A systematic review and meta-analysis of only five studies from liver-fluke-endemic settings linked ultrasound-detected periductal fibrosis with cholangiocarcinoma-related outcomes. Three studies covering 758,686 people yielded a pooled OR of 2.77, but outcomes mixed confirmed, incident and suspected disease, so the estimate is not an individual risk prediction.
Key findings
- The association analysis of 758,686 participants produced a pooled OR of 2.77 (95% CI 2.24-3.44; I²=0%). Prevalence synthesis covered 759,117 people but was extremely heterogeneous, supporting an association signal rather than one universally applicable prevalence estimate.
Why this matters globally
The review connects an accessible ultrasound marker with cancer surveillance in at-risk Southeast Asian communities and frames questions for prospectively validated screening models.
Thai researcher contribution
Thai researchers synthesised evidence directly relevant to the Northeast and other liver-fluke-endemic areas, bringing Thailand's screening experience into international discussion.
Limitations to consider
Only five studies were available; fibrosis and outcome definitions differed, massive screening cohorts dominated parts of the synthesis, prevalence heterogeneity was high, and publication bias was difficult to assess. Ultrasound-detected fibrosis is neither histological confirmation nor proof of a causal precursor.