Increase in mortality rates from intrahepatic cholangiocarcinoma in England and Wales 1968–1998

Abstract

Background-The age standardised mortality rate per 100 000 population for all causes of liver tumours (International Classification of Disease 9 (ICD-9) 155) has almost doubled in England and Wales during the period 1979-1996. We further analysed the mortality statistics to determine which anatomical subcategories were involved. Methods-Mortality statistics for liver tumours of ICD-9 155, 156, and subcategories, and for tumours of the pancreas (ICD-9 157), in England and Wales were investigated from the OYce for National Statistics, London, from 1968 to 1996 inclusive. Data for 1997 and 1998 were also available on intrahepatic cholangiocarcinomas. Results-There has been a marked rise in age standardised mortality rates for intrahepatic cholangiocarcinoma. Since 1993, it represents the commonest recorded cause of liver tumour related death in England and Wales. This is evident in age groups older than 45 years. In contrast, mortality trends from other primary liver tumours, including hepatocellular carcinoma, were unremarkable. Conclusions-The observed increase in mortality from intrahepatic cholangiocarcinoma may represent better case ascertainment and diagnosis due to improved diagnostic imaging, use of image guided biopsies, or increased use of ERCP. However, the trend started before ERCP was introduced nationally, mortality rates have continued to increase steadily thereafter, and there is no clear evidence that diagnostic transfers easily explains the findings. Alternatively, these observations may represent a true increase in intrahepatic bile duct tumours. Epidemiological studies are required to determine whether there is any geographical clustering of cases around the UK. (Gut 2001;48:816-820)

Wisteria floribunda agglutinin-positive mucin 1 is a sensitive biliary marker for human cholangiocarcinoma

“…2,3 Because of the late clinical presentation, CC is in most cases fatal by the time it becomes clinically evident. 4 From a general viewpoint, prognosis of CC is also poor, with a 5-year survival rate of less than 5%.…”

Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971–2001

“…Studies from the United States of America (USA) and the United Kingdom (UK) have shown marked increases in mortality from primary liver cancers in the last two decades of the 20th century (Taylor-Robinson et al, 1997;El-Serag and Mason, 1999;Patel, 2001;Taylor-Robinson et al, 2001;Shaib et al, 2004). While there have been incidence data reported from the USA, there has been no report of recent trends (last 30 years) in incidence from the UK.…”

Mortalidade por neoplasia maligna do fígado e vias biliares intra-hepáticas no Brasil, 1980-2010

“…Isso fortaleceria a hipó-tese de um padrão real de redução do coeficiente de mortalidade por câncer de fígado nas regiões Sudeste e Sul, ressaltando-se a diferença entre os sexos, com declínio dos coeficientes para o feminino, evento este restrito às regiões mencionadas e, aumento para o masculino, notório em todas as regiões. Diferentemente de outros estudos que atribuem o aumento dos casos de câncer de fígado ao aumento da frequência de óbitos por carcinoma hepatocelular ou colangiocarcinoma 4,25 , é difícil avaliar se o incremento dos coeficientes de mortalidade no Brasil também se deve a este fato, pois a maioria dos óbitos na série histórica analisada tem sido codificada como neoplasia maligna do fígado não especificada. A despeito do aumento global do diagnóstico e identificação desses tumores no Brasil, parece persistirem dificuldades inerentes à especificação dos mesmos à luz da CID-10.…”