Geographic and demographic features of neuroendocrine tumors in the United States of America: A population‐based study

Abstract

BACKGROUND: The incidence of neuroendocrine tumors (NETs) is rapidly rising. There are very few studies investigating the role of sociodemographic factors in NETs. This study was aimed at examining how geographic and sociodemographic characteristics shape outcomes in the NET population. METHODS: A retrospective analysis using the Surveillance, Epidemiology, and End Results database was performed, and the NET patient population from 1973 to 2015 was studied. Univariate and multivariable analyses were performed to evaluate patients' disease-specific survival (DSS) and overall survival (OS). Geographic and sociodemographic factors, including the location of residence (urban area [UA] vs rural area [RA]), sex, race, insurance status, and marital status, were included in the analysis. RESULTS: A total of 53,034 patients (5517 in RAs and 47,517 in UAs) were included in the analysis. The incidence of NETs was found to be rising in both RAs and UAs but more rapidly in RAs (with the highest incidence in 2006-2015: 5.93 per 100,000 in RAs vs 4.10 per 100,000 in UAs). Patients from RAs presented at advanced stages in comparison with patients from UAs (regional, 18% vs 16%; distant, 15% vs 13%; P < .01). In the multivariable model, RA patients had a trend toward poorer OS (hazard ratio, 1.05; P = .053) in comparison with UA patients. The multivariable analysis showed significantly worse DSS and OS for uninsured, single, and male patients in comparison with insured, married, and female patients, respectively. CONCLUSIONS: This study has identified sociodemographic disparities in NET outcomes. Access to health care could be a potential contributing factor, although differences in environmental exposure, health behavior, and tumor biology could also be responsible. Cancer 2020;126:792-799.

[Retracted] Epidemiological Analysis and Prognosis of Conjunctival Cancer in the Past Twenty Years: A Population‐Based Retrospective Study Using SEER Data

“…Our study is the first to demonstrate that being single, divorced, or widowed is a risk factor associated with primary site-labeled conjunctival and corneal cancer incidence. Prior studies have primarily only examined the relationship between marital status and other forms of cancer including colorectal cancer [ 22 ], neuroendocrine tumors [ 23 ], and gastric adenocarcinoma [ 24 ] in retrospective [ 25 ] analyses or in prospective analyses [ 26 ]. While several studies have assessed the relationship between marital status and patient prognosis, conclusions have varied significantly among studies.…”

Incidence, prevalence, and survival trends for neuroendocrine neoplasms in Victoria, Australia, from 1982 to 2019: Based on site, grade, and region

“…The first was the US‐based Surveillance, Epidemiology, and End Results (SEER) Program registry analysis, including 35,618 NEN patients, that reported a significant increase in the annual age‐adjusted incidence from 1.09/100,000 in 1973 to 5.25/100,000 in 2004 6 . The most rapid increase has been in the age bracket 40–69 years, 5,11 , localized disease, primary tumoral sites especially small bowel, 8 rectum then stomach, 5,7,12 across all histological grades, 2 and in rural and urban regions 13 …”

Prognostic Impact of Tumor Size on Pancreatic Neuroendocrine Tumor Recurrence May Have Racial Variance

“…As there is a significant difference in racial composition between urban and rural populations, this begs the question of the role of race in neuroendocrine cancer outcomes. 13 Although Black patients comprised 12.8% to 13.7% of patients in the database studies, 24.5% of our patients were Black due to our unique position as the sole comprehensive cancer center in a state with one of the largest African American populations. 6,11,12 In addition, although 59.0% of the Alabama state population is located in urban areas, 95.6% of the state land area is rural.…”

“…These studies found rural patients have an increased incidence of neuroendocrine tumors with an associated decreased OS and DFS as compared with urban populations. [13][14][15] However, there were significant confounders to this geographic disparity, such as income, race, and marital status. As there is a significant difference in racial composition between urban and rural populations, this begs the question of the role of race in neuroendocrine cancer outcomes.…”