Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017

Table 4 Estimated proportions diagnosed via emergency presentation (as opposed to any other route): Results from linear probability models

	Model 1: Unadjusted		Model 2: Demographic-adjusted1		Model 3: Adjusted2
	Estimate	95%CI	Estimate	95%CI	Estimate	95%CI
Population average (intercept)	49.57	(48.94, 50.21)	49.57	(48.95, 50.20)	49.57	(48.95, 50.19)
Cheshire and Merseyside	2.81	(0.08, 5.54)	2.39	(-0.31, 5.10)	2.26	(-0.44, 4.96)
East Midlands	-2.30	(-4.3, -0.29)	-1.76	(-3.74, 0.22)	-1.69	(-3.66, 0.29)
East of England -North	1.81	(-0.83, 4.46)	1.79	(-0.82, 4.40)	2.35	(-0.26, 4.97)
East of England -South	1.46	(-1.12, 4.05)	2.55	(0.00, 5.10)	2.82	(0.27, 5.38)
Greater Manchester	5.36	(2.70, 8.01)	4.59	(1.96, 7.22)	4.75	(2.12, 7.39)
Humber, Coast and Vale	3.44	(0.17, 6.72)	3.57	(0.37, 6.78)	3.50	(0.29, 6.71)
Kent and Medway	-1.98	(-5.73, 1.77)	-2.78	(-6.42, 0.85)	-2.66	(-6.29, 0.97)
Lancashire and South Cumbria	2.83	(-0.46, 6.12)	2.59	(-0.63, 5.82)	2.32	(-0.90, 5.54)
North Central London	-1.29	(-6.11, 3.53)	-1.97	(-6.77, 2.83)	-1.82	(-6.60, 2.97)
North East London	4.85	(0.51, 9.18)	3.44	(-0.89, 7.77)	3.32	(-1.02, 7.66)
North West and South West London	0.02	(-2.85, 2.90)	0.47	(-2.35, 3.28)	0.58	(-2.24, 3.40)
Northern	-0.53	(-2.72, 1.67)	-1.26	(-3.43, 0.91)	-1.34	(-3.51, 0.82)
Peninsula	-11.47	(-14.5, -8.44)	-12.11	(-15.12, -9.09)	-12.44	(-15.44, -9.44)
Somerset, Wiltshire, Avon and Gloucestershire	0.39	(-2.38, 3.15)	1.32	(-1.39, 4.03)	0.61	(-2.10, 3.32)
South East London	2.74	(-1.61, 7.10)	2.78	(-1.51, 7.07)	2.53	(-1.77, 6.82)
South Yorkshire and Bassetlaw	9.36	(5.64, 13.08)	7.67	(3.99, 11.34)	7.74	(4.06, 11.41)
Surrey and Sussex	-3.41	(-5.99, -0.83)	-2.08	(-4.61, 0.45)	-1.97	(-4.49, 0.56)
Thames Valley	-3.81	(-7.79, 0.17)	-1.23	(-5.16, 2.70)	-1.67	(-5.57, 2.22)
Wessex	-3.86	(-6.58, -1.14)	-2.94	(-5.61, -0.27)	-3.39	(-6.04, -0.73)
West Midlands	-2.16	(-3.98, -0.34)	-2.80	(-4.58, -1.02)	-2.58	(-4.36, -0.79)
West Yorkshire and Harrogate	5.15	(2.22, 8.09)	4.33	(1.45, 7.21)	4.56	(1.68, 7.43)
Age 0-44	-5.72	(-10.09, -1.35)	-6.46	(-10.82, -2.10)	-5.66	(-10.06, -1.27)
Age 45-54	-8.39	(-11.01, -5.76)	-8.83	(-11.44, -6.23)	-8.16	(-10.78, -5.53)
Age 55-64	-10.85	(-12.35, -9.35)	-10.98	(-12.47, -9.49)	-10.46	(-11.97, -8.95)
Age 65-74	-6.82	(-7.86, -5.77)	-6.61	(-7.65, -5.57)	-6.32	(-7.36, -5.28)
Age 75-84	3.66	(2.74, 4.58)	3.65	(2.74, 4.56)	3.35	(2.44, 4.27)
