|LETTER TO THE EDITOR
|Year : 2018 | Volume
| Issue : 10 | Page : 820
Contraception, opisthorchiasis, and cholangiocarcinoma
Sora Yasri1, Viroj Wiwanitkit2
1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Hainan, China
|Date of Web Publication||24-Sep-2018|
KMT Primary Care Center, Bangkok
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Yasri S, Wiwanitkit V. Contraception, opisthorchiasis, and cholangiocarcinoma. J Can Res Ther 2018;14, Suppl S3:820
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. It is proved that estrogen can stimulate abnormal growth in biliary tract and can result in further cancer cell proliferation. 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. However, the issue is on oral contraception by estrogen. In the nonendemic areas of opisthorchiasis, it is evidence on “lack of association with cholangiocarcinoma” for short-term oral contraceptive use. However, the case report of “cholangiocarcinoma in a young female taking oral contraceptives” can be available. In addition, according to the immunohistochemical study of cholangiocarcinoma, many cases are positive for estradiol. 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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