New epidemiologic trends in cholangiocarcinoma

Area of Science:

• Oncology
• Gastroenterology
• Epidemiology

Background:

• Cholangiocarcinoma (CCA) is a significant biliary tract and liver malignancy.
• Intrahepatic cholangiocarcinoma (iCCA) incidence is increasing in Western Europe, while extrahepatic cholangiocarcinoma (eCCA) remains stable.
• iCCA mortality rates are rising, exceeding those of eCCA.

Purpose of the Study:

• To analyze trends in cholangiocarcinoma incidence and mortality.
• To identify established and emerging risk factors for iCCA and eCCA.

Main Methods:

• Epidemiological analysis of CCA incidence and mortality trends over three decades.
• Review of known and emerging risk factors associated with CCA subtypes.

Main Results:

• A notable increase in iCCA incidence and mortality observed in Western Europe.
• Stable or declining trends for eCCA incidence and mortality.
• Established risk factors include hepatobiliary flukes, hepatolithiasis, choledochal cysts (Asia), and primary sclerosing cholangitis (West).
• Hepatitis B/C virus infection and cirrhosis are risk factors for iCCA.
• Obesity, diabetes, and metabolic-associated fatty liver disease (MAFLD) are emerging iCCA risk factors.

Conclusions:

• iCCA represents a growing public health concern in Western countries.
• Understanding diverse risk factors is crucial for targeted prevention and treatment strategies for CCA subtypes.