John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
Alejandro Nieto Dominguez , Sarah Elizabeth Eichinger , Ayobami Gbenga Olafimihan , Daniel Guifarro Rivera
Background: Ulcerative colitis (UC) is correlated with gastrointestinal cancer. While the exact mechanism is unknown, it is thought that a chronic inflammatory state may result in the development of malignancies including cholangiocarcinoma. Patients with UC that develop cholangiocarcinoma usually have a poor prognosis and early detection is key to improve survival. Methods: We used the 2016-2019 National Inpatient Sample (NIS) database, the largest all-payer inpatient care database in the United States, to stratify all patients admitted with a diagnosis of cholangiocarcinoma with and without ulcerative colitis, to further characterize their epidemiological characteristics. Results: There were at total of 46,001 patients with a diagnosis of cholangiocarcinoma studied. Of these patients with cholangiocarcinoma, 401 had concomitant UC (0.87%). Individuals with UC in the database had an increased association with cholangiocarcinoma (OR=7.67, 95% CI 6.96-8.46) compared to those without UC. Patients with cholangiocarcinoma and UC tended to be younger (57.8 vs. 67.9 years old without UC), male (69.51% vs. 53.23% without UC), with private insurance (57.5%) vs. patients without UC who predominately had Medicare (59.46%). Patients with cholangiocarcinoma and UC had on average fewer Charleston Comorbidities (64.63% with 3 comorbidities) vs. patients without UC (74.52% with 3 comorbidities). Of patients with cholangiocarcinoma and UC, 65.85% were Caucasian (vs. 64.85% without UC), 6.1% were Black (vs. 10.09% without UC), 3.66% were Hispanic (vs. 12.37% without), and 24.39% were Asian or Pacific Islander (vs 12.79% without). Conclusions: In the population studied, there was a significant correlation between UC and cholangiocarcinoma. Patients with cholangiocarcinoma and UC tended to be younger with fewer comorbidities than their counterparts without. There were nearly double the percentage of Asian patients with cholangiocarcinoma and UC as compared to Asian patients without UC. Understanding the characteristics of patients with UC who develop cholangiocarcinoma is important as it could inform future best practices in potential screening and early detection of carcinomas in patients with UC.
Characteristics of Patients with Cholangiocarcinoma | With UC | Without UC |
---|---|---|
Mean Age | 56.8 (LSE: 1.869, (95% CI: 53.07-60.39) | 67.9 (LSE: 0.136, (95% CI: 67.63-68.17) |
Age groups (p=0.00) | ||
Between 18 and 44 | 24.39% | 3.61% |
Between 45 and 64 | 46.34% | 33.52% |
Between 65 or more | 29.27% | 62.87% |
Sex (p=0.00) | ||
Male | 69.51% | 53.23% |
Female | 30.49% | 46.77% |
Insurance Status (p=0.00) | ||
Medicare | 35% | 59.46% |
Medicaid | 7.5% | 9.87% |
Private Insurance | 57.5% | 27.88% |
Self-Pay | 0% | 2.79% |
Charlson Comorbidity Index (p=0.00) | ||
0 | 0 | 0 |
1 | 0 | 0 |
2 | 35.37% | 25.48% |
3 or more | 64.63% | 74.52% |
Race (p=0.02) | ||
White | 65.85% | 64.85% |
Black | 6.1% | 10.09% |
Hispanic | 3.66% | 12.37% |
Asian or Pacific Islander | 24.39% | 12.79% |
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