Comparison of Clinical Characteristics between Occupational and Sporadic Young-Onset Cholangiocarcinoma

  • Kaneko, Rena (Department of Gastroenterology, Japan Labour Health and Welfare Organization Kanto Rosai Hospital) ;
  • Kubo, Shoji (Department of Hepato-Biliary-Pancreatic Surgery, Graduate School of Medicine Osaka City University) ;
  • Sato, Yuzuru (Department of Gastroenterology, Japan Labour Health and Welfare Organization Kanto Rosai Hospital)
  • Published : 2015.11.04


Background: Since seventeen employees of an offset printing company in Osaka, Japan developed cholangiocarcinoma it has become recognized as an occupational cancer. This study investigated the differences of clinical features between occupational cholangiocarcinoma and sporadic young-onset cholangiocarcinoma. Materials and Methods: Thirty-four young adults (<50 years old) with sporadic cholangiocarcinoma were extracted from the Rosai Hospital Group database (sporadic group) and their clinical features were compared with those of 17 patients with occupational cholangiocarcinoma (occupational group). Results: The 34 patients in the sporadic group were treated for cholangiocarcinoma at 16 different Rosai hospitals. There were significant differences of age (p<0.01), gender (p<0.01), abnormal laboratory tests (p<0.01), and tumor location (p<0.01) between the two groups. The percentage of patients with abnormal laboratory tests was significantly higher in the occupational group than in the sporadic group (p<0.001). Regional dilation of bile ducts, which is a characteristic of occupational cholangiocarcinoma, was not observed in the sporadic group. Conclusions: No cluster of cholangiocarcinoma cases was identified in the Rosai Hospital database. There were differences of clinical features between occupational and sporadic cholangiocarcinoma, which might be helpful for diagnosing occupational cholangiocarcinoma in the future.


Occupational cholangiocarcinoma;juvenile cholangiocarcinoma;organic solvent


  1. Benbrahim-Tallaa L, Lauby-Secretan B, Loomis D, et al (2014). Carcinogenicity of perfluorooctanoic acid, tetrafluoroethylene, dichloromethane, 1, 2-dichloropropane, and 1, 3-propane sultone. Lancet Oncol, 15, 924-5.
  2. Bosman FT, Carneiro F, Hruban RH, Tehise ND (2010). World health organization classifications of tumours. international agency for research on cancer (IARC). WHO classification of tumours of the digestive system. 4th ed. Lyon: World Health Organization, 195-278.
  3. Accessed March 11, 2014.
  4. upational_02.pdf. Accessed March 11, 2014.
  5. Accessed March 11, 2014.
  6. Ikeda A, Miyashiro I, Nakayama T, et al (2013). Descriptive epidemiology of bile duct carcinoma in Osaka. J Clin Oncol, 43, 1150-5.
  7. Kaneko R, Nakazaki N, Tagawa T, et al (2014). Preliminary analysis of labour effect on genesis of cholangiocarcinoma. Nihon Shokakibyo Gakkai Zasshi, 111, 510-1.
  8. Kubo S, Nakanuma Y, Takemura S, et al (2014). Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan. J Hepatobiliary Pancreat Sci, 21, 479-88.
  9. Kubo S, Kinoshita M, Takemura S, et al (2014). Characteristics of printing company workers newly diagnosed with occupational cholangiocarcinoma. J Hepatobiliary Pancreat Sci, 21, 809-17.
  10. Kubo S, Takemura S, Sakata C, et al (2014). Changes in laboratory test results and diagnostic imaging presentation before the detection of occupational cholangiocarcinoma. J Occup Health, 56, 317-22.
  11. Kumagai S, Kurumatani N, Arimoto A, Ichihara G (2013). Cholangiocarcinoma among offset color proof printing workers exposed to 1,2-dichloropropane and/or dichloromethane. Occup Environ Med, 80, 508-10.
  12. Kumagai S, Kurumatani N, Arimoto A, Ichihara G (2014). Time course of blood parameters in printing workers with cholangiocarcinoma. J Occup Health, 56, 279-84.
  13. Ministry of Economy, Trade and Industry & Ministry of the Environment
  14. Ministry of Health, Labour and Welfare. Occupational biliary tract cancer cases in Japan. 2013.
  15. National Institute of Occupational Safety and Health, Japan. Industrial accident in a printing company in Osaka [in Japanese]. Report A-2012-02, 2012.
  16. Okamoto E, Kikuchi K, Endo G (2013). Prevalence of bile duct cancer among printing industry workers in comparison with other industries. J Occup Health, 55, 511-5.
  17. Razumilava N, Gores GJ (2014). Cholangiocarcinoma. Lancet, 21, 2168-79
  18. Suzuki T, Yanagiba Y, Suda M, Wang R (2014). Assessment of the genotoxicity of 1,2-dichloropropane and dichloromethane after individual and co-exposure by inhalation in mice. J Occup Health, 56, 205-14.
  19. Sato Y, Kubo S, Takemura S, et al (2014). Different carcinogenic process in cholangiocarcinoma cases epidemically developing among workers of a printing company in Japan. Int J Clin Exp Pathol, 7, 4745-54.
  20. Tomimaru Y, Kobayashi S, Wada H, et al (2015). Intrahepatic cholangiocarcinoma in a worker at an offset color proof printing company: an autopsy case report. Hepatol Res, 45, 488-93.
  21. Yamada K, Kumagai S, Nagoya T, Endo G (2014). Chemical exposure levels in printing workers with cholangiocarcinoma. J Occup Health, 56, 332-8.
  22. Yamada K, Kumagai S, Endo G (2015). Chemical exposure levels in printing workers with cholangiocarcinoma (second report). J Occup Health, [Epub ahead of print]

Cited by

  1. Risk of Alcohol Consumption in Bladder Cancer: Case-Control Study from a Nationwide Inpatient Database in Japan vol.239, pp.1, 2016,
  2. The PD-1/PD-L1 axis may be aberrantly activated in occupational cholangiocarcinoma vol.67, pp.3, 2017,
  3. Occupational class and male cancer incidence: Nationwide, multicenter, hospital-based case-control study in Japan vol.8, pp.2, 2019,