Incidence and Survival of Gastro-Entero-Pancreatic Neuroendocrine Neoplasms in the Contemporary Era
Authors' conclusion
This cohort study of GEP-NENs found that incidence has continued to rise, largely due to increased diagnosis of nonmetastatic disease; OS and CSS were good but heterogeneous, influenced by demographic and disease-specific factors. These contemporary, population-based estimates provide essential evidence to support patient counselling, survivorship planning, health-system resource allocation, and the design of future NEN research.
Study context
- Population
- Adults diagnosed with incident gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) in Ontario, Canada (2000–2023); median (IQR) age 61 (50–71) years, 6228 (48.4%) female
- Participants
- 12,877 adults
- Outcome
- Annual incidence per 100 000 population; OS (Kaplan-Meier) and CSS (cumulative incidence, noncancer deaths as competing risk)
Methodological detailslinked administrative datasets
- Linked administrative datasets
Main finding
As reported in the abstract
Overall incidence per 100 000, 2000 to 2023
1.83 to 7.46
Nonmetastatic disease incidence per 100 000 per year (6.5-fold rise); minimal change in metastatic presentations
1.48 to 7.18
Ten-year overall survival (OS), all GEP-NENs
63.3%
95% CI 62.3%–64.3%
Ten-year cancer-specific survival (CSS), all GEP-NENs
76.4%
95% CI 75.6%–77.3%
Observational data: associations, not effects.
Further findings
Synchronous metastases
- Individuals with synchronous metastases (16.5%)
- 2313
Incidence by site
- Incidence highest for small intestine, then rectum, pancreas, appendix, stomach, colon; largest increases in gastric and pancreatic NENs
10-year CSS by metastases at diagnosis
- Without metastases at diagnosis
- exceeded 90.0%
- With metastases at diagnosis
- 51.3% (95% CI, 49.7%-52.8%)
Survival by site and associated factors
- Most favorable survival for rectal and appendiceal NENs, least for colonic and pancreatic NENs
- Advancing age, lower socioeconomic status and metastases at diagnosis independently associated with worse OS and CSS; female sex with superior OS and CSS
Original publication
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