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. 2014 Dec;59(12):3103-10.
doi: 10.1007/s10620-014-3276-2. Epub 2014 Sep 10.

Secular trends in the incidence of cholangiocarcinoma in the USA and the impact of misclassification

Gia L Tyson  1 , Jawad A Ilyas, Zhigang Duan, Linda K Green, Mamoun Younes, Hashem B El-Serag, Jessica A Davila
Affiliations

Secular trends in the incidence of cholangiocarcinoma in the USA and the impact of misclassification

Gia L Tyson et al. Dig Dis Sci. 2014 Dec.

Abstract

Background and aims: It has been reported that the incidence of intrahepatic cholangiocarcinoma (ICC) has increased in the USA, while extrahepatic cholangiocarcinoma (ECC) has decreased or remained stable. However, neither the recent trends nor the effects of the misclassification of Klatskin tumors are known.

Methods: Using the Surveillance, Epidemiology, and End Results program databases, we calculated the average annual age-adjusted incidence rates (AA-IRs) of ICC and ECC in 4-year time periods (1992-1995, 1996-1999, 2000-2003, 2004-2007). These AA-IRs were calculated with misclassified as well as correctly classified Klatskin tumors. AA-IRs were also calculated based on age, sex, and race. Multivariable Poisson regression models were used to evaluate the secular trends of ICC and ECC.

Results: The AA-IR of ICC was 0.92 in 1992-1995 and 0.93 in 2004-2007, while the AA-IR of ECC increased from 0.70 in 1992-1995 to 0.95 in 2004-2007. There was no significant trend in AA-IR of ICC (p = 0.07), while there was a significant increase in ECC across the 4-year time periods (p < 0.001). Klatskin tumors comprised 6.7% of CCs with approximately 90 and 45% misclassified as ICC during 1992-2000 and 2001-2007, respectively. Adjusted Poisson models showed no significant differences in the temporal trend of ICC or ECC due to misclassification of Klatskin tumors.

Conclusions: The incidence of ICC has remained stable between 1992 and 2007 with only slight fluctuations, while the incidence of ECC has been increasing. Misclassification of Klatskin tumors does not appear to play a significant role in the trends of CCs.

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Conflict of interest statement

Conflict of interest No conflicts of interest exist for Drs. Tyson, Ilyas, Duan, Green, Younes, El-Serag, or Davila.

Figures

Fig. 1
Fig. 1
Age-adjusted incidence rate of ICC and ECC from 1992 to 2007 including ICD-O Versions 2 (1992–2000) and 3 (2001–2007); a with misclassified Klatskin tumors, b with reclassified Klatskin tumors
Fig. 2
Fig. 2
Age-specific incidence rates of a ICC and b ECC by time period; original SEER classification
See this image and copyright information in PMC

References

    1. Blechacz BR, Gores GJ. Cholangiocarcinoma. Clin Liver Dis. 2008;12:131–50. ix. - PubMed
    1. Gatto M, Bragazzi MC, Semeraro R, et al. Cholangiocarcinoma: update and future perspectives. Dig Liver Dis. 2010;42:253–260. - PubMed
    1. Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 2004;24:115–125. - PubMed
    1. Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. Hepatology. 2011;54:173–184. - PMC - PubMed
    1. Patel T. Cholangiocarcinoma. Nat Clin Pract Gastroenterol Hepatol. 2006;3:33–42. - PubMed

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