Causes and risk factors of bile duct cancer

The causes of most bile duct cancers are unknown. But there are some factors that can increase your risk of developing it.

What are risk factors?

Bile duct cancer is rare. It is not usually clear what has caused bile duct cancer, but there are certain things that can increase the risk of developing it. These are called risk factors. Having a risk factor does not mean you will get cancer. And not having a risk factor does not mean that you will not get it.

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Although younger people can get bile duct cancer, it is most common in people over the age of 65.

Inflammation or irritation in the bile ducts

Long-term inflammation or irritation of the bile ducts can increase the risk of bile duct cancer developing. Things that can cause inflammation or irritation include the following:

  • Primary sclerosing cholangitis (PSC)

    This is a rare condition that causes inflammation of the bile ducts.

  • Bile duct cysts (choledochal cysts)

    Rarely, people are born with cysts in their bile duct. The cysts fill with bile and can cause problems such as jaundice (a yellow tinge to the eyes and skin). These problems usually start in childhood or when you are a young adult.

  • Bile duct stones

    If left untreated for a long time, stones in the bile duct can irritate the duct lining and increase the risk of cancer.

  • Liver fluke infection

    In South East Asia, most bile duct cancers are caused by a parasite called the liver fluke. The flukes get into the bile ducts after someone eats foods such as undercooked fish, which is infected with them.

  • Scarring of the liver (cirrhosis)

    Cirrhosis can increase your risk of bile duct cancer. Common causes of liver scarring include regularly drinking a lot of alcohol, or infection with the hepatitis B or hepatitis C virus.

  • A radioactive dye called Thorotrast

    Thorotrast increases the risk of bile duct cancer. It was used with some x-rays up until the 1960s. But it is not used anymore.

Inherited conditions that increase the risk of bile duct cancer

Some faulty genes that are passed on in families (inherited) can cause conditions which increase the risk of bile duct cancer. These include:

  • Lynch syndrome – this also increases the risk of bowel cancer and womb cancer
  • BRCA1 gene – this also increases the risk of breast cancer
  • cystic fibrosis – this can affect the lungs and digestive system.

About our information

  • References

    Below is a sample of the sources used in our bile duct cancer information. If you would like more information about the sources we use, please contact us at

    Valle JW, Borbath I, Khan SA, et al. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2016; 27, suppl 5, v28-v37. Available from (accessed October 2019).

    Rizvi S, Khan A, Hallemeier C, et al. Cholangiocarcinoma - evolving concepts and therapeutic strategies. Clinical Oncology, 2018; 15, 2, 95-111. Available from (accessed October 2019). 

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 June 2020
Next review: 01 June 2023

This content is currently being reviewed. New information will be coming soon.

Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

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