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Risk Factors for Cholangiocarcinoma in Thailand: A Systematic Review and Meta-Analysis
Authors:Siriporn Kamsa-ard  Supot Kamsa-ard  Vor LuvriaKrittika Suwanrungruang  Patravoot Vatanasapt    Surapon Wiangnon    
Abstract:Background and objective: Cholangiocarcinoma remains a serious public health concern in Thailand. While manyof the risk factors for cholangiocarcinoma in western countries are well-recognized, it remains unclear whether theyare the same in Thailand. We set out to investigate the risk factors for cholangiocarcinoma in Thailand. Methods:Starting March 4, 2016, we reviewed studies found using pre-specified keywords on SCOPUS, Pro Quest ScienceDirect, PubMed, and online public access catalog of Khon Kaen University. Two review authors independently screenedstudies for inclusion criteria, extracted data, and assessed the studied Risk of Bias. The Newcastle-Ottawa Scale and theJoanna Briggs Institute Critical Appraisal Tools were used to assess the quality of included studies. The risk effects offactors were estimated as a pooled adjusted odds ratio with a 95% confidence interval. The heterogeneity of results wasconsidered using the I-square, Tau-square and Chi-square statistics. Results: A strong association was found betweencholangiocarcinoma and age, Opisthorchis viverrini infection, eating raw cyprinoid fish, family history of cancer, liquorconsumption, and taking praziquantel. There was only a mild association found between eating nitrite-containing foods,fresh vegetables, education, smoking behavior, and sex. No association was found between cholangiocarcinoma andeating fermented fish (Pla-ra), northeastern Thai or Chinese sausage, sticky rice, meat, chewing betel nut, or eatingfruit. There were two protective factors including fresh vegetables consumption and education attainment. Conclusion:There are unique risk factors of cholangiocarcinoma in Thailand, including age, Opisthorchis
Keywords:cholangiocarcinoma  risk factors  Systematic review  Thailand
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