TEN-YEARS TREND IN THE INCIDENCE RATES OF INTRA-HEPTIC CHOLANGIOCARCINOMA IN THE UNITED STATES
BACKGROUND: Intrahepatic cholangiocarcinoma (IHC) is as aggressive tumor of the liver, accounting for about 10% of all cholangiocarcinomas. It is estimated that IHC affects approximately one to two per 100,000 persons in the Western world. The main purpose of the study is to describe trends in incidence of IHC among hospitalized patients in the US hospitals between 2005 and 2014.
METHOD: We estimated the incidence rates of Intrahepatic cholangiocarcinoma in the US from 2005 to 2014, by analyzing the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, a nationally representative sample of discharges from US hospitals sponsored by the Agency for Healthcare Research and Quality. The outcomes of study include changes in the number and incidence rate of IHC hospitalization, cost of care, length of hospital stay and patient demographics. We abstracted all cases of IHC using diagnostic code 155.1 from International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM]). A weighted estimate was used in all analysis.
RESULT: Between 2005 and 2014, about 104,035 IHC related admissions were reported nationwide. The incidence rate of intrahepatic cholangiocarcinoma in United States increased nearly 2-fold from 2.36 per 100,000 (95% CI, 2.03-2.69) in 2005 to 4.38 per 100,000 (95% CI, 4.10-4.67) in 2014. This represents a percentage change of 85.6% from 2005 to 2014. The rates of admission increased among patients within the age group of 60 to 69 years and a decreasing in trend was observe for patients ages 70 years or older (p-value < 0.0001). There was a remarkable increase in IHC diagnosis across all races. Particularly, among White, the rates increased from 1.42 per 100, 000 in 2005 to 2.84 per 100, 000 in 2014. Total median charge per admission significantly increased from $22, 647 in 2005 to $37, 611 in 2014. Further, mortality rate among patients with IHC decreased remarkably over a ten-year period (p-value, <0.05). There were no significant differences in admission rates between males and females.
CONCLUSION: The rate of IHC has approximately doubled over the past decade. Although, there was a notable decrease in the mortality over a ten-year period, the cost of care for inpatients care for patients with IHC has risen significantly. This tumor has poor prognosis associated with it and hence further studies to elucidate the risk factors are necessary.