Editing Primary sclerosing cholangitis (section)

=== Related diseases ===
PSC is strongly associated with IBD, in particular [[ulcerative colitis]] (UC) and to a lesser extent [[Crohn's disease]]. As many as 5% of patients with IBD are co-diagnosed with PSC,<ref>{{cite journal | vauthors = Olsson R, Danielsson A, Järnerot G, Lindström E, Lööf L, Rolny P, Rydén BO, Tysk C, Wallerstedt S | display-authors = 6 | title = Prevalence of primary sclerosing cholangitis in patients with ulcerative colitis | journal = Gastroenterology | volume = 100 | issue = 5 Pt 1 | pages = 1319–1323 | date = May 1991 | pmid = 2013375 | doi = 10.1016/0016-5085(91)90784-I }}</ref> and approximately 70% of people with PSC have IBD.<ref name=Robbins/> Of note, the presence of colitis appears to be associated with a greater risk of liver disease progression and bile duct cancer (cholangiocarcinoma) development, although this relationship remains poorly understood.<ref>{{cite journal | vauthors = Boonstra K, Weersma RK, van Erpecum KJ, Rauws EA, Spanier BW, Poen AC, van Nieuwkerk KM, Drenth JP, Witteman BJ, Tuynman HA, Naber AH, Kingma PJ, van Buuren HR, van Hoek B, Vleggaar FP, van Geloven N, Beuers U, Ponsioen CY | display-authors = 6 | title = Population-based epidemiology, malignancy risk, and outcome of primary sclerosing cholangitis | journal = Hepatology | volume = 58 | issue = 6 | pages = 2045–2055 | date = December 2013 | pmid = 23775876 | doi = 10.1002/hep.26565 | hdl-access = free | s2cid = 205889681 | hdl = 1887/117347 }}</ref> Close monitoring of PSC patients is vital.

Various forms of gallbladder disease such as [[gallstone]]s and gallbladder [[Polyp (medicine)|polyp]]s are also common in those with PSC.<ref name="Lazaridis2016"/> Approximately 25% of people with PSC have gallstones.<ref name="Lazaridis2016"/> Ultrasound surveillance of the gallbladder every year is recommended for people with PSC.<ref name="Lazaridis2016"/> Any person with PSC who is found to have a mass in the gallbladder should undergo [[cholecystectomy|surgical removal of the gallbladder]] due to the high risk of cholangiocarcinoma.<ref name="Lazaridis2016"/> [[Osteoporosis]] (hepatic osteodystrophy) and [[hypothyroidism]] are also associated with PSC.{{cn|date=September 2022}}

A 2–3:1 male-to-female predilection occurs in primary sclerosing cholangitis.<ref name=Robbins/>  PSC can affect men and women at any age, although it is commonly diagnosed in the fourth decade of life, most often in the presence of IBD.<ref name=":0" />  PSC progresses slowly and is often asymptomatic, so it can be present for years before it is diagnosed and before it causes clinically significant consequences.  Relatively few data are available on the [[Prevalence (epidemiology)|prevalence]] and [[Incidence (epidemiology)|incidence]] of PSC, with studies in different countries showing annual incidence of 0.068–1.3 per 100,000 people and prevalence 0.22–8.5 per 100,000; given that PSC is closely linked with ulcerative colitis, the risk is likely higher in populations where UC is more common.<ref>{{cite journal | vauthors=Feld JJ, Heathcote EJ |title=Epidemiology of autoimmune liver disease |journal= Journal of Gastroenterology and Hepatology|volume=18 |issue=10 |pages=1118–28 |date=October 2003 |pmid=12974897 |doi=10.1046/j.1440-1746.2003.03165.x |s2cid=24075827 |doi-access= }}</ref>  In the United States, an estimated 29,000 individuals have PSC.<ref name="Lazaridis2016"/>