Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, Tennessee.
Cancer Epidemiol Biomarkers Prev. 2023 Nov 1;32(11):1660-1667. doi: 10.1158/1055-9965.EPI-23-0562.
The incidence of cholangiocarcinoma and gallbladder cancer has been increasing and decreasing respectively in the United States, whereas their mortality has been declining since 1980, which suggests improved overall survival of biliary tract cancers (BTC). We aimed to investigate temporal trends of BTC stages and survival and their associations with demographic factors.
A total of 55,163 patients with BTC collected from 2000 to 2018 from the NCI Surveillance, Epidemiology, and End Results 18 registry were included in this study. We assessed the temporal trend of BTC stages with diagnosis years using the annual percentage of change (APC) in the proportion of the stages. We estimated the association of BTC survival and stages with diagnosis years and demographic factors using the Cox regression models.
While localized BTC proportion remained little changed from 2006 to 2018, the proportion of regional and distant BTCs significantly decreased (APC = -2.3%) and increased (APC = 2.7%), respectively, through the years. The overall and cancer-specific survival increased from 41.0% and 47.3% in 2000 to 2004 to 51.2% and 53.8% in 2015 to 2018, respectively. Patients with BTC who were older, Black, unmarried, or had lower socioeconomic status (SES) had significantly poorer overall survival.
We found that distant and regional BTC significantly increased and decreased, respectively, and the BTC survival significantly improved over time. Age, sex, race, SES, and marital status were significantly associated with overall survival and less evidently with cancer-specific survival of patients with BTC.
Our findings suggest that demographic factors were associated with BTC stages and BTC survival.
在美国，胆管癌和胆囊癌的发病率分别呈上升和下降趋势，而自 1980 年以来其死亡率一直在下降，这表明胆道癌（BTC）的总体生存率有所提高。我们旨在研究 BTC 分期和生存的时间趋势及其与人口统计学因素的关系。
本研究共纳入了 2000 年至 2018 年期间来自 NCI 监测、流行病学和最终结果 18 登记处的 55163 名 BTC 患者。我们使用各分期比例的年度百分比变化（APC）评估了 BTC 分期的时间趋势与诊断年份之间的关系。我们使用 Cox 回归模型估计了 BTC 生存和分期与诊断年份和人口统计学因素的关系。
尽管局部 BTC 的比例自 2006 年至 2018 年基本保持不变，但局部和远处 BTC 的比例分别显著下降（APC = -2.3%）和增加（APC = 2.7%）。总体生存率和癌症特异性生存率从 2000 年至 2004 年的 41.0%和 47.3%增加到 2015 年至 2018 年的 51.2%和 53.8%。BTC 患者中年龄较大、为黑人、未婚或社会经济地位（SES）较低者，其总体生存率显著较低。
我们发现远处和局部 BTC 分别显著增加和减少，并且 BTC 生存随时间显著改善。年龄、性别、种族、SES 和婚姻状况与 BTC 患者的总体生存率显著相关，与癌症特异性生存率的相关性较小。
我们的研究结果表明，人口统计学因素与 BTC 分期和 BTC 生存有关。
