“…The incidence of CCA can therefore be quite elevated in endemic regions, for example, it can be as high as 100 per 100,000 people in certain regions of Thailand [ 9 ]. In other parts of the world where liver flukes are not endemic, some of the risk factors for CCA have included primary sclerosing cholangitis, hepatolithiasis/choledocholithiasis, Caroli’s disease, congenital hepatic fibrosis, choledochal cysts, viral hepatitis B and C infections, liver cirrhosis, chemical exposures, diabetes, and obesity [ 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Almost all of these risk factors are related to chronic inflammation to the biliary tract.…”