P1725 - Mortality Trends of Intrahepatic Cholangiocarcinoma Across the United States: Shift in Two Decades

Obaid Ur Rehman, MBBS¹, Malik Saad Hayat, MBBS², Muhammad Mukarram Shoaib, MBBS², Zain A. Nadeem, MBBS³, Eeman Ahmad, MBBS⁴, Ahmad Zain, MD⁵, Fatima Ashfaq, MBBS^6
1Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; ²King Edward Medical University, Lahore, Punjab, Pakistan; ³Allama Iqbal Medical College, Lahore, Punjab, Pakistan; ⁴Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Punjab, Pakistan; ⁵UChealth Parkview Medical Center, Pueblo, CO; ⁶Nishtar Medical University, Lahore, Punjab, Pakistan

Introduction: Intrahepatic cholangiocarcinoma (ICC) accounts for 20% to 25% of cholangiocarcinomas — the highest prevalence among primary liver malignancies, second to hepatocellular carcinoma. We aim to delineate the ICC-related mortality trends in the US stratified by age, sex, race, and region.

Methods: We retrieved death certificates data from the CDC-WONDER database for adults aged ≥25 years. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were examined using annual percent change (APC) and the average annual percent change (AAPC) using Joinpoint regression.

Results: From 1999 to 2020, a total of 107,149 ICC-related deaths occurred in the US. The overall AAMR displayed a rising trend during this period (APC 3.59, 95% CI 3.34 - 3.83). The AAMRs were higher for males (1.7, 95% CI 1.6 - 1.7) than females (1.3, 95% CI 1.3 - 1.3), and increased consistently for both males (APC 3.40, 95% CI 3.17 - 3.64) and females (APC 3.39, 95% CI 3.11 - 3.67). The highest AAMRs were displayed by NH Asians or Pacific Islanders (1.9, 95% CI 1.9 - 2), followed by NH American Indians or Alaska Natives (1.7, 95% CI 1.6 - 1.8) and Hispanics or Latinos (1.6, 95% CI 1.6 - 1.7). The lowest AAMRs were exhibited by NH Blacks or African Americans (1.4, 95% CI 1.4 - 1.4) and NH Whites (1.4, 95% CI 1.4 - 1.4). The Northeast had the highest AAMR throughout the study period (1.6, 95% CI 1 - 2), followed by nearly equal mortality rates in the Midwest (1.3, 95% CI 0.8 - 1.7) and West (1.5, 95% CI 1 - 1.9), and the lowest in the South (1.3, 95% CI 0.8 - 1.7). States with the highest AAMRs were Hawaii, Rhode Island, and Washington. Urban areas had higher ICC-related mortality rates than rural areas, with AAMRs of 1.4 (95% CI 1.3 - 1.5) and 1.3 (95% CI 1.1 - 1.4), respectively. From 1999 to 2020, the AAMRs showed a greater rise in urban areas (APC 3.47, 95% CI 3.23 - 3.71) compared to rural areas (APC 3.11, 95% CI 2.81 - 3.41). The majority of ICC-related deaths occurred in the decedent’s home (45%). We observed the highest number of AAMR among adults aged ≥85 years (11.2, 95% CI 10.3 - 12.1).

Discussion: Results show an increase in ICC-related deaths among men, NH Asian or Pacific Islanders, residents of the Northeast and urban areas, and adults aged ≥85 years. Targeted policies and strategies must be implemented to decrease the burden of ICC in these high-risk groups focusing on enhancing healthcare access and encouraging lifestyle modifications.



Disclosures:


Obaid Ur Rehman, MBBS¹, Malik Saad Hayat, MBBS², Muhammad Mukarram Shoaib, MBBS², Zain A. Nadeem, MBBS³, Eeman Ahmad, MBBS⁴, Ahmad Zain, MD⁵, Fatima Ashfaq, MBBS⁶. P1725 - Mortality Trends of Intrahepatic Cholangiocarcinoma Across the United States: Shift in Two Decades, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.