Abstract
BACKGROUND: Cholangiocarcinoma (CCA) is a heterogeneous group of aggressive malignancies arising from the biliary tree. Epidemiological data show an increase in the incidence of intrahepatic CCA in Western countries and a stable or decrease in the incidence of extrahepatic CCA. There are conflicting results in literature regarding the trend of the incidence of gallbladder cancer. However, most studies refer to a time period before 2000. AIM: To investigate the recent epidemiology of CCA and gallbladder cancer in Northeast Italy using regional data of hospital admissions. METHODS: We performed a 17-year (2007-2023) retrospective analysis of hospital discharge records of the Veneto Region. During the period 10778 first hospital admissions for biliary tract cancers in the main or secondary diagnosis were recorded. Data were analyzed by the χ (2) test for categorical data and the Student's t-test for continuous data to assess differences in percentages and averages, respectively. Trends in the age-standardized hospitalization rate were evaluated using Joinpoint regression, estimating annual percentage changes (APC). RESULTS: The total number of hospitalizations for biliary tract cancers remained stable over the past 17 years (186 hospitalizations/year for intrahepatic CCA, 211 for extrahepatic CCA, and 237 for gallbladder cancer/unspecified biliary tract). Age-standardized hospitalization rates for intrahepatic and extrahepatic CCA decreased respectively from 4.9 cases to 3.4 per 100000 inhabitants (APC = -2.0, 95% confidence interval: -3.2 to -0.7, P < 0.001) and from 6.7 to 3.8 cases per 100000 inhabitants (APC = -3.2, 95% confidence interval: -4.2 to -2.1, P < 0.001). Instead, hospitalizations for gallbladder cancer remained stable, with an average rate of 5.5 per 100000 inhabitants. Overall, hospitalization rates for biliary tract cancers increased with age in both genders. CONCLUSION: Our study reported a decreasing hospitalization rate for CCA and a stable trend for gallbladder cancer over a 17-year period, suggesting a change in the epidemiology of these tumors.