Cancer epidemiology · 2025
Malignancies of the small intestine: incidence and trends in a nationwide registry.
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Schafrat Pascale J M, van Erning Felice N, Zwinderman Koos, Dekker Evelien, Farina Sarasqueta Arantza, de Vos-Geelen Judith, Bouwense Stefan A W, Goedegebuure Ruben S A, Vermeulen Louis, de Hingh Ignace H J T, Sommeijer Dirkje W
Аннотация
BACKGROUND: Malignancies of the small intestine are rare and understudied. Improved knowledge about trends in incidence and distribution of specific subtypes might guide clinicians and researchers to further improve diagnostic and treatment strategies and ultimately improve prognosis.
METHODS: This nationwide retrospective cohort study from the Netherlands Cancer Registry included all patients diagnosed with a malignancy of the small intestine in the Netherlands between 2000 and 2022. Malignancies were divided into seven subgroups: adenocarcinomas, neuroendocrine neoplasms (NENs), lymphomas, gastrointestinal stromal tumors (GISTs), other sarcomas, metastases, and "other". Age-standardized incidence rates, overall- and relative survival were reported.
RESULTS: A total of 11.194 patients with a malignancy of the small intestine were included. Age-standardized incidence rates (per 100.000 person-years) more than doubled between 2000 and 2020 (1.88-3.94, p < 0.001), with the largest increase in NENs (0.53-1.57, p < 0.001), followed by adenocarcinomas (0.78-1.22, p = 0.004). The most prevalent malignancy in the small intestine shifted from adenocarcinomas to NENs from 2017 onwards. NENs were mostly located in the ileum and adenocarcinomas were most frequently diagnosed in the duodenum. Survival varied significantly between subgroups. Survival of patients with lymphomas and GISTs improved over time, in contrast with patients with adenocarcinomas and NENs.
CONCLUSION: The incidence of malignancies of the small intestine in the Netherlands has more than doubled over the past two decades, mostly due to an increase in NENs and adenocarcinomas. Survival outcomes for these malignancies did not improve, highlighting the urgent need to further study these rare cancer subtypes in the small intestine.
METHODS: This nationwide retrospective cohort study from the Netherlands Cancer Registry included all patients diagnosed with a malignancy of the small intestine in the Netherlands between 2000 and 2022. Malignancies were divided into seven subgroups: adenocarcinomas, neuroendocrine neoplasms (NENs), lymphomas, gastrointestinal stromal tumors (GISTs), other sarcomas, metastases, and "other". Age-standardized incidence rates, overall- and relative survival were reported.
RESULTS: A total of 11.194 patients with a malignancy of the small intestine were included. Age-standardized incidence rates (per 100.000 person-years) more than doubled between 2000 and 2020 (1.88-3.94, p < 0.001), with the largest increase in NENs (0.53-1.57, p < 0.001), followed by adenocarcinomas (0.78-1.22, p = 0.004). The most prevalent malignancy in the small intestine shifted from adenocarcinomas to NENs from 2017 onwards. NENs were mostly located in the ileum and adenocarcinomas were most frequently diagnosed in the duodenum. Survival varied significantly between subgroups. Survival of patients with lymphomas and GISTs improved over time, in contrast with patients with adenocarcinomas and NENs.
CONCLUSION: The incidence of malignancies of the small intestine in the Netherlands has more than doubled over the past two decades, mostly due to an increase in NENs and adenocarcinomas. Survival outcomes for these malignancies did not improve, highlighting the urgent need to further study these rare cancer subtypes in the small intestine.