Jensen Morten Daniel, West Joe, Weber Britta, Mortensen Frank Viborg, Jepsen Peter
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
JHEP Rep. 2025 Jun 24;7(9):101493. doi: 10.1016/j.jhepr.2025.101493. eCollection 2025 Sep.
BACKGROUND & AIMS: Cholangiocarcinomas have a poor prognosis, and the incidence is rising in most countries. We examined time-trends in incidence and mortality in a nationwide Danish cohort.
We used nationwide health databases to identify all Danish citizens diagnosed with cholangiocarcinoma from 1995 to 2022. We computed age-standardised incidence rates, stage distribution, and age- and sex-adjusted 1-year mortality.
The median age of the 5,787 patients with cholangiocarcinoma was 72 years, and 53% were female. Overall, the age-standardised incidence rate per 100,000 person-years almost doubled, from 3.93 (95% CI 3.59-4.26) in 1995-1998 to 6.79 (6.42-7.16) in 2019-2022. This rate increased five-fold for intrahepatic cholangiocarcinoma from 0.75 (0.61-0.90) in 1995-1998 to 3.85 (3.57-4.13) in 2019-2022, while for extrahepatic cholangiocarcinoma it decreased from 2.42 (2.16-2.69) in 1995-1998 to 1.30 (1.14-1.47) in 2019-2022. Although individuals aged 18-59 years had the lowest incidence rate of cholangiocarcinoma (any type), they experienced the steepest annual increase (3.2% 2.7% in those aged 60-79 and 2.1% in those ≥80 years; for interaction = 0.01). Among all patients with cholangiocarcinoma, the proportion with localised resectable disease increased from 7% in 2004-2006 to 12% in 2019-2022. We saw a decrease in age- and sex-adjusted 1-year mortality between 1995 and 2022: 81% (77-84) in 1995-1998 . 65% (63-68) in 2019-2022. The decrease in 1-year mortality was universal, with the largest decrease in patients aged 18-59 years (from 67% in 1995-1998 to 49% in 2019-2022) and in 60-79-year-olds.
The incidence of cholangiocarcinoma in Denmark increased in 1995-2022, driven by an increasing incidence of intrahepatic cholangiocarcinoma. Meanwhile, 1-year mortality decreased, likely reflecting earlier diagnosis and better treatments.
Cholangiocarcinomas have a poor prognosis, and the incidence is rising in most countries. In Europe, all countries but Denmark have shown an increasing incidence of intrahepatic cholangiocarcinoma. The incidence of cholangiocarcinoma in Denmark between 1995 and 2022 increased, driven by a large increase in intrahepatic cholangiocarcinomas. The proportion with localised resectable disease increased while 1-year mortality decreased, though it remained high (65% in 2019-2022). Knowledge of incidence and mortality risk is valuable for doctors to understand the disease, identify risk factors, and design preventive care studies; for healthcare providers to allocate resources; and for patients to understand their prognosis.
胆管癌预后较差，且在大多数国家发病率呈上升趋势。我们研究了丹麦全国队列中胆管癌发病率和死亡率的时间趋势。
我们利用全国健康数据库，识别出1995年至2022年期间所有被诊断为胆管癌的丹麦公民。我们计算了年龄标准化发病率、分期分布以及年龄和性别调整后的1年死亡率。
5787例胆管癌患者的中位年龄为72岁，53%为女性。总体而言，每10万人年的年龄标准化发病率几乎翻了一番，从1995 - 1998年的3.93（95%置信区间3.59 - 4.26）增至2019 - 2022年的6.79（6.42 - 7.16）。肝内胆管癌的发病率从1995 - 1998年的0.75（0.61 - 0.90）增至2019 - 2022年的3.85（3.57 - 4.13），增长了五倍，而肝外胆管癌的发病率则从1995 - 1998年的2.42（2.16 - 2.69）降至2019 - 2022年的1.30（1.14 - 1.47）。尽管18 - 59岁的个体胆管癌（任何类型）发病率最低，但他们的年增长率最高（60 - 79岁人群为3.2%，≥80岁人群为2.7%，18 - 59岁人群为2.1%；交互作用P = 0.01）。在所有胆管癌患者中，局限性可切除疾病患者的比例从2004 - 2006年的7%增至2019 - 2022年的12%。我们观察到1995年至2022年间年龄和性别调整后的1年死亡率有所下降：1995 - 1998年为81%（77 - 84），2019 - 2022年为（65%）（63 - 68）。1年死亡率的下降是普遍的，18 - 59岁患者下降幅度最大（从1995 - 1998年的67%降至2019 - 2022年的49%），60 - 79岁患者也是如此。
1995 - 2022年丹麦胆管癌发病率上升，主要是由肝内胆管癌发病率增加所致。同时，1年死亡率下降，这可能反映了早期诊断和更好的治疗效果。
胆管癌预后较差，且在大多数国家发病率呈上升趋势。在欧洲，除丹麦外所有国家肝内胆管癌发病率均呈上升趋势。1995年至2022年丹麦胆管癌发病率上升，主要是由肝内胆管癌大幅增加所致。局限性可切除疾病患者的比例增加，而1年死亡率下降，尽管仍处于较高水平（2019 - 2022年为65%）。了解发病率和死亡风险对于医生了解疾病、识别风险因素以及设计预防保健研究；对于医疗服务提供者分配资源；以及对于患者了解其预后都具有重要价值。
