Any cause of chronic inflammation and/or infection to the bile ducts can increase the risk of developing CCA due to long-standing repeat damage, these include bile duct stones or parasites. (e.g. liver flukes, recurrent pyogenic cholangitis)

These are some other inflammatory conditions can increase the risk of developing CCA.

• Ulcerative Colitis – This is chronic inflammation of the large intestine that is often associated with inflammation of the bile duct (a condition known as sclerosing cholangitis). Patients with primary sclerosing cholangitis (PSC) are at an elevated risk for CCA.
• Congenital Bile Duct Cysts (Choledochal Cysts) - These are abnormal dilated bile ducts, they are usually congenital in nature and are typically diagnosed in childhood but may develop or be detected in adulthood. The lining of these sacs often contains pre-cancerous cells that increase the risk of developing cancer later in life.
• Parasite infestation - Liver fluke infections are not uncommon especially in Asia, it occurs when people eat raw or poorly cooked fish that are infected with these tiny parasite worms. In humans, these flukes live in the bile ducts and can cause bile duct cancer. The types most closely related to CCA are Clonorchis sinensis, Schistosomiasis japonica and Opisthorchis viverrini
• Chronic Hepatitis C infection – This is a risk factor for intrahepatic CCA.
• Exposure to cancer-causing (carcinogenic) agents such as Asbestos, Thorotrast, dioxins, nitrosamines, and vinyl chloride has been linked causing CCA.
• Smoking – Studies suggests that intrahepatic CCA is more common among heavy smokers.
• Diabetes and Obesity - These metabolic conditions appear to be an increasingly associated risk factors for intrahepatic CCA.