Decreasing trends in cholangiocarcinoma incidence and relative survival in Khon Kaen, Thailand: An updated, inclusive, population-based cancer registry analysis for 1989–2018

Abstract

Background Cholangiocarcinoma (CCA) is a leading cause of cancer death in northeastern Thailand. We reported on the incidence of CCA using only one method. In the current study, we used three different statistical methods to forecast future trends and estimate relative survival. Methods We reviewed the CCA cases diagnosed between 1989 and 2018 recorded in the population-based Khon Kaen Cancer Registry (KKCR). Annual percent change (APC) was calculated to quantify the incidence rate trends using Joinpoint regression. Age-period-cohort models (APC model) were used to examine the temporal trends of CCA by age, calendar year, and birth cohort. We projected the incidence of CCA up to 2028 using three independent approaches: the Joinpoint, Age-period-cohort, and Nordpred models. Survival assessments were based on relative survival (RS). Results The respective APC in males and females decreased significantly (-3.1%; 95%CI: -4.0 to -2.1 and -2.4%; 95%CI: -3.6 to -1.2). The APC model—AC-P for male CCA—decreased according to a birth-cohort. The CCA incidence for males born in 1998 was 0.09 times higher than for those born in 1966 (Incidence rate ratios, IRR = 0.09; 95%CI: 0.07 to 0.12). The relative incidence for female CCA similarly decreased according to a birth-cohort (IRR = 0.11; 95%CI: 0.07 to 0.17). The respective projection for the age-standardized rate for males and females for 2028 will be 7.6 per 100,000 (102 patients) and 3.6 per 100,000 (140 patients). The five-year RS for CCA was 10.9% (95%CI: 10.3 to 11.6). Conclusion The incidence rate of CCA has decreased. The projection for 2028 is that the incidence will continue to decline. Nevertheless, the survival of patients with CCA remains poor.

Dense GM-CSFRα-expressing immune infiltration is allied with longer survival of intrahepatic cholangiocarcinoma patients

“…The high expressions of GM-CSF in CCA and increased GM-CSFR α -expressed ICI seemed to benefit CCA patients, particularly the worse prognostic subtype, the non-papillary one, demonstrated by longer survival times ( Zen et al, 2006 ). It is worth mentioning that the characteristics of the iCCA patients in the current study represented a heterogeneous patient population in a liver-fluke endemic area ( Kamsa-Ard et al, 2021 ). Using multivariate Cox regression analysis with backward selection, light GM-CSFR α -expressing ICI was emphasized as an independent unfavorable prognostic factor for iCCA patients.…”

S3-Leitlinie Diagnostik und Therapie biliärer Karzinome – Langversion

“…In Südostasien ist die CCA-Inzidenz höher als in anderen Ländern. Ein wichtiger Risikofaktor dort sind parasitäre Infektionen mit Leberegeln wie Opisthorchis viverrini oder Clonorchis sinensis, die zu chronischen Cholangitiden führen [483,484]. Infektionen mit Opisthorchis viverrini oder Clonorchis sinensis sind endemisch in Südostasien und sind mutmaßlich jährlich für mehr als 7000 CCA-Neuerkrankungen in dieser Region verantwortlich [485].…”

Pesticide exposure and risk of cholangiocarcinoma: A hospital‐based matched case–control study

“…Thailand has one of the highest incidence rates of CCA globally [6]. In Thailand, the respective overall ASR for CCA between 1989 and 2018 for all ages in males versus females was 36.1 per 100,000 person-years (95% CI: 35.3-36.8) versus 14.4 per 100,000 person-years (95% CI: 13.9-14.8) [9]. The increased incidence is accompanied by low 5-year relative survival rates (5%-30% between 2000 and 2014) because many cases go undetected for decades and are diagnosed late [10].…”