Publication Name	World Journal of Gastroenterology
Manuscript ID	84581
Country	United Kingdom

Category	Oncology
Manuscript Type	Retrospective Cohort Study
Article Title	Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017
Manuscript Source	Unsolicited Manuscript
All Author List	Amy Zalin-Miller, Sophie Jose, Craig Knott, Lizz Paley, Daniela Tataru, Helen Morement, Mireille B Toledano and Shahid A Khan
Funding Agency and Grant Number	Funding Agency Grant Number AMMF – The Cholangiocarcinoma Charity
Corresponding Author	Amy Zalin-Miller, MSc, Senior Researcher, Department of Analytics, Health Data Insight CIC, Capital Park, Fulbourn, Cambridge CB21 5XE, United Kingdom. amy.zalin@nhs.net
Key Words	Cholangiocarcinoma; Route to diagnosis; Two week wait; Emergency presentation; Regional variation
Core Tip	We investigated changes to routes to diagnosis for cholangiocarcinoma patients across England’s 21 regional Cancer Alliances over a 12-year period, and factors associated with differences. We found almost half (49.6%) of 22632 patients in the study were diagnosed via Emergency Presentation, a route associated with late presentation, advanced disease and poorer outcomes. Those diagnosed by Two week wait referral through a primary care doctor, where earlier diagnoses are possible, increased from 9.8-19.8% from 2006-2017, still considered low. Significant regional variation was found, alongside the discovery that age, comorbidities and underlying liver disease had independent associations with their routes to diagnosis.
Citation	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; 29(24): 3825-3842

Received	2023-03-20 13:55
Peer-Review Started	2023-03-20 13:58
To Make the First Decision
Return for Revision	2023-04-27 05:08
Revised	2023-05-05 21:38
Second Decision	2023-05-25 02:53
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2023-05-25 09:12
Articles in Press	2023-05-25 09:12
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript	2023-06-13 13:19

ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com