The management, epidemiology, and clinical outcomes of cholangiocarcinoma in Africa were systematically reviewed and published in BMC Gastroenterology. There were only 11 studies from 4 African countries, which is not representative of the whole continent. 

“Our current review provides some foundational published work needed to guide future studies and support proposed research,” first author Akwi W. Asombang, MD, MPH, of the Division of Gastroenterology/Hepatology at Massachusetts General Hospital in Boston and the coauthors of the study wrote.

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Of the 11 studies that were included in this systematic review, 8 were from North Africa (6 from Egypt and 2 from Tunisia) and only 3 were from sub-Saharan Africa (2 from South Africa and 1 from Nigeria). 

The majority of studies (n=10) reported management and outcomes, while only 1 reported epidemiology and risk factors.

The median age of patients ranged from 52 to 61 years. The proportion of the disease was higher in men than in women in Egypt, but this difference was not seen in any other African country. 

Data differentiating the pathogenesis of intrahepatic and extrahepatic cholangiocarcinoma were limited, but the clinical presentation of patients in Africa was similar to that of patients in other continents.

Surgical interventions were curative and prevented disease progression, while chemotherapy was mainly used for palliative care. 

The authors also noted that risk factors such as primary sclerosing cholangitis and Opisthorchis viverrini and Clonorchis sinensis infestations caused by eating raw fish are rare in Africa and that diagnostic capabilities such as radiography and endoscopy are lacking; this likely means that a proper diagnosis is not reached in most cases.

“Further studies are required to explore the etiology, pathogenesis, management, and clinical outcomes of intra versus extrahepatic cholangiocarcinoma in Africa,” the authors concluded.


Asombang AW, Chishinga N, Mohamed MF, et al. Systematic review of cholangiocarcinoma in Africa: epidemiology, management, and clinical outcomes. BMC Gastroenterol. Published online March 11, 2023. doi:10.1186/s12876-023-02687-6