Abstract: National Trends of Cholangiocarcinoma Mortality in the United States with reference to South Dakota: A Negative Binomial Analysis.
Cholangiocarcinoma (CCA) has been noted to have increasing mortality globally. This study aims to evaluate the demographic, racial and geographic trends in CCA mortality across the United States.
Data was extracted through Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research by using ICD-10 codes C22.1, C24.0, C24.8 and C24.9 for people over 65 years of age, for the years 1999-2023. Age-adjusted mortality rates (AAMR) per 1,000,000 individuals and annual percentage changes (APC), with 95% confidence intervals, were analyzed across various demographic groups and geographical regions through Joinpoint regression. Negative Binomial Regression was utilized to compute adjusted Incidence Rate Ratios (IRRs), with South Dakota (SD) as the reference.
Our analysis revealed a total of 131,125 deaths in the United States from 1999 to 2023 due to CCA. Overall, there was a consistent increasing trend in the AAMR from 90.8 to 163.1 per 1,000,000 (AAPC: 2.40, 95% CI: 2.15 to 2.65). Males had a consistently higher AAMR than females across all years. African American population showed the highest increase in AAMR over the study years (AAPC: 3.36). Highest CCA-related mortality was seen in Rhode Island, followed by Massachusetts. Highest increase in mortality over the period was seen in Louisiana (AAPC 3.38, 95% CI: 1.70-5.10). Based on negative binomial regression, each one-year increase was associated with approximately 1% increase in AAMR (IRR=1.021, 95% CI: 1.020-1.022). Alaska had a 66% higher (IRR 1.66) and Rhode Island had a 23% higher incidence of mortality (IRR 1.23) when compared to SD. Mississippi had the lowest incidence of mortality, 51% less when compared to SD (IRR 0.49).
The upward trajectory of CCA mortality is disproportionately higher in some states and underscores the need for additional research aimed at understanding risk factors driving this increase.
Data was extracted through Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research by using ICD-10 codes C22.1, C24.0, C24.8 and C24.9 for people over 65 years of age, for the years 1999-2023. Age-adjusted mortality rates (AAMR) per 1,000,000 individuals and annual percentage changes (APC), with 95% confidence intervals, were analyzed across various demographic groups and geographical regions through Joinpoint regression. Negative Binomial Regression was utilized to compute adjusted Incidence Rate Ratios (IRRs), with South Dakota (SD) as the reference.
Our analysis revealed a total of 131,125 deaths in the United States from 1999 to 2023 due to CCA. Overall, there was a consistent increasing trend in the AAMR from 90.8 to 163.1 per 1,000,000 (AAPC: 2.40, 95% CI: 2.15 to 2.65). Males had a consistently higher AAMR than females across all years. African American population showed the highest increase in AAMR over the study years (AAPC: 3.36). Highest CCA-related mortality was seen in Rhode Island, followed by Massachusetts. Highest increase in mortality over the period was seen in Louisiana (AAPC 3.38, 95% CI: 1.70-5.10). Based on negative binomial regression, each one-year increase was associated with approximately 1% increase in AAMR (IRR=1.021, 95% CI: 1.020-1.022). Alaska had a 66% higher (IRR 1.66) and Rhode Island had a 23% higher incidence of mortality (IRR 1.23) when compared to SD. Mississippi had the lowest incidence of mortality, 51% less when compared to SD (IRR 0.49).
The upward trajectory of CCA mortality is disproportionately higher in some states and underscores the need for additional research aimed at understanding risk factors driving this increase.