Care delivery among patients with early-onset versus average-onset cholangiocarcinoma: a nationwide retrospective analysis

Background

Cholangiocarcinoma (CCA) is an aggressive biliary malignancy with increasing incidence and poor prognosis. Although traditionally considered a disease of older adults, early-onset CCA (EOCCA; age <50 years) may represent a clinically distinct subgroup. Data evaluating diagnostic and treatment trajectories in EOCCA remain limited. Patients and methods: Using the Komodo Healthcare Map claims database (2017-2024), patients with CCA were identified using International Classification of Diseases, 10th Revision, codes and categorized as having EOCCA or average-onset CCA. Outcomes included time from first diagnosed symptom to CCA diagnosis, diagnostic delay (≥30 days), time to first intervention, and type of first intervention. Multivariable logistic, log-gamma, and competing-risk regression models evaluated associations between demographic and insurance factors and care delivery outcomes.