Descriptive epidemiology and survival analysis of acromegaly in Korea

Abstract Acromegaly is a rare, slowly progressive disease. Its mechanism is not fully understood, and epidemiological research on Korean patients with acromegaly is scarce. To determine the incidence and prevalence of acromegaly and assess the comorbidities and survival benefits based on treatment options. This nationwide population-based cohort study was conducted using data of the Korean Health Insurance Review and Assessment claims database to evaluate the incidence of newly diagnosed acromegaly cases during 2013–2017. During the 5-year period, 1,093 patients were newly diagnosed with acromegaly. The average annual incidence was 4.2 cases per million per year, and the prevalence was 32.1 cases per million during this period. The incidence of hypertension was low after medical treatment (hazard ratio 0.257, 95% confidence interval: 0.082–0.808, P = 0.0201), but the incidence of diabetes showed no significant difference across treatment modalities. Over a period of 6 years since diagnosis, we found that patients treated for acromegaly had a significantly higher survival rate than those untreated (P = 0.0003). The annual incidence rate of Korean patients with acromegaly was similar to that reported in previous studies. Using nationwide population data, our study emphasized the importance of treatment in acromegaly patients.

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Aplastic Anemia in Thailand: Incidence and Treatment Outcome from a Prospective Nationwide Population-Based Study

Blood ◽

10.1182/blood-2020-137047 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 8-9

Author(s):

Lalita Norasetthada ◽

Somchai Wongkhantee ◽

Jindaratn Chaipokam ◽

Kanyaporn Charoenprasert ◽

Suporn Chuncharunee ◽

...

Keyword(s):

Aplastic Anemia ◽

Anabolic Steroid ◽

Real World ◽

Conflicts Of Interest ◽

Bone Marrow Failure ◽

Population Based ◽

Annual Incidence ◽

Severe Aplastic Anemia ◽

Treatment Modalities ◽

Population Based Study

Background: Incidence of Aplastic Anemia (AA) in Asia tends to be higher than in western countries, but contemporary real-world incidence and outcomes of AA in Asia remain limited. This study aimed to explore the incidence across the country regions and to evaluate the patient outcomes according to age, the severity of disease, and treatment modalities. Method: This is a prospective multicenter nationwide population-based observational study of patients with AA aged over 15 years old, diagnosed between August 1st, 2014 to July 31st, 2016, with a longitudinal follow-up period over 2 years, from 30 medical centers. Patients with suspected hypocellular MDS and congenital bone marrow failure syndrome were excluded. Results: During the study period of 2 years, there were 348 newly diagnosed patients with aplastic anemia, giving the annual incidence of 4.6 per million inhabitants. There was a higher annual incidence of severe (SAA) and very severe aplastic anemia (VSAA) (3.8 per million) than non-severe aplastic anemia (NSAA) (0.8 per million). The incidence was greater among older patients with a peak incidence in patients aged 60-89 years old. (Figure 1) There was a high variation in the geographic incidences across country regions, ranging from 2.6 to 6.6 per million per year. (Figure 2) The 2-year overall survival (OS) for NSAA, SAA, and VSAA were 65.5%, 49.3%, and 20.1%, respectively (P < 0.001). Patients aged older than 60 years had the worst OS (42.6% as compared with 47.7% for the age 41-60 years and 64.5% for the age 15-40 years, P = 0.002). Among patients with SAA and VSAA (n = 280), the overall response rate (ORR) among patients treated with rabbit anti-thymocyte globulin and/or cyclosporin A (rATG±CsA) was significantly superior than those treated with CsA-based therapy and those treated with anabolic steroid (44.4% vs. 36.4% and 31.2%, respectively, P < 0.001). Among evaluable patients, ORR after the 1st treatment with rATG±CsA at 3, 6, 12 and 24 months were 23.9%, 43.8%, 68.4% and 89.2%, respectively. The 2-year OS among SAA/VSAA patients treated with rATG±CsA, CsA-based therapy, and anabolic steroid were 54.8%, 54.5%, and 37.6% (P = 0.037), respectively (Figure 3). From multivariate analysis, age > 60 years (HR 1.63, 95%CI, 1.14-2.33, P = 0.007), VSAA (HR 2.24, 95% CI, 1.45-3.46, P < 0.001) and not receiving immunosuppressive therapy or anabolic steroid (HR 4.96, 95%CI, 2.88-8.54, P <0.001), were independently associated with inferior OS among patients with SAA/VSAA. Conclusion: The incidence rate of AA in Thailand from this contemporary nationwide population-based study is high, especially in the elderly. Patients treated with rATG±CsA had superior survival than those receiving anabolic steroid. The real-world outcome of patients with SAA/VSAA, especially in those aged over 60 years, is substantially poor. Figure 1 Disclosures No relevant conflicts of interest to declare.

