Impact of neuroendocrine morphology on cancer outcomes and stage at diagnosis: a UK nationwide cohort study 2013-2015

Br J Cancer. 2019 Nov;121(11):966-972. doi: 10.1038/s41416-019-0606-3. Epub 2019 Oct 25.

Abstract

Background: The diagnosis of neuroendocrine neoplasms (NENs) is often delayed. This first UK population-based epidemiological study of NENs compares outcomes with non-NENs to identify any inequalities.

Methods: Age-standardised incidence rate (ASR), 1-year overall survival, hazard ratios and standardised mortality rates (SMRs) were calculated for all malignant NENs diagnosed 2013-2015 from UK national Public Health records. Comparison with non-NENs assessed 1-year overall survival (1YS) and association between diagnosis at stage IV and morphology.

Results: A total of 15,222 NENs were identified, with an ASR (2013-2015 combined) of 8.6 per 100,000 (95% CI 8.5-8.7); 4.6 per 100 000 (95% CI, 4.5-4.7) for gastro-entero-pancreatic (GEP) NENs. The 1YS was 75% (95% CI, 73.9-75.4) varying significantly by sex. Site and morphology were prognostic. NENs (predominantly small cell carcinomas) in the oesophagus, bladder, prostate, and female reproductive organs had a poorer outcome and were three times more likely to be diagnosed at stage IV than non-NENs.

Conclusion: Advanced stage at diagnosis with significantly poorer outcomes of some NENs compared with non-NENs at the same anatomical site, highlight the need for improved access to specialist services and targeted service improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intestinal Neoplasms / diagnosis*
  • Intestinal Neoplasms / epidemiology*
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Mortality
  • Neoplasm Staging
  • Neuroendocrine Tumors / diagnosis*
  • Neuroendocrine Tumors / epidemiology*
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Prognosis
  • United Kingdom / epidemiology