Pesticides, Fresh Water Fish, Liver Flukes and Nitrosamines: A Story of Cholangiocarcinoma Development in Thailand


Cholangiocarcinoma is a common hepatobiliary carcinoma in Thailand. It is believed that both chronicexposure to liver fluke infestation and nitrosamine exposure are the two main underlying factors leading to thecarcinogenesis. Here, the author further extrapolates and proposes a new hypothesis based on the environmentalecological data that the stimulation of fresh water fish by contaminated pesticide in water reservoirs might be apossible background of the high prevalence of cholangiocarcinoma in Thailand