Age 85+	14.83	(13.56, 16.10)	14.87	(13.59, 16.14)	14.28	(12.98, 15.57)
Female	1.91	(1.29, 2.53)	0.94	(0.32, 1.55)	1.11	(0.49, 1.72)
Male	-2.02	(-2.68, -1.37)	-0.99	(-1.64, -0.34)	-1.17	(-1.83, -0.52)
Quintile 1 (least deprived)	-4.93	(-6.24, -3.62)	-4.91	(-6.21, -3.60)	-4.61	(-5.92, -3.31)
Quintile 2	-2.69	(-3.93, -1.46)	-2.65	(-3.87, -1.43)	-2.50	(-3.71, -1.28)
Quintile 3	-0.66	(-1.92, 0.60)	-0.44	(-1.69, 0.80)	-0.41	(-1.65, 0.83)
Quintile 4	3.11	(1.84, 4.38)	3.00	(1.74, 4.25)	2.86	(1.61, 4.11)
Quintile 5 (most deprived)	5.20	(3.91, 6.49)	5.02	(3.70, 6.33)	4.67	(3.36, 5.99)
2006	1.72	(-0.66, 4.10)			1.85	(-0.49, 4.19)
2007	0.49	(-1.92, 2.91)			1.40	(-0.98, 3.79)
2008	1.58	(-0.68, 3.85)			2.50	(0.28, 4.71)
2009	2.38	(0.21, 4.56)			2.47	(0.33, 4.61)
2010	0.79	(-1.34, 2.91)			0.64	(-1.43, 2.71)
2011	-0.26	(-2.37, 1.85)			-0.05	(-2.13, 2.02)
2012	-1.10	(-3.20, 1.00)			-1.38	(-3.42, 0.66)
2013	1.28	(-0.76, 3.32)			1.24	(-0.74, 3.22)
2014	1.01	(-1.05, 3.07)			0.32	(-1.70, 2.33)
2015	-0.81	(-2.79, 1.17)			-1.37	(-3.31, 0.57)
2016	-1.83	(-3.79, 0.13)			-2.22	(-4.15, -0.30)
2017	-3.58	(-5.50, -1.66)			-3.27	(-5.16, -1.38)
Adenomas and adenocarcinomas	-0.56	(-0.74, -0.37)			-0.38	(-0.58, -0.19)
Other morphology	6.73	(4.52, 8.93)			4.64	(2.31, 6.97)
eCCA	-3.41	(-4.74, -2.08)			-2.84	(-4.16, -1.53)
iCCA	0.80	(0.43, 1.17)			0.81	(0.44, 1.18)
Other subtype	0.56	(-1.89, 3.01)			-1.26	(-3.74, 1.22)
Charlson 0	-2.09	(-2.46, -1.71)			-1.28	(-1.66, -0.90)
Charlson 1	3.97	(2.27, 5.67)			1.95	(0.29, 3.62)
Charlson 2	5.21	(2.88, 7.55)			2.74	(0.45, 5.02)
Charlson 3 +	10.24	(7.92, 12.56)			7.63	(5.31, 9.95)
Liver disease -No	0.07	(-0.11, 0.24)			-0.19	(-0.36, -0.01)
Liver disease -Yes	-0.86	(-3.18, 1.45)			2.45	(0.10, 4.70)

¹Adjustment for: Age, gender, income deprivation quintile.

²Adjustment for: Age, gender, income deprivation quintile, Charlson comorbidity index, underlying liver disease at diagnosis, diagnosis year, tumour morphology, tumour sub- type.

Apart from intercept, estimates represent the percentage- point difference from the weighted cohort average probability of each route. If 95%CI does not contain zero, the percentage- point difference from average will be more than 2 SD and indicates variation that is unlikely to be due to chance. Bold indicates a difference that is > 2 SD above or below average. iCCA: Intrahepatic cholangiocarcinoma; eCCA: Extrahepatic cholangiocarcinoma.