Intrahepatic cholangiocarcinoma mortality in the USA, 1999-2020: a 21-year population-based analysis

Intrahepatic cholangiocarcinoma (ICC) is an aggressive liver malignancy with a persistently low 5-year survival rate of approximately 9%. In recent decades, mortality associated with ICC has increased in the USA and globally.

To assess national trends in ICC-related mortality in the USA from 1999 to 2020, stratified by demographic and regional characteristics.

ICC mortality data were extracted from Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) from 1999 to 2020. Age-adjusted mortality rate (AAMR) per 100,000 population and Annual Percentage Change (APC), along with 95% confidence intervals (CI), were determined. Joinpoint regression analysis was employed to examine trends across demographic groups (age, gender, race/ethnicity) and geographic regions.

A total of 113,450 ICC-related deaths occurred between 1999 and 2020. The overall ICC-related AAMR steadily increased from 0.98 in 1999 to 2.04 in 2020, with an APC of 3.55. Males had higher AAMR (2.32) as compared to females (1.83). Non-Hispanic (NH) Asian or Pacific Islander had the highest AAMR (2.61), with the highest APC (4.19) recorded among NH-Black or African American individuals. Mortality rates were highest in people aged 85+, with the highest APC (4.43) observed in people aged 45-54. Wisconsin, Minnesota, Connecticut, Washington, Hawaii, and Rhode Island had approximately double the AAMR than the states that fell in the lower 10th percentile. Large metropolitan areas had the highest AAMR (4.28) compared to rural areas.

ICC-related mortality has steadily increased in the USA over the study period. Stratified analysis reveals significant demographic and regional disparities. Understanding these patterns is essential for guiding targeted public health interventions and improving early detection and treatment strategies.