Descriptive epidemiology of cholangiocarcinoma in Italy
ABSTRACT Very little data exist on the epidemiology of cholangiocarcinoma in Italy.
We focus on the descriptive epidemiology of cholangiocarcinoma in Italy.
Data on incidence were obtained from the Italian Association of Tumour Registries while mortality data were obtained from the Italian National Institute of Statistics.
A progressive increase of incidence with age was seen for extra-hepatic, intra-hepatic and not otherwise specified cholangiocarcinoma. Crude incidence rates were higher for extra-hepatic cholangiocarcinoma than those for intra-hepatic cholangiocarcinoma and in men compared to women. An increasing incidence trend was observed, from 1988 to 2005, for both extra-hepatic- and intra-hepatic cholangiocarcinoma with a 3-6% yearly increase and with a rate of increase higher for men than for women and for intra-hepatic- than for extra-hepatic cholangiocarcinoma. For intra-hepatic cholangiocarcinoma, the mortality rates progressively increased from 0.15 per million in 1980 to 5.9 per million in 2003, when mortality for this cancer surpassed extra-hepatic cholangiocarcinoma. Mortality rates for extra-hepatic cholangiocarcinoma showed an increasing trend from 1980 to 1994 but, in contrast to intra-hepatic cholangiocarcinoma, a stable or slightly decreasing trend from 1995 to 2003 was observed.
In Italy, cholangiocarcinoma showed a progressive increase in incidence and mortality in the last two decades mainly in intra-hepatic cholangiocarcinoma.
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ABSTRACT: Rationale, aims and objectivesPrimary liver cancer consists of distinct subtypes with differing aetiology so it is valuable to study the incidence of these subtypes separately. This study aims to investigate time and socio-economic deprivation trends in the incidence of primary liver cancer subtypes in England, identifying the burden in the population.Methods Data were extracted from the population-based National Cancer Data Repository (NCDR) for patients diagnosed with primary liver cancer between 1990 and 2009. Subtypes were defined by the 10th edition of the International Classification of Diseases (ICD-10) codes: liver cell carcinoma (C22.0), intrahepatic bile duct carcinoma (C22.1), other (C22.2-C22.4, C22.7) and unspecified (C22.9). A sensitivity analysis was carried out on the main histological subtypes of liver cell carcinoma and intrahepatic bile duct using the 2nd edition of the International Classification of Diseases for Oncology (ICD-O-2). Male and female age-standardized incidence rates per 100 000 World standard population were calculated for each year and for the period 1999-2009 by socio-economic deprivation quintile.ResultsA total of 40 945 patients were diagnosed with primary liver cancer between 1990 and 2009. Liver cell carcinoma incidence increased in men from 0.63 in 1990 to 2.48 per 100 000 in 2009. While incidence was low in women, rates increased from 0.18 to 0.59, respectively. Intrahepatic bile duct carcinoma incidence increased between 1990 and 2009 from 0.40 to 1.25 per 100 000 in men, and from 0.28 to 1.08 in women. Incidence of the other liver cancer subtype remained low throughout the study period at less than 0.3 per 100 000 in each year in both men and women. The highest rate of liver cell carcinoma and intrahepatic bile duct carcinoma was generally in men and women resident in the most deprived areas between 1999 and 2009. The largest difference by deprivation quintile was observed for liver cell carcinoma in men, where the incidence was more than double in the most deprived quintile with an average rate of 3.56 per 100 000 compared to the least deprived quintile at 1.43.Conclusions Liver cell carcinoma and intrahepatic bile duct carcinoma incidence increased between 1990 and 2009 in both sexes. This pattern was largely driven by patients living in the most deprived areas. Differences observed may be due to the variation in the prevalence of known risk factors such as chronic hepatitis B and C viral infections and excessive alcohol consumption.Journal of Evaluation in Clinical Practice 06/2014; 20(4). DOI:10.1111/jep.12188 · 1.58 Impact Factor
Journal of Hepatology 06/2014; DOI:10.1016/j.jhep.2014.01.021 · 10.40 Impact Factor
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ABSTRACT: Cholangiocarcinoma (CCA) is a rare malignancy of the liver, arising from bile ducts. The incidence is increasing worldwide, but the prognosis has remained dismal and virtually unchanged in the past 30 years. Although several risk factors have been associated with the development of this cancer, none of them are normally identified in most patients. Diagnosis in advanced stages of the disease and limited therapeutic options contribute to poor survival rates. The recent analysis of genetic and epigenetic alterations occurring in CCA has shed new light in the understanding of the molecular mechanisms leading to the malignant transformation of biliary cells. Further studies in this direction may foster new diagnostic, prognostic and therapeutic approaches. This review provides a global overview of recent advances in CCA and describes the most important genetic mutations and epigenetic alterations so far reported in CCA.