TY - JOUR
T1 - Risk factors, epidemiology and prognosis of cholangiocarcinoma in Finland
AU - Barner-Rasmussen, Nina
AU - Pukkala, Eero
AU - Hadkhale, Kishor
AU - Färkkilä, Martti
N1 - Funding Information:
This study was supported by a grant from Finska Läkaresällskapet and Svenska Kulturfonden. The funding sources had no involvement in the study.
Publisher Copyright:
© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.
PY - 2021
Y1 - 2021
N2 - Background: Cholangiocarcinoma (CCA) is a cancer arising from the intra- and extrahepatic bile ducts. The early stages are often asymptomatic, CCA is frequently diagnosed in an advanced stage and the prognosis of CCA is often dismal. Objective: Our objective was to estimate the incidence of CCA in Finland and to identify risk factors for CCA, with a special interest in primary sclerosing cholangitis (PSC). Methods: We identified all CCA cases during 1974–2018 from the Finnish Cancer Registry and calculated age-standardised incidence rates. Five controls for each case were extracted from the Population Registry, matched by age, gender and municipality of residence at the time of diagnosis. Odds ratios (ORs) for risk factors were estimated with conditional logistic regression and survival estimates with the Kaplan–Meier method. Results: Incidence of CCA remained stable in both genders; the age-standardised rate (World Standard) in 2013–2017 in males and females was 1.7 per 100,000 person years and 1.3 per 100,000 person years, respectively. Primary sclerosing cholangitis carried a 30-fold risk of intrahepatic cholangiocarcinoma (iCCA) and 25-fold risk of extrahepatic cholangiocarcinoma (eCCA). Diabetes, inflammatory bowel disease and liver cirrhosis were associated with iCCA, whereas cholelithiasis and viral hepatitis C were associated with eCCA. The cumulative 5-year survival was 4.6%. Conclusions: The incidence of CCA has been stable. Known risk factors for CCA were confirmed, with PSC having the highest OR. Survival remains poor.
AB - Background: Cholangiocarcinoma (CCA) is a cancer arising from the intra- and extrahepatic bile ducts. The early stages are often asymptomatic, CCA is frequently diagnosed in an advanced stage and the prognosis of CCA is often dismal. Objective: Our objective was to estimate the incidence of CCA in Finland and to identify risk factors for CCA, with a special interest in primary sclerosing cholangitis (PSC). Methods: We identified all CCA cases during 1974–2018 from the Finnish Cancer Registry and calculated age-standardised incidence rates. Five controls for each case were extracted from the Population Registry, matched by age, gender and municipality of residence at the time of diagnosis. Odds ratios (ORs) for risk factors were estimated with conditional logistic regression and survival estimates with the Kaplan–Meier method. Results: Incidence of CCA remained stable in both genders; the age-standardised rate (World Standard) in 2013–2017 in males and females was 1.7 per 100,000 person years and 1.3 per 100,000 person years, respectively. Primary sclerosing cholangitis carried a 30-fold risk of intrahepatic cholangiocarcinoma (iCCA) and 25-fold risk of extrahepatic cholangiocarcinoma (eCCA). Diabetes, inflammatory bowel disease and liver cirrhosis were associated with iCCA, whereas cholelithiasis and viral hepatitis C were associated with eCCA. The cumulative 5-year survival was 4.6%. Conclusions: The incidence of CCA has been stable. Known risk factors for CCA were confirmed, with PSC having the highest OR. Survival remains poor.
KW - cholangiocarcinoma
KW - epidemiology
KW - liver
KW - primary sclerosing cholangitis
KW - risk factors
U2 - 10.1002/ueg2.12154
DO - 10.1002/ueg2.12154
M3 - Article
AN - SCOPUS:85114983290
SN - 2050-6406
VL - 9
SP - 1128
EP - 1135
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 10
ER -
