Small Bowel Cancer in Western Canada

Abstract

Based on incident cases of small intestinal cancers in the four western Canadian provinces reported in the population-based cancer registries of British Columbia, Alberta, Saskatchewan and Manitoba we evaluated the descriptive epidemiological characteristics such as age, sex and subsite distribution of adenocarcinomas, carcinoids, lymphomas and sarcomas for the period 1975-1989. The distribution of adenocarcinomas, carcinoids and lymphomas presented a clear trend along the length of the small bowel. Most of the adenocarcinomas (54.7%) occurred in the duodenum and their relative frequency decreased in aboral direction: 29.9% in the jejunum and 16.0% in the ileum. The carcinoids showed an opposite trend, an increasing relative frequency in aboral direction: 3.9% in the duodenum, 9.2% in the jejunum and 86.7% in the ileum. Lymphomas were more frequent in the ileum (49.5%) compared to jejunum (29.4%) and duodenum (21.0%). Most sarcomas occurred along the jejunum (46.7%). The mean and median ages of lymphoma and sarcoma patients were significantly lower compared to adenocarcinoma and carcinoid cases. There was no difference in mean and median age by gender in the adenocarcinoma and carcinoid categories, but in the lymphoma and sarcoma groups males were significantly younger than females.

Descriptive epidemiology of small intestinal malignancies: the German Cancer Registry experience

“…In contrast to the USA, we did not find relevant increases of the incidence rates of all tumours of the small intestine combined or the histological subgroups for either sex over time. Analyses of cancer registry data from Canadian provincial registries by Gabos et al (1993) showed a small increasing trend for malignant lymphomas in both genders, although the incidence estimates were based on small numbers in comparison to the number of lymphoma cases in the GDR.…”

Incidence of Small Bowel Cancer in the United States and Worldwide: Geographic, Temporal, and Racial Differences

“…For example, while the rates of adenocarcinomas and carcinoid tumors in the U.S. have been rising, incidence rates in Germany have not been increasing [17]. A Canadian study [18] did not find increasing trends for histologic types of small bowel cancer, except for a small increasing trend in malignant lymphomas, and a study in Denmark of carcinoid tumors [19] also found no clearly discernible increase. Nevertheless, comparisons between registries may be limited, due to differences in completeness of case ascertainment and the sources and procedures used in obtaining population estimates.…”

Small Bowel Tumors: What the Surgeon Can Not Forget

“…The lineage of the epithelial benign Neoplasms not the small intestine include leiomyomas, fibromas, neurofibromas and lymphomas. With the exception of lymphomas and neurofibromas, which are seen with greater frequency in the ileum, the other focus preferably in the jejunum [12].…”

“…When located in the ileum, are demonstrating clinically with pain, nausea and bloating [14]. The suspected diagnosis is usually made through radiological examination contrasted and confirmation by surgical exploration [12]. …”