{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T16:48:49Z","timestamp":1783270129537,"version":"3.54.6"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014570","name":"Graduate School, Khon Kean University, Thailand","doi-asserted-by":"publisher","award":["651H222-c"],"award-info":[{"award-number":["651H222-c"]}],"id":[{"id":"10.13039\/501100014570","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cholangiocarcinoma (CCA) is major health issue in Thailand, with high incidences in different parts of country. This study examines the association between spatial variables and CCA in Thailand.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Thailand\u2019s four population-based cancer registries provided data for this retrospective cohort analysis between January 1, 2012, and December 31, 2021. 6,379 diagnosed CCA cases were found in 554 sub-districts. Moran\u2019s <jats:italic>I<\/jats:italic> and Local Indicators of Spatial Association (LISA) measured geographic dispersion and estimated sex age-standardized rates (ASRs). Multivariable log-linear regression assessed geography and CCA, calculating adjusted incidence rate ratios (IRRs) and 95% confidence interval (CI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 6,379 CCA cases, 63.9% were male, and the mean age at diagnosis was 66.2 years (standard deviation = 11.07 years). CCA ASRs for both sexes in Thailand was 8.9 per 100,000 person-years. The northeastern region had the greatest ASR at 13.4 per 100 000 person-years. Moran\u2019s <jats:italic>I<\/jats:italic> and LISA studies grouped regions by spatial variables. The association between spatial variables and CCA demonstrated that the northern region exhibited elevation (adjusted IRRs = 0.82, 95%CI: 0.78 to 0.87) and distance from water sources variable (adjusted IRRs = 0.91, 95%CI: 0.82 to 0.99). The central region elevation variable (adjusted IRRs = 0.85, 95%CI: 0.76 to 0.94). This was the distance from water sources (adjusted IRRs = 0.96, 95%CI: 0.93 to 0.99) and population density variable (adjusted IRRs = 0.94, 95%CI: 0.93 to 0.96) in the northeastern region. Population density (adjusted IRRs = 1.09, 95%CI: 1.02 to 1.15) and average temperature variable (adjusted IRRs = 1.05, 95%CI: 1.02 to 1.09) were significant in the southern region.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Spatial variables associated with CCA indicate that ASR differs across Thailand. So environmental and climate factors can inform targeted public health strategies to address CCA in high-risk areas throughout Thailand.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311035","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T18:41:47Z","timestamp":1733942507000},"page":"e0311035","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spatial analysis of cholangiocarcinoma in Thailand from 2012 to 2021; a population-based cancer registries study"],"prefix":"10.1371","volume":"19","author":[{"given":"Oraya","family":"Sahat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1554-7696","authenticated-orcid":true,"given":"Supot","family":"Kamsa-ard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apiporn Thinkhamrop","family":"Suwannatrai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apiradee","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siriporn","family":"Kamsa-ard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surichai","family":"Bilheem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karnchana","family":"Daoprasert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atit","family":"Leklob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surin","family":"Uadrang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chalongpon","family":"Santong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithima","family":"Sriket","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasan","family":"Chansaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"issue":"1","key":"pone.0311035.ref001","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/s41572-021-00300-2","article-title":"Cholangiocarcinoma","volume":"7","author":"PJ Brindley","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0311035.ref002","first-page":"331","article-title":"Cholangiocarcinoma: Experience of Srinagarind Hospital","volume":"27","author":"V Bhudhisawasdi","year":"2012","journal-title":"Srinagarind Medical Journal"},{"issue":"3","key":"pone.0311035.ref003","first-page":"143","article-title":"Current concept in the management of cholangiocarcinoma","volume":"20","author":"N. 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