Retrospective cohort study of incidence and survival of gastro-entero-pancreatic neuroendocrine neoplasms

Diagnostic practices, awareness, and care delivery for gastro-enetero-pancreatic neuroendocrine neoplasms (GEP-NENs) have evolved substantially. A population-based, retrospective cohort study in Ontario, Canada, investigated trends in incidence, overall survival and cancer-specific survival for GEP-NENs over the past two decades. Among 12 877 individuals diagnosed with GEP-NENs from 2000 to 2023 (median age 61 years; IQR 50-71; 48.4% female), the incidence of GEP-NENs increased from 1.83 to 7.46 per 100 000, predominantly due to nonmetastatic disease (1.48 to 7.46 per 100 000). Incidence was highest for small intestine primaries, followed by rectum, pancreas, appendix, stomach, and colon. The 10-year overall survival was 63.3% (95% CI 62.3-64.3) and the 10-year cancer specific-survival was 76.4% (75.6-77.3). Cancer-specific survival exceeded 90.0% at 10 years for patients without metastases at diagnosis but was 51.3% (95% CI 49.7-52.8) for patients with metastases at diagnosis. The authors conclude that these findings suggest that the rising burden of GEP-NENs largely reflects increased detection of early-stage disease.