Biliary tract cancer incidence and trends in the United States by demographic group, 1999-2013
Biliary tract cancer incidence and trends in the United States by demographic group, 1999-2013
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DOI：
10.1002/cncr.31942
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发表时间：
2019-05-01
期刊：
影响因子：
6.2
通讯作者：
Koshiol, Jill
中科院分区：
文献类型：
--
作者：
Van Dyke, Alison L.;Shiels, Meredith S.;Koshiol, Jill
背景胆道癌（BTC）是罕见但致命的癌症（胆囊癌[GBC]、肝内胆管癌[ICC]、肝外胆管癌[ECC]和乏特壶腹癌[AVC]）。美国最近的一项研究报告了45岁以下人群和黑人中GBC的发病率增加;然而，该研究没有研究其他胆道部位的趋势。方法本研究的特点是人口统计学差异的BTC发病率和时间趋势的解剖部位。使用基于人群的北美中央癌症登记协会数据计算1999-2013年各研究中心和人口统计学组的年龄校正发病率、发病率比（IRR）和估计年百分比变化（eAPC）。对于各年龄组eAPC存在显著差异的研究中心，按年龄组比较IRR。结果GBC的发病率在女性（eAPC，-0.5%/y; P = .01）和所有种族/民族组中下降，除了非西班牙裔黑人，其中发病率增加（1.8%/y; P < .0001）。虽然GBC率在18至44岁的人群中增加（eAPC，1.8%/y; P = .01），但在45岁或以上的人群中下降（-0.4%/y; P = .009）。年轻人GBC发病率的性别（P < .0001）和种族/民族差异（P = .003至.02）大于老年人。在此期间，ICC（eAPC，3.2%/年; P <0.0001）和ECC率（1.8%/年; P = 0.001）在性别和种族/民族组中稳步上升。尽管年轻成人（eAPC，1.8%/y; P = 0.03）而非老年人（-0.20%/y; P = 0.30）的AVC发病率增加，但性别和种族/民族IRR并不因年龄而异。结论BTC率和时间趋势的差异模式已被确定的解剖部位和人口统计组。这些发现强调了大型汇集项目的必要性，以评估解剖部位的BTC风险因素。
Background Biliary tract cancers (BTCs) are rare but deadly cancers (gallbladder cancer [GBC], intrahepatic cholangiocarcinoma [ICC], extrahepatic cholangiocarcinoma [ECC], and ampulla of Vater cancer [AVC]). A recent US study reported increasing GBC incidence among people younger than 45 years and blacks; however, it did not examine trends for other biliary tract sites. Methods This study characterized demographic differences in BTC incidence rates and time trends by anatomic site. Population-based North American Association of Central Cancer Registries data were used to calculate age-adjusted incidence rates, incidence rate ratios (IRRs), and estimated annual percent changes (eAPCs) for 1999-2013 by site and demographic group. For sites with significant differences in eAPC by age group, IRRs were compared by age group. Results GBC incidence rates declined among women (eAPC, -0.5%/y; P = .01) and all racial/ethnic groups except for non-Hispanic blacks, among whom rates increased (1.8%/y; P < .0001). Although GBC rates increased among 18- to 44-year-olds (eAPC, 1.8%/y; P = .01), they decreased among people 45 years old or older (-0.4%/y; P = .009). Sex (P < .0001) and racial/ethnic differences (P = .003 to .02) in GBC incidence were larger for younger people than older people. During this period, ICC (eAPC, 3.2%/y; P < .0001) and ECC rates (1.8%/y; P = .001) steadily increased across sex and racial/ethnic groups. Although AVC incidence rates increased among younger adults (eAPC, 1.8%/y; P = .03) but not older adults (-0.20%/y; P = .30), sex and racial/ethnic IRRs did not differ by age. Conclusions Differential patterns of BTC rates and temporal trends have been identified by anatomic site and demographic groups. These findings highlight the need for large pooling projects to evaluate BTC risk factors by anatomic site.