Small bowel cancer is a rare but important finding on DAE. The per-patient incidence in our series was 3.6%. A recent multicenter Japanese series showing a higher incidence of small bowel tumors (14%) included polyposis syndrome patients and benign lesions, which were excluded from our study. The high frequency of neuroendocrine tumors in our series was also in contrast to the Japanese series, where lymphoma and GIST were more common. This may reflect a difference between our referral populations. Most of our patients underwent surgery as a consequence of these findings, underscoring the importance of identifying these tumors. DAE provides direct endoscopic access to the small bowel and is a valuable tool in the diagnosis of small bowel cancers.