East Carolina University Greenville, NC, United States
Hassam Ali, MD, Rahul Pamarthy, MD, Mary-Jane O. Williams, MD, Prashant Mudireddy, MD East Carolina University, Greenville, NC
Introduction: We studied the incidence trends of the pancreatic neuroendocrine tumor (carcinoid type) by demographics in United States.
Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 registry was assessed using temporal trends analysis. International classification of diseases (ICD)-0–2 was used through 2000, and ICD-0–3 following 2001 for coding. Cases in age group 30 yrs and above from 2000 to 2017 were included which had a microscopically confirmed diagnosis. Cases in patients 30 yrs and below were excluded due to negligible representation.
Results: There was a rise in carcinoid type pancreatic neuroendocrine tumors (PNETs) in all ethnicities in recent years. The total number of cases in males and females was 3,201, which made 2.2% of all the pancreatic cancers reported from 2000-2017. The total cases were more in males (n = 1753) than females (n = 1448). There was a male predominance with incidence risk ratio (IRR) 1.4, Confidence interval (CI) 1.3-1.5, (p < 0.05). In males, the incidence continued to rise based on age groups and peaked at 60-64 (n = 255) and 65-69 (n = 303). The incidence in females was also highest in age groups 60-64 (n = 205) and 65-69 (n = 218)—the incidence declined after 70 years in both genders (Figure 1b & 1c). The rates showed a positive trend after 2010 in all races except American Indian/Alaska Native (Figure 1a). The annual percentage change (APC) in white males was highest, 32.5% (p < 0.05). APC in white females was 30.3% (p < 0.05). The APC in black males could not be calculated due to at least one year without cases, while in black females was 26.9% (p < 0.05).
Discussion: Recent years saw a rise in carcinoid tumors that has been unreported previously. The etiology for this conceivable shift in distribution can only be speculated at this time. The rising incidence of carcinoid PNETs could be attributed to the widespread adoption of high-resolution imaging and the increased detection of incidentalomas. However, we only included cases that were malignant and had a microscopically confirmed diagnosis. Previously immunohistochemical techniques for staining of carcinoid tumors were limited as well. Currently, most risk factors associated with pancreatic adenocarcinoma, except diabetes, are not linked to PNETs. There could be a possible association between alcohol and PNETs. Family history, sarcoma, ovarian, gallbladder and gastric cancer may have some association. Further comparative data is needed for any definitive conclusion.
Figure: Carcinoid pancreatic neuroendocrine tumor trends by ethnicity and age groups from 2000-2017. 1a: Incidence trends by ethnicities/race, 1b: Incidence trends in males by age group, 1c: Incidence trends in females by age group
Hassam Ali indicated no relevant financial relationships.
Rahul Pamarthy indicated no relevant financial relationships.
Mary-Jane Williams indicated no relevant financial relationships.
Prashant Mudireddy indicated no relevant financial relationships.
Hassam Ali, MD, Rahul Pamarthy, MD, Mary-Jane O. Williams, MD, Prashant Mudireddy, MD. P0006 - Recent Incidence Trends for Carcinoid Type Pancreatic Neuroendocrine Tumors in the United States, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.