The Epidemiology of Gastroenteropancreatic Neuroendocrine Tumors
Section snippets
Methods
The SEER program was used to provide comprehensive epidemiology data on GEP-NETs. Data were also identified from the End Results Group (ERG) and the Third National Cancer Survey (TNCS) programs of the National Cancer Institute (NCI) between 1950 and 1971. The SEER program (Fig. 1) was established in 1973 by the NCI to provide representative cancer incidence and survival rates in the United States and has collected information on all cancer cases diagnosed in 9 areas or registries (SEER 9
Results
A total of 49,012 NETs were included in the SEER epidemiology analysis, including 29,664 patients with GEP-NETs. The distribution of NETs by GEP primary site as accrued in successive national registries is detailed in Table 2. In the most recent SEER registry (SEER 17), more than half of all NETs (61.0%) were GEP-NETs, with highest frequency in the rectum (17.7% of NETs), small intestine (17.3% of NETs) and colon (10.1% of NETs). Pancreatic, gastric, and appendiceal sites accounted for 7.0%,
Discussion
The overall incidence of GEP-NETs continues to exhibit a persistent increase, maintaining the trend noted in earlier epidemiologic studies.5, 10, 11, 12, 13 Although the incidence increased at all primary sites, the change is mostly accounted for by the escalation in rectal and small intestinal NETs, with the highest proportional change occurring in rectal and gastric NETs. Because the anatomic location exhibiting the most change is luminal, it is appealing to attribute observations of increase
Summary
GEP-NET disease is increasing in incidence, and there is evidence that in specific areas such as rectum, small intestine, and stomach, this incidence is escalating at a greater rate. There is a distinct epidemiologic profile for each primary site. For example, rectal NETs are diagnosed at a younger age and a lower stage and demonstrate good survival, whereas colonic NETs are diagnosed at an older age and a higher stage and have poor survival. As might be expected, based on advances in diagnosis
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B.L. was supported in part by the Murray Jackson Clinical Fellowship, Genesis Oncology Trust, Auckland, New Zealand.
The authors have nothing to disclose.