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Increasing trends in the prevalence of prior cancer in newly diagnosed lung, stomach, colorectal, breast, cervical, and corpus uterine cancer patients: A population-based study

10.21203/rs.3.rs-41046/v2 ◽

2021 ◽

Author(s):

Akira Sato ◽

Keisuke Matsubayashi ◽

Toshitaka Morishima ◽

Kayo Nakata ◽

Koji Kawakami ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Research ◽

Cancer Patients ◽

Uterine Cancer ◽

Treatment Options ◽

Temporal Trends ◽

Treatment Strategies ◽

Population Based ◽

Trend Test ◽

Newly Diagnosed

Abstract Background: Cancer survivors are frequently excluded from clinical research, resulting in their omission from the development of many cancer treatment strategies. Quantifying the prevalence of prior cancer in newly diagnosed cancer patients can inform research and clinical practice. This study aimed to describe the prevalence, characteristics, and trends of prior cancer in newly diagnosed cancer patients in Japan. Methods: Using Osaka Cancer Registry data, we examined the prevalence, characteristics, and temporal trends of prior cancer in patients who received new diagnoses of lung, stomach, colorectal, female breast, cervical, and corpus uterine cancer between 2004 and 2015. Site-specific prior cancers were examined for a maximum of 15 years before the new cancer was diagnosed. Temporal trends were evaluated using the Cochran-Armitage trend test. Results: Among 275,720 newly diagnosed cancer patients, 21,784 (7.9%) had prior cancer. The prevalence of prior cancer ranged from 3.3% (breast cancer) to 11.1% (lung cancer). In both sexes, the age-adjusted prevalence of prior cancer had increased in recent years (P values for trend < 0.001), especially in newly diagnosed lung cancer patients. The proportion of smoking-related prior cancers exceeded 50% in patients with newly diagnosed lung, stomach, colorectal, breast, and cervical cancer. Conclusions: The prevalence of prior cancer in newly diagnosed cancer patients is relatively high, and has increased in recent years. Our findings suggest that a deeper understanding of the prevalence and characteristics of prior cancer in cancer patients is needed to promote more inclusive clinical research and support the expansion of treatment options.

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ACTR-38. A SINGLE CENTER STUDY: LONG-TERM OUTCOMES OF COMBINED CHEMORADIATION THERAPY WITH TEMOZOLOMIDE FOR NEWLY DIAGNOSED GLIOBLASTOMA IN KOREAN PATIENT

Neuro-Oncology ◽

10.1093/neuonc/noz175.080 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi21-vi21

Author(s):

Kyeong-O Go ◽

Ha Young Yang ◽

Kihwan Hwang ◽

Jung Ho Han ◽

Hyoung Soo Choi ◽

...

Keyword(s):

