Epidemiology of cholangiocarcinoma

Aim: We aimed to analyze temporal trends in mortality from intrahepatic (ICC) and extrahepatic (ECC) cholangiocarcinoma in selected countries worldwide. Methods: Official death certification data for ICC and ECC and populations estimates for 29 countries worldwide (17 from Europe, 8 from the Americas, and 4 from Australasia) and for Hong Kong Special Administrative Region of the People's Republic of China (SAR), from 1995 to 2018, were extracted from the World Health Organization and the Pan American Health Organization databases. Age-standardized mortality rates were computed. A joinpoint regression analysis was performed. Results: In both sexes, ICC mortality rates increased in most countries considered, including the USA, the UK, and Australia; in some countries, including Italy and France, the increasing trends leveled off over the most recent years. In men, around 2016, the highest rates (1.7-2.3/100,000) were observed in Hong Kong SAR, Portugal, France, Spain, Australia, Austria, the UK, and Canada; Latin American countries and some eastern European countries had the lowest rates (0.2-0.8/100,000). A similar pattern was observed in women, but with lower rates (from 1.7/100,000 in Hong Kong SAR to 0.14/100,000 in Argentina). ECC mortality declined in most European and Australasian countries, but it tended to increase in Americas. In both sexes, rates were below 1/100,000 around 2016, with the only exceptions being Japan (2.6/100,000 men and 1.2/ 100,000 women) and Hungary (1.5/100,000 men and 1.1/100,000 women). Conclusion: ICC mortality increased in most areas of the world, likely due to increased prevalence of risk factors and improved cancer recognition and classification. ECC mortality fell in most countries, largely due to the widespread use of cholecystectomy.