Primary sclerosing cholangitis, part 2: Cancer risk, prevention, and surveillance

James H. Tabibian, Ahmad H. Ali, Keith Lindor

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Primary sclerosing cholangitis (PSC) is a chronic, fibroinflammatory, progressive cholangiopathy. In a clinically significant proportion of patients, the disease course of PSC is punctuated by carcinogenesis, namely cholangiocarcinoma, gallbladder carcinoma, hepatocellular carcinoma, and/or colorectal carcinoma. Indeed, malignancy is arguably the most consequential sequela and the cause of nearly 50% of deaths in patients with PSC. This statistic is multifactorial, relating partly to the premalignant nature of PSC, challenges in diagnosis due to obscuration of cancer by the inflammation and fibrosis inherent to PSC, and the unpredictability of which type of cancer will develop in PSC and when. Here, in the second of a 2-part series, we review cancer risk, prevention, and surveillance in patients with PSC. We also discuss potential cancer surveillance strategies in PSC and, where evidence is limited, make pragmatic recommendations based on current data and expert opinion.

Original languageEnglish (US)
Pages (from-to)427-432
Number of pages6
JournalGastroenterology and Hepatology
Issue number7
StatePublished - Jul 2018


  • Biliary tract neoplasm
  • Cirrhosis
  • Colorectal neoplasm
  • Early detection of cancer
  • Hepatocellular carcinoma
  • Inflammatory bowel disease

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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