Epidemiologic trends in neuroendocrine tumors: An examination of incidence rates and survival of specific patient subgroups over the past 20 years

• Published in: Seminars in oncology Vol. 45; no. 4; pp. 249 - 258
• Main Authors: Sackstein, Paul E., O'Neil, Daniel S., Neugut, Alfred I., Chabot, John, Fojo, Tito
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2018
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Carcinoid; Child; Epidemiology; Female; Humans; Incidence; Male; Middle Aged; Neuroendocrine tumor; Neuroendocrine Tumors - epidemiology; SEER; SEER Program; Survival; Survival Analysis; Young Adult; SEER; Carcinoid; Neuroendocrine tumor; Epidemiology; Survival
• ISSN: 0093-7754; 1532-8708
• DOI: 10.1053/j.seminoncol.2018.07.001

Neuroendocrine tumors (NETs) represent a small proportion of cancers, but are increasing in incidence due to incidental diagnosis. We examined NET incidence and survival over time in a population-based registry. We identified all NET cases diagnosed between 1995 and 2014 in the Surveillance, Epidemiology, and End Results database, November 2016 submission. We determined incidence rates and calculated overall and cancer-specific survival curves in different subgroups stratified by grade, stage, and age at diagnosis. We identified 85,133 patients with a diagnosis of NET between 1995 and 2014. Patients with grade 1, localized NETs had the best median overall survival (233 months, 95% confidence intervals [CI] not estimable) and 5-year cancer-specific survival (97.6%; 95% CI, 97.4%, 97.8%). The median overall survival decreased with age across the entire spectrum of ages, with patients >70 years having a particularly poor prognosis (28.0 months; 95% CI, 26.5, 29.5). Patients >70 years old often had distant (34.3%) or grade 3 disease (40.8%), but even elderly patients with lower grade and/or stage disease had worse median overall survival compared with younger subjects. Age appears to be associated with a worse prognosis independent of NET stage, and grade at the time of diagnosis. Patients with grade 1, localized NETs have an excellent long-term prognosis. Further research is warranted on reducing intensity of surveillance in these patients.