Prior non-comparative data showed increasing incidence of rectal neuroendocrine tumors (RNET) in the US. We aimed to evaluate age-specific RNET incidence rates and time-trends in demographic- and tumor-specific populations. The RNET age-adjusted incidence rates were calculated from the United States Cancer Statistics (USCS) database between 2001 and 2020. The population was stratified by age into older (≥55 years) and younger adults (<55 years), as well as by sex and race. The tumors were categorized by their stage at diagnosis into early and late. The annual percentage change (APC) and average APC (AAPC) were estimated using joinpoint regression and Monte Carlo permutation analysis. Pairwise comparison assessed for parallelism and coincidence. There were 59,846 patients diagnosed with RNET between 2001 and 2020 (50.3% women). Overall, the RNET incidence rates during this period were increasing in younger but not older adults (AAPC = 3.12 vs. −1.10; AAPC difference = 4.22,p< 0.001), with non-identical non-parallel data (p-values < 0.001). While similar results were seen in men, a greater age-specific difference was noted in women (AAPC = 3.31 vs. −1.10; AAPC difference = 4.41,p= 0.003). The difference between younger and older adults was seen in non-Hispanic White (AAPC-difference = 4.89;p< 0.001) and non-Hispanic Black (AAPC-difference = 3.33;p= 0.03) patients, and, in most years, among Hispanic and Non-Hispanic Asian/Pacific Islander patients, and it was mostly driven by early-stage tumors (AAPC-difference = 3.93;p< 0.001). The nationwide data show a significantly increasing RNET incidence in younger adults, most notably in younger women and in early-stage tumors, seen in various races. Future studies should evaluate RNET risk factors and outcomes in demographic-specific populations.
既往非比较性数据显示美国直肠神经内分泌肿瘤发病率呈上升趋势。本研究旨在评估不同年龄段人群及特定人口学与肿瘤特征亚组的发病率及其时间变化趋势。基于2001年至2020年美国癌症统计数据库，计算了直肠神经内分泌肿瘤的年龄调整发病率。研究人群按年龄分为老年组（≥55岁）与年轻组（<55岁），并按性别、种族进行分层。肿瘤根据诊断分期分为早期和晚期。采用连接点回归模型和蒙特卡洛置换分析估算年度百分比变化及平均年度百分比变化，并通过配对比较检验趋势线的平行性与重合性。2001-2020年间共有59,846例直肠神经内分泌肿瘤确诊病例（女性占50.3%）。总体而言，该时期年轻组发病率持续上升而老年组未见增长（平均年度百分比变化=3.12对比-1.10；差值=4.22，p<0.001），两组数据呈非平行非重合趋势（p值均<0.001）。男性群体呈现相似规律，而女性群体的年龄差异更为显著（平均年度百分比变化=3.31对比-1.10；差值=4.41，p=0.003）。这种年龄差异在非西班牙裔白人（平均年度百分比变化差值=4.89，p<0.001）和非西班牙裔黑人（差值=3.33，p=0.03）患者中持续存在，在多数年份也见于西班牙裔及非西班牙裔亚裔/太平洋岛民患者，且主要由早期肿瘤驱动（平均年度百分比变化差值=3.93，p<0.001）。全国数据显示年轻成人直肠神经内分泌肿瘤发病率显著上升，在年轻女性及早期肿瘤患者中尤为明显，这一趋势跨越多种族群体。未来研究应针对特定人口学群体深入探讨直肠神经内分泌肿瘤的危险因素及临床结局。
The Incidence of Rectal Neuroendocrine Tumors Is Increasing in Younger Adults in the US, 2001–2020
肿瘤(癌症)患者之家