Epidemiology of neuroendocrine tumors of the appendix in the USA: a population-based national study (2014-2019)

Abstract

Background The appendix is the third most common place for neuroendocrine tumors (NETs) along the digestive tract and NETs are the most common neoplasms of the appendix. However, there are limited population-based data on the epidemiology of this disease. Using a large database, we sought to describe the epidemiology and risk association of NETs of the appendix. Method We queried a multi-institutional database (Explorys Inc., Cleveland, OH, USA), comprising 360 hospitals in the United States (US), for patients with a diagnosis of NETs of the appendix from 2014-2019. Results Of the 30,324,050 individuals in the database, 2020 patients had an appendiceal NET diagnosis (0.007%). The most common presenting symptoms included abdominal pain, nausea, vomiting and diarrhea. Patients with appendiceal NETs were more likely to be female (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.24-1.49), Caucasian (OR 2.71, 95%CI 2.40-3.07), with a history of smoking (OR 1.82, 95%CI 1.65-2.01), family history of primary gastrointestinal malignancy (OR 7.26, 95%CI 6.31-8.33), diagnosis of multiple endocrine tumor type 1 (OR 52.31, 95%CI 23.15-118.23), or neurofibromatosis type 1 (OR 16.37, 95%CI 7.24-37.01). Conclusions In a population-based study in the US, using the Explorys database, we found the overall prevalence of NETs of the appendix to be 7 per 100,000 persons. The incidence in the year January 2019-January 2020 was 0.4 per 100,000 individuals. These rates are higher than previously reported and may be more accurate, given the more comprehensive nature of the Explorys database.

Appendiceal Well-Differentiated Neuroendocrine Tumors: A Single-Center Experience and New Insights into the Effective Use of Immunohistochemistry

“…Sixty percent of our patients were female, in keeping with past reports of slight female predominance. 8,16 Our series affected seven children (10%). The mean age was 40 years, consistent with younger age distribution compared to other neuroendocrine tumors of other sites.…”

Epidemiology and risk of colorectal cancer in patients with a history of Helicobacter pylori infection: a population-based study

“…First, it was limited by the use of a large research database that could lead to overpowering and overestimation of the measured outcomes. However, the Explorys database has been validated in multiple fields, including gastroenterology [ 14 , 15 ]. Second, some variables were not accessible; therefore, we could not control for patients who had a history of radiation therapy or a history of CRC, or those who had been using aspirin.…”

“…Access to the database is granted to participating healthcare systems. Use of the Explorys platform has been validated in multiple fields, including gastroenterology [ 14 , 15 ].…”

Non‐alcoholic steatohepatitis is independently associated with a history of gestational diabetes mellitus

“…Use of the Explorys platform has been validated in multiple fields including gastroenterology and endocrinology. [11][12][13] Patient selection. Female patients with age greater than 18 years were included in our cohort.…”