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Updated: Jun 5, 2025
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Spatial analysis of cholangiocarcinoma in Thailand from 2012 to 2021; a population-based cancer registries study
Oraya Sahat1, Supot Kamsa-Ard2, Apiporn Thinkhamrop Suwannatrai3
1Student of Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Background:
Cholangiocarcinoma (CCA) is major health issue in Thailand, with high incidences in different parts of country. This study examines the association between spatial variables and CCA in Thailand.
Methods:
Thailand's four population-based cancer registries provided data for this retrospective cohort analysis between January 1, 2012, and December 31, 2021. 6,379 diagnosed CCA cases were found in 554 sub-districts. Moran's I and Local Indicators of Spatial Association (LISA) measured geographic dispersion and estimated sex age-standardized rates (ASRs). Multivariable log-linear regression assessed geography and CCA, calculating adjusted incidence rate ratios (IRRs) and 95% confidence interval (CI).
Results:
Of 6,379 CCA cases, 63.9% were male, and the mean age at diagnosis was 66.2 years (standard deviation = 11.07 years). CCA ASRs for both sexes in Thailand was 8.9 per 100,000 person-years. The northeastern region had the greatest ASR at 13.4 per 100 000 person-years. Moran's I and LISA studies grouped regions by spatial variables. The association between spatial variables and CCA demonstrated that the northern region exhibited elevation (adjusted IRRs = 0.82, 95%CI: 0.78 to 0.87) and distance from water sources variable (adjusted IRRs = 0.91, 95%CI: 0.82 to 0.99). The central region elevation variable (adjusted IRRs = 0.85, 95%CI: 0.76 to 0.94). This was the distance from water sources (adjusted IRRs = 0.96, 95%CI: 0.93 to 0.99) and population density variable (adjusted IRRs = 0.94, 95%CI: 0.93 to 0.96) in the northeastern region. Population density (adjusted IRRs = 1.09, 95%CI: 1.02 to 1.15) and average temperature variable (adjusted IRRs = 1.05, 95%CI: 1.02 to 1.09) were significant in the southern region.
Conclusion:
Spatial variables associated with CCA indicate that ASR differs across Thailand. So environmental and climate factors can inform targeted public health strategies to address CCA in high-risk areas throughout Thailand.
