title: A nationwide population-based study shows increasing incidence of cholangiocarcinoma.
abstract: OBJECTIVE
  An increasing incidence of cholangiocarcinoma (CCA) has been reported in Western countries, but evidence is lacking in Asia. We investigated the incidence of CCA in a nationwide cohort.
  
  
  METHODS
  We conducted a nationwide cohort study based on data from the Taiwan National Health Insurance Research Database (NHIRD) between 1998 and 2008. A total of 6,491 CCA patients were recruited. Adjusted incidences, cumulative incidences, and stratified analyses were used to detect trends regarding CCA incidence in Taiwan.
  
  
  RESULTS
  The incidence of CCA increased by 2.01-fold, from 1.79 in 1998 to 3.60 in 2008 per 100,000 persons. For extrahepatic CCA, the incidence increased by 1.5-fold from 0.48 to 0.73 per 100,000. Intrahepatic CCA increased by 3.0-fold from 0.72 to 2.19 per 100,000. The rising incidence of CCA was observed across all sexes and ages, especially in those older than 65 years of age. The proportion of CCA patients who underwent surgery and the overall survival rates remained stable.
  
  
  CONCLUSIONS
  The incidence of both intrahepatic and extrahepatic CCA increased significantly between 1998 and 2008. Rising trends were observed among different ages and sexes, especially in the elderly population.
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Teng-Yu
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan.|Department of Internal Medicine, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.|Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.affiliation: Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Ken N
authors.initials: KN
authors.lastname: Kuo
authors.affiliation: Division of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hsiu J
authors.initials: HJ
authors.lastname: Ho
authors.affiliation: Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Tzu-Ting
authors.initials: TT
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan. lee.david@kimo.com.|Faculty of Medicine, School of Medicine, National Yang-Ming University, 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. lee.david@kimo.com.|Department of Public Health, China Medical University, Taichung, Taiwan. lee.david@kimo.com.|Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan. lee.david@kimo.com.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Wu
keywords: Epidemiology; Hepatobiliary cancers; Liver tumors