Routes to diagnosis and treatment of Cholangiocarcinoma (AMMF)


Inequalities in the speed and quality of diagnosis and the management of cancer may have an impact on outcome. Cholangiocarcinoma (CCA) is typically asymptomatic in early stage disease and so most patients present with advanced disease. In England, half of the patients with cholangiocarcinoma are diagnosed during an emergency presentation, and currently available data show these patients have a 12-month net survival of 16.7%.

Previous studies by the National Cancer Registry and Analysis Service (NCRAS) have found that diagnosis in this patient group is less likely to be by routes associated with a better outcome, and that this has not improved over time in-line with improvements seen in other cancers. It is also thought that access to treatment might vary amongst this patient group.

The purpose of this study is to describe the route to diagnosis and treatment of CCA patients, as well as the geographic variation in these factors across England. The results of the study will support future work on reducing the health inequality and identifying areas for targeted service improvement.

In collaboration with:

This work was commissioned by the AMMF and undertaken in collaboration with NHS England.



Report to AMMF in 2022.
Journal papers in preparation


Zalin-Miller A, Jose S, Knott C, Paley L, Tataru D, Morement H, Toledano MB, Khan SA. Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017. World J Gastroenterol. 2023 Jun 28;29(24):3825-3842. doi: 10.3748/wjg.v29.i24.3825. PMID: 37426314; PMCID: PMC10324535. 


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