Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States

Cancer disparities are well-established across measures of cancer incidence and mortality. Cholangiocarcinoma, a common hepatic malignancy, is no exception to these inequities. Globally and within the United States, Asian, Hispanic, and Indigenous peoples of the Americas, Alaskan Natives, and Pacifi...

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Main Authors: Oyepeju F. Abioye, Rebekah Kaufman, Tim F. Greten, Cecilia Monge
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-04-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO-24-00537
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author Oyepeju F. Abioye
Rebekah Kaufman
Tim F. Greten
Cecilia Monge
author_facet Oyepeju F. Abioye
Rebekah Kaufman
Tim F. Greten
Cecilia Monge
author_sort Oyepeju F. Abioye
collection DOAJ
description Cancer disparities are well-established across measures of cancer incidence and mortality. Cholangiocarcinoma, a common hepatic malignancy, is no exception to these inequities. Globally and within the United States, Asian, Hispanic, and Indigenous peoples of the Americas, Alaskan Natives, and Pacific Islander populations experience higher incidence rates of cholangiocarcinoma. These same groups and non-Hispanic Black individuals simultaneously experience lower disease-specific survival, highlighting the role of social factors in cholangiocarcinoma outcome inequities. Higher age-standardized death rates from cholangiocarcinoma are associated with a lower social determinant index (SDI) in Andean Latin America, Southern Latin America, and Central sub-Saharan Africa. SDI, which evaluates education, fertility, and income, can be used to model the social determinants of health (SDOH). The SDOH also affect cholangiocarcinoma survival in the United States as factors such as migratory status, insurance status, and geographic location can cause treatment delays and worsened outcomes. Despite these inequities, limited research exists on the topic of disparities in cholangiocarcinoma when compared with other malignancies, and clinical trial under-representation remains a significant concern. Representing diverse populations in cholangiocarcinoma clinical trials is exceedingly important as populations with the highest incidence are simultaneously under-represented in clinical trials. Diversity in clinical trial enrollment and research regarding cholangiocarcinoma is needed to create robust databases and biobanks that can be used to develop targeted treatments and guidelines. In addition, risk factors, including parasitic infections, infectious diseases, and environmental exposures, are associated with cholangiocarcinoma but vary by global region, highlighting the need to study unique risk factors for cholangiocarcinoma across diverse populations. Without research that represents the populations that suffer most from this cancer, incidence and mortality inequities will continue to have a disproportionate burden.
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spelling doaj-art-573ec862c324484a8a2ca6eda01276622025-08-20T02:27:35ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO-24-00537Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United StatesOyepeju F. Abioye0Rebekah Kaufman1Tim F. Greten2Cecilia Monge3Dana Farber Cancer Institute, Boston, MADana Farber Cancer Institute, Boston, MAThoracic and Gastrointestinal Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MDThoracic and Gastrointestinal Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MDCancer disparities are well-established across measures of cancer incidence and mortality. Cholangiocarcinoma, a common hepatic malignancy, is no exception to these inequities. Globally and within the United States, Asian, Hispanic, and Indigenous peoples of the Americas, Alaskan Natives, and Pacific Islander populations experience higher incidence rates of cholangiocarcinoma. These same groups and non-Hispanic Black individuals simultaneously experience lower disease-specific survival, highlighting the role of social factors in cholangiocarcinoma outcome inequities. Higher age-standardized death rates from cholangiocarcinoma are associated with a lower social determinant index (SDI) in Andean Latin America, Southern Latin America, and Central sub-Saharan Africa. SDI, which evaluates education, fertility, and income, can be used to model the social determinants of health (SDOH). The SDOH also affect cholangiocarcinoma survival in the United States as factors such as migratory status, insurance status, and geographic location can cause treatment delays and worsened outcomes. Despite these inequities, limited research exists on the topic of disparities in cholangiocarcinoma when compared with other malignancies, and clinical trial under-representation remains a significant concern. Representing diverse populations in cholangiocarcinoma clinical trials is exceedingly important as populations with the highest incidence are simultaneously under-represented in clinical trials. Diversity in clinical trial enrollment and research regarding cholangiocarcinoma is needed to create robust databases and biobanks that can be used to develop targeted treatments and guidelines. In addition, risk factors, including parasitic infections, infectious diseases, and environmental exposures, are associated with cholangiocarcinoma but vary by global region, highlighting the need to study unique risk factors for cholangiocarcinoma across diverse populations. Without research that represents the populations that suffer most from this cancer, incidence and mortality inequities will continue to have a disproportionate burden.https://ascopubs.org/doi/10.1200/GO-24-00537
spellingShingle Oyepeju F. Abioye
Rebekah Kaufman
Tim F. Greten
Cecilia Monge
Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
JCO Global Oncology
title Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
title_full Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
title_fullStr Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
title_full_unstemmed Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
title_short Disparities in Cholangiocarcinoma Research and Trials: Challenges and Opportunities in the United States
title_sort disparities in cholangiocarcinoma research and trials challenges and opportunities in the united states
url https://ascopubs.org/doi/10.1200/GO-24-00537
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