In a study reported in a research letter in JAMA Oncology, Abboud et al found that the incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) has increased in many organ sites during recent years in the United States.
Study Details
In the study, age-adjusted GEP-NETs incidence rates from 2001 to 2020 were calculated using data from the U.S. Cancer Statistics database, which covers approximately 98% of the U.S. population. Annual percentage change (APC) and average APC (AAPC) were estimated, with P < .001 considered statistically significant.
Key Findings
A total of 277,230 individuals (50.5% female) were diagnosed with GEP-NETs over the study period. Of these tumors, 65.4% were in older patients (aged ≥ 55 years).
The most common tumor sites were the anorectum (21.9%), pancreas (16.8%), and stomach (9.9%).The most cases by state were reported in California (10.3%). The highest incidence per 100,000 population by state was in Louisiana (5.44). The highest incidence per 100,000 population by region was in the Northeast (4.31).
Overall, the incidence of GEP-NETs increased during the study period (AAPC = 3.8%), with increases seen in most organs. The greatest increases were observed in the appendix (AAPC = 12.9%), pancreas (8.8%), duodenum (5.0%), jejunum (4.9%), esophagus (4.7%), biliary tract (3.8%), stomach (3.4%), ileum (2.8%), and anorectum (1.2%). Stable trends in AAPC were observed for the cecum, liver, and gallbladder, with a decrease observed in the colon (−1.0 %).
The increase in incidence was higher in female patients vs male patients (AAPC = 3.8% vs 3.6%) and in younger vs older adults (AAPC = 5.2% vs 2.7%). Many GEP-NETs (55.4%) were diagnosed as early-stage tumors; a greater increase in incidence was observed in patients with early-stage tumors (AAPC = 5.2%, 95% confidence interval [CI] = 4.5%–5.8%, P < .001) than in late-stage tumors (AAPC = 3.4% 95% CI = 3.1%–3.7%, P < .001).
The investigators concluded: “This study found an overall rising incidence of GEP-NETs across most organs—notably in the appendix, pancreas, and small intestine—[which was] more pronounced in females and younger adults and with early-stage tumors. The colon showed a decreasing incidence trend, whereas the cecum, liver, and gallbladder displayed stable trends.”
Yazan Abboud, MD, of the Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, is the corresponding author of the JAMA Oncology article.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
