A Longitudinal Analysis of Cholangiocarcinoma-Related Mortality in the United States

Document Type

Conference Proceeding

Publication Date

10-2024

Publication Title

American Journal of Gastroenterology

Abstract

Introduction: Cholangiocarcinoma (CCA) is the second most common primary liver malignancy with high rates of mortality. Many studies report increasing rates of both intrahepatic CCA (iCCA) and extrahepatic CCA (eCCA) in the United States (US). We aimed to investigate CCA-related mortality rates between 1999-2020, and to identify the most vulnerable patient populations for death in the US. Methods: Mortality data was retrieved from multiple cause-of-death files in the CDC repository, using ICD-10 codes for iCCA (C22.1) and eCCA (C24.0, C24.8, C24.9). Age-adjusted mortality rate (AAMR) and 95% confidence interval were compared across demographic and geographic factors. Log-linear regression models were used to analyzed temporal mortality trends, presented as average annual mortality rate (AAPC). Results: Between 1999-2020, a total of 148,871 CCA-related deaths were identified, with 36,048 deaths due to eCCA and 113,450 deaths due to iCCA. AAMR for was increased from 1.51 [95% CI, 1.46-1.55] in 1999 to 2.55 [2.50-2.60] in 2020 with an AAPC of 12.40%, P, 0.001 (Figure 1). From 1999 to 2020, the annual iCAA mortality rate increased, with AAPC 13.55%, P, 0.001 while annual eCCA mortality remained stable, with AAPC -0.43%, P50.11. Higher mortality rates were observed in males compared to females for both iCAA (AAMR 1.77 [1.75-1.78] vs 1.35 [1.34-1.36]) and eCAA (AAMR 0.55 [0.54-0.56] vs 0.44 [0.44-0.45]). Higher iCAA mortality rate was observed in Hispanic populations (AAMR 1.75 [1.72 -1.79]) compared to non-Hispanic (AAMR 1.51 [1.50-1.52]) populations, and in urban (AAMR 1.56 [1.55-1.57]) compared to rural (AAMR 1.38 (1.36-1.41]) communities, and was highest among Asian (AAMR 2.05 [2.00-2.10]) populations. There were no observed differences in eCCA mortality rates across racial, ethnic, or urbanization categories. Similar AAMR was observed among 4 US census regions for both iCCA and eCCA. Conclusion: AAMR has increased for both iCCA and eCCA between 1999-2020 in the US. Significant variations were seen across gender, ethnicity, race, and rural-urban settings for iCCA mortality, while no significant differences were seen for eCCA mortality. Further investigations for understanding the epidemiology and risk factors for most vulnerable populations are essential to mitigate health disparities and potentially CCA mortality.

Volume

119

Issue

10S

First Page

S13

Comments

American College of Gastroenterology Annual Scientific Meeting, October 25-30, 2024, Philadelphia, PA

Last Page

S14

DOI

10.14309/01.ajg.0001028436.63026.71

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