Radiation Therapy ◽

Adjuvant Treatment ◽

Genetic Factors ◽

Newly Diagnosed ◽

Factors Affecting ◽

Korean Patients ◽

Significant Difference ◽

Newly Diagnosed Glioblastoma

Abstract In newly diagnosed glioblastoma (GBM), Temozolomide (TMZ) during and after radiation therapy has become standard treatment. This study describes the long-term use and follow-up results of this therapy for GBM. From 2004 to 2013 in a single institute, 112 Korean patients with newly diagnosed GBM were analyzed retrospectively. The Kaplan-Meier method, the two-sided log-rank test and Cox’s regression analysis was used to determine survival and its affecting factors. The toxicities of TMZ were evaluated using CTCAE v5.0. During the median follow-up period of 18.8 months, median PFS and OS were 9.2 and 20.3 months, respectively. This better survival outcome than the Stupp’s original study might be probably a large treatment effect of a single institution, ethnicity, and associated genetic factors. The TMZ during radiation therapy was completed in 108 patients (96.4%) and TMZ after radiation therapy in 59 patients (52.7%). Eight patients presented with grade 3 or 4 hematologic toxic effects during the protocol. Sixty-six patients (58.9%) received salvage treatment because of the poor response to adjuvant treatment or progression of the disease who achieved completion of adjuvant treatment was shown significantly longer median OS (p= 0.007) and PFS (p< 0.001). Age (< 60 years), preoperative KPS score (≥ 90), the extent of resection (≥ 78% by volumetric measurement, gross total resection), and completion of the Stupp’s protocol were significant factors affecting better survival. Between the sexes, and ages over 65 years did not show any significant difference among their groups. With marginal significances, the mutated IDH-1 and the methylated MGMT promoter showed longer median PFS(p= 0.075 and 0.777, respectively) and OS (p= 0.085 and 0.131, respectively). TMZ during and after radiation therapy might be effective and safe for newly diagnosed Korean patients with GBM. Further studies about various clinical and genetic factors affecting better survival are mandatory.

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A60 THE INCIDENCE OF INFLAMMATORY BOWEL DISEASE IS DECREASING IN SASKATCHEWAN: A POPULATION-BASED COHORT STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.059 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 71-73

Author(s):

J A Osei ◽

J Peña-Sánchez ◽

S Fowler ◽

N Muhajarine ◽

G G Kaplan ◽

...

Keyword(s):

Health Care ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Population Based ◽

Incidence Rates ◽

Age Group ◽

Newly Diagnosed ◽

Average Annual Incidence ◽

Inflammatory Bowel ◽

Group Sex

Abstract Background Canada has one of the highest inflammatory bowel disease (IBD) incidence rates worldwide, although within Canada rates vary. Evidence show increasing incidence rates of IBD in Ontario (i.e. adults aged 30–60), stable in Alberta and decreasing in Manitoba. Additionally, higher incident rates of IBD have been identified among urban regions compared to rural regions. There is limited data on the incidence of IBD in Saskatchewan. Aims The study objectives were to 1) estimate IBD incidence rates in Saskatchewan from 1999 to 2016, and 2) test for differences in IBD incidence rates for rural and urban regions of Saskatchewan. Methods A population-based study was conducted using linked provincial administrative health databases. Individuals age 18+ old with newly diagnosed Crohn’s disease (CD) or ulcerative colitis (UC) were identified using a validated case definition. Generalized linear models with a negative binomial distribution were used to estimate incidence rates and incidence rate ratios (IRR) adjusted for age group, sex, and rurality with 95% confidence intervals (95%CI). Results In total, 4,908 newly diagnosed individuals with IBD were included. The average annual incidence rate of IBD decreased from 75 (95%CI 67–84) per 100,000 people in 1999 to 15 (95%CI 12–18) per 100,000 population in 2016. This decrease was evident in both UC (from 36/100,000 [95%CI 31–42] in 1999 to 6/100,000 [95%CI 4–8] in 2016) and CD (37/100,000 [95%CI 32–42] in 1999 to 8/100,000 [95%CI 6–10] in 2016). A significant decline of 6.9% (95%CI 6.2–7.6) in the average annual incidence of IBD was estimated between 1999 and 2016 (see Figure 1). Urban residents had a greater overall risk of IBD (IRR=1.19, 95%CI 1.11–1.27) than rural residents. This risk difference was statistically significant for CD (IRR=1.25, 95%CI 1.14–1.36), but not UC (IRR=1.08, 95%CI 0.97–1.19). Conclusions A decreasing trend in IBD incidence in Saskatchewan was identified after adjusting for age group, sex, and rural/urban region of residence. Around 150 new cases of IBD are still diagnosed annually in Saskatchewan, but this estimate is lower than estimates from other provinces. Urban dwellers have a 25% higher risk of CD onset compared to their rural counterparts. This finding could suggest the presence of specific risk factors in urban settings that require further investigation. Health care providers and decision-makers should plan IBD-specific health care programs taking into account these specific IBD rates in Saskatchewan. Funding Agencies College of Medicine, University of Saskatchewan

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Comparative effectiveness of radical cystectomy versus bladder-sparing treatment for muscle-invasive urothelial carcinoma: A population-based report.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.334 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 334-334 ◽

Cited By ~ 1

Author(s):

