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. 2022 Sep 23:23:100510.
doi: 10.1016/j.lanepe.2022.100510. eCollection 2022 Dec.

Incidence and survival of neuroendocrine neoplasia in England 1995-2018: A retrospective, population-based study

Benjamin E White  1 , Brian Rous  2 , Kandiah Chandrakumaran  1 , Kwok Wong  2 , Catherine Bouvier  3 , Mieke Van Hemelrijck  4 , Gincy George  4 , Beth Russell  4 , Rajaventhan Srirajaskanthan  5 , John K Ramage  1   5
Affiliations

Incidence and survival of neuroendocrine neoplasia in England 1995-2018: A retrospective, population-based study

Benjamin E White et al. Lancet Reg Health Eur. .

Abstract

Background: Neuroendocrine neoplasia (NEN) incidence is rising internationally. We aimed to evaluate the epidemiology of NEN in England and examine changes in survival over time.

Methods: A retrospective, population-based study using nationally representative data between 1995 and 2018 from the National Cancer Registry and Analysis Service (NCRAS) in England was conducted on 63,949 tumours. Age-standardized incidence was calculated using Office for National Statistics (ONS) data. Overall survival (OS) was calculated using the Kaplan-Meier estimator. Multivariable analysis was performed using an accelerated failure time model.

Findings: Of 63,949 cases, 50.5% (32,309) were female. Age-adjusted incidence increased 3.7-fold between 1995 and 2018 from 2.35 to 8.61 per 100,000. In 2018, highest incidence occurred in lung (1.47 per 100,000), small intestine (1.46 per 100,000), pancreas (1.00 per 100,000) and appendix (0.95 per 100,000). In multivariable analysis, age, sex, morphology, stage, site and deprivation were independent predictors of survival (p < 0.001). Survival of the entire cohort, and by primary site, is improving over time.

Interpretation: NEN incidence continues to rise in England with survival improving over time. Relatively high survival compared to other cancers is an issue for long-term outcomes and funding of care.

Funding: Data were extracted and transferred using a grant from Neuroendocrine cancer UK.

Keywords: Carcinoid; Epidemiology; Incidence; Neuroendocrine neoplasia; Neuroendocrine tumour; Predictors of survival; Survival.

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Conflict of interest statement

JKR supervised securing funding for the grant from Neuroendocrine Cancer UK (NCUK) to process the data in the initial planning of the work. CB states that NCUK receives donation, grant and sponsorship money from patients, businesses and not-for-profit organisations. CB is a board member of the International Neuroendocrine Cancer Alliance (INCA). The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Age standardized incidence of 63,949 neuroendocrine neoplasia from 1995–2018 in England. 95% confidence interval displayed. Data source: NCRAS. (B) Age standardized incidence of 40,534 NEN at main sites from 1995–2018 in England with average percentage change per year and absolute rise. Data source: NCRAS.
Figure 2
Figure 2
Kaplan–Meier predicted 5–year survival of (A) 11,080 neuroendocrine tumours and (B) 3,754 neuroendocrine carcinomas between 2012 and 2018 in England. Source data: NCRAS.
Figure 3
Figure 3
Kaplan-Meier predicted survival of NEN by stage (A), tumour morphology (B), sex (C) and site (D) from 2012–2018 in England. Source data: NCRAS.
See this image and copyright information in PMC

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