The following statement(s) is/are true concerning carcinoma of the bile ducts

d. Ulcerative colitis is associated with an increased incidence of bile duct cancer

e. Choledochal cysts may be associated with the development of bile duct cancer

Cancer of the bile ducts is even less common than gallbladder carcinoma and is seen in 0.01% to 0.46% of all autopsies. Unlike gallbladder cancer, which is more frequent in females, males have a higher incidence of bile duct cancer. The average age range of diagnosis between is 50 and 70 years. Similar to gallbladder cancer, there is an association between bile duct cancer and gallstones. This association is, however, not as direct as for gallbladder cancer with only 25% to 57% of patients with bile duct cancer having gallstones. Biliary tract infection is associated with these tumors; for example, patients with Clonorchis sinensis infection and chronic typhoid carriers have a higher incidence of bile duct cancer than the general population. Choledochal cysts are also associated with bile duct cancer. Patients with ulcerative colitis have a marked increase incidence of bile duct tumors which tend to follow a more aggressive course.