Exploring the rising incidence of neuroendocrine tumors: A population‐based analysis of epidemiology, metastatic presentation, and outcomes

Abstract

BACKGROUND: An increased incidence of neuroendocrine tumors (NETs) has been reported worldwide, but the reasons underlying this rise have not been identified. By assessing patterns of metastatic presentation, this study sought to examine the epidemiologic characteristics of NETs and the contribution of early-stage detection to the rising incidence. METHODS: A population-based retrospective cohort study was conducted with prospectively maintained databases linked at the Institute for Clinical Evaluative Sciences. Adult patients with a NET diagnosis from 1994 to 2009 in Ontario, Canada were included. The main outcomes included the overall and site-specific incidence, proportion of metastatic disease, overall survival (OS), and recurrence-free survival (RFS). RESULTS: Five thousand six hundred nineteen NET cases were identified. The incidence of NETs increased from 2.48 to 5.86 per 100,000 per year. Metastases were found in 20.8% at presentation and in another 38% after the initial diagnosis. The proportion of metastases at presentation decreased from 1994 to 2009 (from 29% to 13%). Therefore, although the incidence of all NETs increased, the overall incidence of metastases did not change (0.63-0.69 per 100,000 per year). The 10-year OS rate was 46.5%, and the RFS rate was 64.6%. In addition to the primary tumor site, independent predictors of worse OS included an advanced age (P <.0001), male sex (P <.0001), a low socioeconomic status (P <.0001), and rural living (P 5 0.049). CONCLUSIONS: The incidence of NETs has markedly increased over the course of 15 years. This is the first study to provide evidence suggesting that the increase in the incidence of NETs may be due to increased detection. In addition to tumor characteristics, low income and rural residency portend worse survival for patients with NETs. Cancer 2015;121:589-97.

Biologics in gastrointestinal and pancreatic neuroendocrine tumors

“…While annual incidence in the U.S. is estimated to be between two and five cases per 100,000 people, reports of rising incidence-in part a result of improvements in detection-and the relatively long survival of NET patients has translated into a prevalence greater than that of gastric and pancreatic adenocarcinomas combined (1)(2)(3). Over half of NETs originate in the gastrointestinal tract and pancreas,…”

Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma (zasady postępowania rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

“…The percentage of g-NENs in relation to all NENs significantly differs between reports. An Austrian study gave 23%, a Canadian study gave 5%, and Taiwan study gave 7.4%, whereas the SEER programme gave 6% [3,4]. The differences indicate the need for multicentre, prospective studies with long-term analysis in order to better describe the epidemiology of these neoplasms in Europe.…”

Clinical significance of nestin and its association with survival in neuroendocrine lung tumours

“…Moreover, the same pulmonary neuroendocrine cells probably give rise to all of these tumour types [15]. In the light of increasing incidence of neuroendocrine neoplasms [16], there is a great need for marker identification, which would be useful to predict prognosis and facilitate treatment. We hypothesized that nestin, due to its role in carcinogenesis, could be a potential biomarker in lung neuroendocrine tumours.…”