Objectives: Cholangiocarcinoma is the second most common primary liver tumor with a highly aggressive course and poor prognosis (5-year survival ≤15%). Here, we assessed trends in regional and demographic differences in cholangiocarcinoma-related mortality in the United States from 1999 to 2020. Methods: The CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database was utilized to examine death certificates (1999-2020) for cholangiocarcinoma-related mortality. Age-adjusted mortality rates were extracted per 100,000 individuals, and their associated annual percent changes with 95% CIs were calculated. To identify overall trends for demographic (sex, race, ethnicity, and age) and regional groups, Joinpoint regression (NCI, version 5.0.2) was utilized. Results: One lakh forty-eight thousand eight hundred fifty-one cholangiocarcinoma-related deaths occurred between 1999 and 2020. The overall age-adjusted mortality rate has increased from 1.9 in 1999 to 3.2 in 2020. Higher mortality rates were observed for males (males: 2.9 vs. females: 2.3), non-Hispanic Asian or Pacific Islander patients (3.3), and metropolitan area residents (2.6). African Americans exhibited the highest annual percent increase since 1999 (3.47; 95% CI: 3.01-4.12). Rhode Island, Connecticut, Massachusetts, Minnesota, Wisconsin, Illinois, Washington, Alaska, and Hawaii ranked in the top 90th percentile, and the northeast region had the highest overall age-adjusted mortality rates. Conclusions: In the last 2 decades, Cholangiocarcinoma-related mortality has increased overall in the United States. Demographic and geographic disparities persist, with higher age-adjusted mortality rates observed in males, Asians, and individuals residing in the northeast region and metropolitan areas. Further research and targeted strategies for different demographics are needed to curb increasing levels of Cholangiocarcinoma-related mortality in the United States.
Jamil et al. (2025) studied this question.