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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Epidemiological trends of cholangiocarcinoma and gallbladder cancer in Northeastern Italy: Administrative analysis over a 17-year period (2007-2023)
Vincenzo Baldo, Andrea Cozza, Valentina Grego, Patrizia Furlan, Claudia Cozzolino, Mario Saia, Silvia Cocchio, Annarosa Floreani
Vincenzo Baldo, Andrea Cozza, Valentina Grego, Patrizia Furlan, Claudia Cozzolino, Silvia Cocchio, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Padova 35128, Veneto, Italy
Vincenzo Baldo, Silvia Cocchio, Preventive Medicine and Risk Assessment Unit, Azienda Ospedale Università Padova, Padova 35128, Veneto, Italy
Mario Saia, Clinical Governance, Azienda Zero of Veneto Region, Padova 35132, Veneto, Italy
Annarosa Floreani, University of Padua, Padova 35128, Veneto, Italy
Annarosa Floreani, Scientific Institute for Research, Hospitalization and Healthcare Negrar, Verona 37024, Veneto, Italy
Co-corresponding authors: Vincenzo Baldo and Valentina Grego.
Author contributions: Baldo V, Floreani A, and Cocchio S contributed to the study conception and design and supervision; Saia M contributed to the data collection; Furlan P contributed to the statistical analysis; Furlan P, Cozzolino C, Grego V, and Cozza A contributed to data analysis and data interpretation; Grego V, Furlan P, and Floreani A contributed to drafting the manuscript; All authors read and agreed to the published version of the manuscript and were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: Hospital discharge records were obtained from the administrative databases of the Veneto Region, and the disclosure and utilization of such records for educational and scientific purposes do not necessitate approval from ethical committees. On January 24, 2023, the Veneto Region implemented the code of conduct for the use of health data for educational and scientific publication purposes (Official Bulletin of the Region, No. 10), as established by the European Committee (European Regulation 2016/679). This implementation received approval from the Italian Personal Data Protection Authority on January 14, 2021.
Informed consent statement: Adhering to the current Italian privacy legislation, the publication and utilization of HDR data, along with the processing methods, must occur exclusively in aggregate form, without any reference to patients’ personal information.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The technical appendix, statistical code, and original dataset are available from the corresponding author at
valentina.grego@studenti.unipd.it.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Valentina Grego, MD, Doctor, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, Padova 35128, Veneto, Italy.
valentina.grego@studenti.unipd.it
Received: December 16, 2024
Revised: February 20, 2025
Accepted: March 31, 2025
Published online: May 15, 2025
Processing time: 152 Days and 16 Hours
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 χ2 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.
Core Tip: Cholangiocarcinoma (CCA) comprises aggressive biliary malignancies with varying trends in incidence. While intrahepatic CCA has increased in Western countries, extrahepatic CCA shows stable or declining rates, and gallbladder cancer trends remain inconsistent. This study analyzed 17 years (2007-2023) of hospitalization data from Northeast Italy, finding that overall biliary tract cancer hospitalizations remained stable, with decreased rates for intrahepatic and extrahepatic CCA, particularly in males. Gallbladder cancer hospitalizations showed no significant gender differences or trends. Age-related increases in hospitalization rates were noted for all biliary cancers, indicating evolving epidemiology and emphasizing the importance of continued regional monitoring.
