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. 2022 Aug 3;19(15):9551.
doi: 10.3390/ijerph19159551.

Comparison of Cholangiocarcinoma and Hepatocellular Carcinoma Incidence Trends from 1993 to 2012 in Lampang, Thailand

Pianpian Cao  1 , Laura S Rozek  2   3 , Donsuk Pongnikorn  4 , Hutcha Sriplung  5 , Rafael Meza  1
Affiliations

Comparison of Cholangiocarcinoma and Hepatocellular Carcinoma Incidence Trends from 1993 to 2012 in Lampang, Thailand

Pianpian Cao et al. Int J Environ Res Public Health. .

Abstract

Liver cancer is the most common cancer in Northern Thailand, mainly due to the dietary preference for raw fish, which can lead to infection by the parasite, O. viverrini, a causal agent of cholangiocarcinoma. We conducted a temporal trend analysis of cross-sectional incidence rates of liver cancer in Lampang, Northern Thailand. Liver cancer data from 1993-2012 were extracted from Lampang Cancer Registry. The multiple imputation by chained equations method was used to impute missing histology data. Imputed data were analyzed using Joinpoint and age-period-cohort (APC) models to characterize the incidence rates by gender, region, and histology, considering hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). We observed a significant annual increase in CCA incidence and a considerable decrease in HCC incidence for both genders in Lampang. The APC analysis suggested that CCA incidence rates were higher in older ages, younger cohorts, and later years of diagnosis. In contrast, HCC incidence rates were higher in older generations and earlier years of diagnosis. Further studies of potential risk factors of CCA are needed to better understand and address the increasing burden of CCA in Lampang. Our findings may help to draw public attention to cholangiocarcinoma prevention and control in Northern Thailand.

Keywords: Jointpoint analysis; O. viverrini infection; age-period-cohort model; cholangiocarcinoma; hepatocellular carcinoma; liver cancer; liver fluke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
The proportion of HCC in 1993 by sex with a given number of imputations. The proportions stabilized after about 100 imputations, strengthening our argument that more rounds of imputations are needed especially when the percentage of missing is large, and the sample size is small.
Figure 1
Figure 1
Age-adjusted incidence rate trends by sex and histology before and after imputation.
Figure 2
Figure 2
Age, period, and cohort effects of AP-C models for male and female HCC.
Figure 3
Figure 3
Age, period, and cohort effects of AC-P models for male and female CCA.
See this image and copyright information in PMC

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