or preventive action:

  • Primary sclerosing cholangitis is an autoimmune disease that leads to chronic inflammation and scarring in the bile ducts. People with primary sclerosing cholangitis are at particularly high risk for developing cholangiocarcinoma.
  • Choledochal cyst occurs as a result of a congenital (born with it) malformation of a bile duct in which a fluid-filled sac forms in the bile duct. Patients with choledochal cysts are at a high enough risk for cholangiocarcinoma to justify preventive surgical removal in many cases.

Screening for high risk

For most of the risk factors, the overall risk for developing gallbladder and bile duct cancers remains very low and screening for tumor markers or with surveillance imaging is not justified in most cases. However, people with primary sclerosing cholangitis should talk to their doctor about screening by:

  • Measuring CA19-9. This protein is made by pancreas and bile duct cancer cells, and measuring the level of CA19-9 in your blood may be used as a screening test. However, since normal, non-cancer cells can also produce this due to inflammation, it is an imperfect tool.
  • Cross-sectional imaging to detect potential early tumors may also be used to screen patients at particularly high risk for these cancers.

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