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Muñoz-Martínez et al. Hepatoma Res 2022;8:30 Hepatoma Research
DOI: 10.20517/2394-5079.2022.22

Review Open Access

Cholangiocarcinoma: early detection and screening

in high-risk population

2
1,5
4,5
3,5
Sergio Muñoz-Martínez , Jordi Rimola , María Carlota Londoño , Andrés Cárdenas , Alejandro Forner 1,5
1
Barcelona Clinic Liver Cancer (BCLC) group, Liver Unit, ICMDM, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona,
Barcelona 08036, Spain.
2
Barcelona Clinic Liver Cancer (BCLC) group, Radiology Department, Hospital Clinic Barcelona, IDIBAPS, Barcelona 08036,
Spain.
3
Liver Unit, ICMDM, Hospital Clinic Barcelona, IDIBAPS. University of Barcelona, Barcelona 08036, Spain.
4
GI/Liver Transplant Unit, ICMDM, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona 08036, Spain.
5
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
Correspondence to: Dr. Alejandro Forner, Barcelona Clinic Liver Cancer (BCLC) group, Liver Unit, ICMDM, Hospital Clinic
Barcelona, c/ Villarroel, 170, Escala 9-11, Planta 4, IDIBAPS. University of Barcelona. Barcelona 08036, Spain. Email:
aforner@clinic.cat
How to cite this article: Muñoz-Martínez S, Rimola J, Londoño MC, Cárdenas A, Forner A. Cholangiocarcinoma: early detection
and screening in high-risk population. Hepatoma Res 2022;8:30. https://dx.doi.org/10.20517/2394-5079.2022.22
Received: 20 Apr 2022 First decision: 22 Jun 2022 Revised: 5 Jul 2022 Accepted: 29 Jul 2022 Published: 30 Jul 2022
Academic Editors: Feng Shen, Kenneth Siu Ho Chok, Nan Li, Giuliano Ramadori Copy Editor: Haixia Wang Production Editor:
Haixia Wang

Abstract
Cholangiocarcinoma (CCA) is a highly lethal malignancy that comprises approximately 15% of all the primary liver
tumors and 3% of gastrointestinal cancers. Diagnosis is often done when the disease is already at advanced stages,
resulting in poor outcomes. Prevention of risk factors and early diagnosis are the cornerstones for improving
survival. Early diagnosis is feasible in the setting of surveillance programs in patients at high risk of CCA such as
patients with primary sclerosing cholangitis. Regrettably, surveillance of CCA in this population is hampered by the
low diagnostic accuracy of current tumor markers at earlier stages, the difficulties of imaging techniques for the
differential diagnosis between benign and malignant biliary strictures, and the need for invasive procedures for
diagnostic confirmation. In this review we discuss the rationale for surveillance of CCA in high-risk populations,
particularly patients with primary sclerosing cholangitis, the recommended tools for surveillance and diagnostic
work-up, and future perspectives.

Keywords: Surveillance, cholangiocarcinoma, primary sclerosing cholangitis, magnetic resonance, tumor biomarker

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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