Trends in the Mortality of Biliary Tract Cancers Based on Their Anatomical Site in the United States From 2009 to 2018

INTRODUCTION: Recent trends in the incidence and mortality of biliary tract cancers are unknown. We estimated the trends in biliary tract cancers–related incidence and mortality stratified by anatomical site, age, sex, and race/ethnicity in the US adults. METHODS: We performed a population-based trend analysis using the US national incidence (2009–2017) and mortality records (2009–2018). We identified age-standardized incidence and mortality from intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma, gallbladder cancer, and ampulla of Vater cancer using appropriate ICD-10 code. Temporal mortality was calculated by joinpoint trend analysis with estimates of annual percentage change (APC) described as each trend segment. RESULTS: The incidence rates of ICC increased linearly (APC 8.9%, 95% confidence interval [CI] 7.8%–10.0%) while gallbladder cancer-related incidence rates remained stable early and decreased significantly later in the study (APC −2.8%, 95% CI −5.5% to −0.0% [2014–2017]). Age-standardized mortality from biliary tract cancers steadily increased with an annual increase of 2.0% (95% CI 1.6%–2.3%). Although there was a linear increase in the ICC-related mortality (APC 3.5%, 95% CI 3.1%–3.8%), extrahepatic cholangiocarcinoma–related mortality tended to remain stable earlier and increased later (APC 7.0%, 95% CI 4.6%–9.5% [2013–2018]). By contrast, gallbladder cancer–related mortality steadily decreased over 10 years (APC −1.6%, 95% CI −2.1% to −1.1%). Significant differences in mortality and changes in trends over time were observed in non-Hispanic blacks, Hispanics, and non-Hispanic Asians. DISCUSSION: In this analysis of nationally representative data, changing mortality trends in various biliary tract cancers was noted with a disproportionately higher burden of fatality in minorities.