Spatio-Temporal Analysis of Cholangiocarcinoma in a High Prevalence Area of Northeastern Thailand: A 10-Year Large Scale Screening Program

Document Type : Research Articles

Authors

1 Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.

2 Cholangiocarcinoma Research Institute (CARI), Khon Kaen, Thailand.

3 Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

4 Health and Epidemiology Geoinformatics Research (HEGER), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.

5 Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

6 Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

7 Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

8 Department of Applied Epidemiology, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.

Abstract

Background: Cholangiocarcinoma (CCA) is experiencing a global increase, particularly in Northeast Thailand, which has the highest global incidence rates. However, there is a paucity of studies on CCA screening, especially in high-risk populations. This study aimed to investigate the distribution and spatial patterns of CCA in Northeast Thailand over a ten-year screening period. Methods: The study included CCA patients from the Cholangiocarcinoma Screening and Care Program (CASCAP) between 2013 and 2022, which encompasses 20 provinces and 282 districts in Northeast of Thailand. CCA data were based on pathological diagnosis to determine the distribution and spatial patterns. Results: Of the 2,515 CCA patients, approximately two-thirds were males (63.98%), and the majority were aged over 55 years (72.72%), with a mean age of 61.12 ± 9.13 years. The highest percentage of CCA cases occurred in 2014 at 19.01% of all patients, followed by 2018 at 15.23%. The overall CCA incidence rate in Northeast Thailand over ten years was 32 per 100,000 population. Hotspot statistical analysis identified high-scoring geographic clusters in the upper and middle regions, showing a tendency to expand from hotspot areas into nearby areas. Conclusion: The distribution of CCA in Northeast Thailand has continued to rise over the past decade, particularly in the upper and middle regions. Targeted screening in high-risk areas and increased awareness of CCA risks are crucial to mitigate its impact.

Keywords

Main Subjects