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Year : 2018  |  Volume : 14  |  Issue : 10  |  Page : 820

Contraception, opisthorchiasis, and cholangiocarcinoma

1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Hainan, China

Date of Web Publication24-Sep-2018

Correspondence Address:
Sora Yasri
KMT Primary Care Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.191029

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How to cite this article:
Yasri S, Wiwanitkit V. Contraception, opisthorchiasis, and cholangiocarcinoma. J Can Res Ther 2018;14, Suppl S3:820

How to cite this URL:
Yasri S, Wiwanitkit V. Contraception, opisthorchiasis, and cholangiocarcinoma. J Can Res Ther [serial online] 2018 [cited 2020 Feb 26];14:820. Available from: http://www.cancerjournal.net/text.asp?2018/14/10/820/191029


The role of estrogen in the development of cholangiocarcinoma is very interesting. It is evidence that catechol-cholesterol is an important parasitic metabolite that results in cancer development.[1] It is proved that estrogen can stimulate abnormal growth in biliary tract and can result in further cancer cell proliferation.[2] Hence, at present, it is already mentioned that excessive estrogen should be added as an important risk factor for cholangiocarcinoma adding to the general known risk, i.e., opisthorchiasis due to raw fish intake. However, an important concern is on female contraception. The use of hormone in contraception is common, and it is usually a controversial issue in medicine [Table 1]. For injection contraception, Depot medroxyprogesterone acetate is not an estrogen, there is no clinical problem. In addition, it is already proven to be safe in patients with opisthorchiasis.[3] However, the issue is on oral contraception by estrogen.[4] In the nonendemic areas of opisthorchiasis, it is evidence on “lack of association with cholangiocarcinoma” for short-term oral contraceptive use.[5] However, the case report of “cholangiocarcinoma in a young female taking oral contraceptives” can be available.[6] In addition, according to the immunohistochemical study of cholangiocarcinoma, many cases are positive for estradiol.[7] Until now, there is no clear evidence on the effect of long-term use of oral estrogen in patients with opisthorchiasis. To play safe, it is suggested that nonoral contraception is more preferable for any patient with opisthorchiasis.
Table 1: The effects of various female contraception methods on cholangiocarcinoma

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 > References Top

Brindley PJ, da Costa JM, Sripa B. Why does infection with some helminths cause cancer? Trends Cancer 2015;1:174-82.  Back to cited text no. 1
Mancino A, Mancino MG, Glaser SS, Alpini G, Bolognese A, Izzo L, et al. Estrogens stimulate the proliferation of human cholangiocarcinoma by inducing the expression and secretion of vascular endothelial growth factor. Dig Liver Dis 2009;41:156-63.  Back to cited text no. 2
Grossman RA, Asawasena W, Chalpati S, Taewtong D, Tovanabutra S. Effects of the injectable contraceptive depot medroxyprogesterone acetate in Thai women with liver fluke infestation: final results. Bull World Health Organ 1979;57:829-37.  Back to cited text no. 3
Chulacharit E, Petchakit V, Rosenfield AG. Oral contraception and liver fluke disease. J Obstet Gynaecol Br Commonw 1972;79:657-0.  Back to cited text no. 4
Rosenberg L. The risk of liver neoplasia in relation to combined oral contraceptive use. Contraception 1991;43:643-52.  Back to cited text no. 5
Littlewood ER, Barrison IG, Murray-Lyon IM, Paradinas FJ. Cholangiocarcinoma and oral contraceptives. Lancet 1980;1:310-1.  Back to cited text no. 6
Liossi AK, Aroni KG, Kyrkou KA, Kittas C, Markaki SP. Immunohistochemical study of sex steroid hormones in primary liver cancer. Cancer Detect Prev 1988;13:195-201.  Back to cited text no. 7


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