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While viral hepatitis and liver fluke infections have been associated with HCC and iCCA, respectively, other environmental risk factors, overall risk factor commonality and combinatorial roles, and effects on survival have not been systematically examined. We conducted a TIGER\u2010LC consortium\u2010based population study covering all high\u2010incidence areas of both malignancies across Thailand: 837 HCC, 1474 iCCA, and 1112 controls (2011\u20132019) were comprehensively queried on lifelong environmental exposures, lifestyle, and medical history. Multivariate logistic regression and Cox proportional hazards analyses were used to evaluate risk factors and associated survival patterns. Our models identified\n                    <jats:italic>shared<\/jats:italic>\n                    risk factors between HCC and iCCA, such as viral hepatitis infection, liver fluke infection, and diabetes, including\n                    <jats:italic>novel and shared<\/jats:italic>\n                    associations of agricultural pesticide exposure (OR range of 1.50; 95% CI: 1.06\u20132.11 to 2.91; 95% CI: 1.82\u20134.63) along with vulnerable sources of drinking water. Most patients had multiple risk factors, magnifying their risk considerably. Patients with lower risk levels had better survival in both HCC (HR 0.78; 95% CI: 0.64\u20130.96) and iCCA (HR 0.84; 95% CI: 0.70\u20130.99). Risk factor co\u2010exposures and their common associations with HCC and iCCA in Thailand emphasize the importance for future prevention and control measures, especially in its large agricultural sector. The observed mortality patterns suggest ways to stratify patients for anticipated survivorship and develop plans to support medical care of longer\u2010term survivors, including behavioral changes to reduce exposures.\n                  <\/jats:p>","DOI":"10.1002\/ijc.35034","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T15:54:07Z","timestamp":1716047647000},"page":"1387-1399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The landscape of etiological patterns of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in Thailand"],"prefix":"10.1002","volume":"155","author":[{"given":"Benjarath","family":"Pupacdi","sequence":"first","affiliation":[{"name":"Translational Research Unit Chulabhorn Research Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A.","family":"Loffredo","sequence":"additional","affiliation":[{"name":"Department of Oncology Georgetown University Medical Center  Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuradha","family":"Budhu","sequence":"additional","affiliation":[{"name":"Laboratory of Human Carcinogenesis, Center for Cancer Research National Cancer Institute  Bethesda Maryland USA"},{"name":"Liver Cancer Program Center for Cancer Research, National Cancer Institute  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siritida","family":"Rabibhadana","sequence":"additional","affiliation":[{"name":"Laboratory of Chemical Carcinogenesis Chulabhorn Research Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vajarabhongsa","family":"Bhudhisawasdi","sequence":"additional","affiliation":[{"name":"Laboratory of Chemical Carcinogenesis Chulabhorn Research Institute  Bangkok 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Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thaniya","family":"Sricharunrat","sequence":"additional","affiliation":[{"name":"Pathology and Forensic Medicine Department Chulabhorn Hospital, Chulabhorn Royal Academy  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suleeporn","family":"Sangrajrang","sequence":"additional","affiliation":[{"name":"National Cancer Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kannika","family":"Phornphutkul","sequence":"additional","affiliation":[{"name":"Rajavej Hospital  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul S.","family":"Albert","sequence":"additional","affiliation":[{"name":"Biostatistics Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sungduk","family":"Kim","sequence":"additional","affiliation":[{"name":"Biostatistics Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis C.","family":"Harris","sequence":"additional","affiliation":[{"name":"Laboratory of Human Carcinogenesis, Center for Cancer Research National Cancer Institute  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chulabhorn","family":"Mahidol","sequence":"additional","affiliation":[{"name":"Laboratory of Chemical Carcinogenesis Chulabhorn Research Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9735-606X","authenticated-orcid":false,"given":"Xin Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Laboratory of Human Carcinogenesis, Center 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