Incidence and Mortality Trends of Cholangiocarcinoma; Are Asian Patients Different From Other Ethnicities?

Abstract

Abstract Background Cholangiocarcinoma is the most common biliary cancer and the second most common primary cancer of the liver. It is estimated that cholangiocarcinoma is responsible for 13% of overall cancer-related mortality worldwide. In this study, we examined the incidence and mortality temporal trends of cholangiocarcinoma since the year 2000. Methods We used SEER 18 database to study cholangiocarcinoma cases in the US during 2000-2015. Incidence and mortality rates of cholangiocarcinoma were calculated by race and were expressed in 1,000,000 person-years. Annual percent change (APC) was calculated using joinpoint regression software. Results We reviewed 2,191 patients with cholangiocarcinoma. Most patients were Caucasians (1,800), followed by blacks (193), Asians (182), and American Indians (16), with incidence rates of 1.643, 1.431, 1.451, and 1.199 per 100,000 person-years, respectively. The incidence rates of cholangiocarcinoma did not significantly change over the study period among Caucasians (APC=1.345, p-value =0.06), blacks (APC=1.085, p-value = 0.22), and Asians (APC=0.48, p-value = 0.76). Mortality due to cholangiocarcinoma was 1.391, 1.203, 1.194, and 1.029 per 100,000 person-years in Caucasians, blacks, Asians, and American Indians, respectively. Mortality rates of both whites and Asians did not change significantly over the study period. However, mortality rates increased significantly in Blacks (APC=3.564, p-value= 0.001). Conclusion In a large cohort study, mortality rate for cholangiocarcinoma in Asian patients is better than Caucasian and Black patients. There are stable mortality rates over time, with the worsening mortality among blacks, which indicates need to address disparities in health care for cholangiocarcinoma. More research is warranted to understand how to improve outcomes in patients with cholangiocarcinoma.