Anas Raed, MD1, Amol Sharma, MD1, Shreyu Umapathy, 2, Subbaramia Sridhar, MBBS, MPH, FRCP, FRCPC, FACG3, John Erikson Yap, MD4, Humberto Sifuentes, MD5 1Augusta University, Augusta, GA; 2August Georg University, Augusta, GA; 3AUMC, Augusta, GA; 4Medical College of Georgia at Augusta University, Augusta, GA; 5Medical College of Georgia, Augusta, GA
Introduction: While the small intestine comprises the largest part of gastrointestinal (GI) tract, small intestinal cancers (SIC) are rare and only account for 5% of newly diagnosed cancer of the GI tract. The objectives of our study were to: 1. Assess the annual percent change (APC) of SIC among the US population younger and older than 50; 2. Explore the APC among these two populations by histology type, location, gender, and race.
Methods: We utilized the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) programs to distinguish all the cases of SIC diagnosed between 2001 & 2016. The cases of SIC were identified using the site from the ICD code for Oncology (ICD-O-3), coded as “small intestine”. The age-adjusted incidence and APC were then calculated.
Results: There were 132,876 SIC cases between 2001 & 2016, with 114,476 (86.2%) cases ≥50 years. Females 46.3%, Caucasians 81.7%, African-Americans 14.6% and Others 3.7%. A total of 26.8% were adenocarcinoma, 49.2% neuroendocrine, 14.3% lymphoma & 9.7% sarcoma. 34% cases were located in the duodenum, 10.3% were in the jejunum, 26.1% were in the ileum, 29.6% were unspecified site. An increase in the incidence rates of SIC was noted in all age groups since 2001, but was higher in the age group < 50 years with APC 2.6 (CI: 2.2-3.0). With regards to the histology, increased incidence were noted in the neuroendocrine tumors, followed by sarcoma, adenocarcinoma in that order with an APC 3.3 (CI: 2.8, 3.8), 2.3 (CI: 1.4, 3.2) & 0.7 (CI: 0.5, 0.9), respectively. On the other hand, lymphomas showed decreased incidence with APC 1.0 (CI: -1.6, -0.4). The incidence rates have increased in females more than males with APC 2.0 (CI: 1.7, 2.4) vs 1.5 (CI: 1.1, 1.8). The African-Americans have highest increased risk with APC 2.1 (CI: 1.7, 2.4), when compared to others with APC 2.0 (CI: 1.4, 2.6), or Caucasians 1.7 (CI: 1.3, 2.1). The duodenum had the highest increased rate with APC 2.8 9 (CI: 2.4, 3.1). The APC was greatest in the age group 55-59 years (2.6, [CI: 2.0, 3.1]). Among individuals < 50 years, age 40-44 years had highest increased risk with APC 3.2 (CI: 2.6, 3.8).
Discussion: The incidence of SIC is rapidly increasing among multiple histology types, especially in all women younger than 50 years, with highest increased rates among the African-Americans. The duodenum is the location with the highest increased rate. All attempts at intervention is required to reduce the risk of this disease.
Anas Raed indicated no relevant financial relationships.
Amol Sharma indicated no relevant financial relationships.
Shreyu Umapathy indicated no relevant financial relationships.
Subbaramia Sridhar indicated no relevant financial relationships.
John Erikson Yap indicated no relevant financial relationships.
Humberto Sifuentes indicated no relevant financial relationships.
Anas Raed, MD1, Amol Sharma, MD1, Shreyu Umapathy, 2, Subbaramia Sridhar, MBBS, MPH, FRCP, FRCPC, FACG3, John Erikson Yap, MD4, Humberto Sifuentes, MD5. P3012 - Minority and Women’s Health Disparities: Small Intestinal Cancer Updates, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.