Maxine Sun ◽

Giorgio Gandaglia ◽

Pierre I. Karakiewicz ◽

Jim C. Hu ◽

Simon P. Kim ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Radical Cystectomy ◽

Advanced Disease ◽

Population Based ◽

Disease Stage ◽

Treatment Modalities ◽

Radiation Hazard ◽

Survival Outcomes ◽

Significant Difference ◽

Muscle Invasive

334 Background: Radical cystectomy (RC) represents the standard of care for patients with muscle-invasive urothelial carcinoma of the urinary bladder (UCUB). Alternative organ-conserving treatments such as chemotherapy and/or radiotherapy have gained interest. We sought to compare survival outcomes of patients according to treatment modalities, in a stage-for-stage analysis. Methods: We relied on the Surveillance, Epidemiology, and End Results Medicare-linked database to identify 12,950 patients diagnosed with T2–T4a N0/x M0 UCUB between years 1992 and 2009. Treatment types include RC (n=5207), chemotherapy/radiation (n=2,669), and surveillance (n=5,074). Following instrumental variable analysis, Cox- and competing-risks regression analyses were performed for prediction of overall survival (OS) and cancer-specific mortality (CSM), respectively. All analyses were stratified according to disease stage (T2, T3, T4a). Results: After adjusting for potential confounders, OS was more favorable for RC relative to chemotherapy/radiation (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.02–2.40) or surveillance (HR: 1.82, 95% CI: 1.20–2.78) in patients with T2 UCUB. For the same stage, CSM rates were lower in the surgery group compared to chemotherapy/radiation (HR: 2.05, 95% CI: 1.14–3.67) or surveillance (HR: 1.95, 95% CI: 1.09–3.48). When analyses focused on individuals with more advanced disease (T3–T4a), no statistically significant difference was observed between chemotherapy/radiation relative to RC for both OS and CSM. Conclusions: In the current retrospective population-based cohort, RC was associated with improved survival outcomes relative to its alternative treatment counterparts. However, this effect was only observable in patients with T2 disease. Conversely, no difference between chemotherapy/radiation vs. surgery was noted in patients with more advanced disease stage.

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Recent epidemiology of patients with Gastro-Entero-Pancreatic Neuroendocrine Neoplasms (GEP-NEN) in Japan: a population-based study

10.21203/rs.3.rs-18847/v2 ◽

2020 ◽

Author(s):

Toshihiko Masui ◽

Tetsuhide Ito ◽

Izumi Komoto ◽

Shinji Uemoto

Keyword(s):

Cancer Registry ◽

Population Data ◽

Population Based ◽

National Registry ◽

Neuroendocrine Neoplasms ◽

Population Based Study ◽

National Cancer Registry ◽

Exact Etiology ◽

Using Data ◽

Population Based Registry

Abstract Background: The worldwide prevalence and incidence of neuroendocrine neoplasms (NEN) have been increasing recently, although few studies have analyzed data on the current situation of NENs in Japan. Here, the Japan Neuroendocrine Tumor Society (JNETS) planned to investigate the recent incidence and distribution of these tumors using data from the national cancer registry started in 2016. This study examined the incidence and distribution of primary sites as well as disease progression from this population-based registry. Methods: A retrospective, population-based study using data from the national cancer registry in Japan (NCR) was conducted to evaluate patients with gastro-entero-pancreatic NEN (GEP-NEN) in 2016. Associated population data were used to determine annual age-adjusted incidences. Results: A total of 6735 individuals were diagnosed with GEP-NEN in Japan in 2016. Annual onset incidence was 0.70/100,000 for pancreatic NEN and 2.84/100,000 for gastrointestinal NEN. NEN in the ileum accounted for only 1% of total GEP-NENs in Japan. Most NENs in the esophagus or lungs were neuroendocrine carcinomas (NECs), while the majority of those in the duodenum, ileum, appendix and rectum were grade 1 neuroendocrine tumors (NETs). Median age at initial diagnosis was in between 60 to 65. Initial progression of the tumor was mostly limited to local for tumors in the duodenum, appendix and rectum, while those in the esophagus, stomach and colon tended to show distant metastasis. In Japan, initial treatment for GEP-NENs was resection even if the tumor was NEC.Conclusions: This is the first report of a national registry-based incidence and distribution of GEP-NEN in Japan. These data will serve as an important first step to determining the exact etiology and trends for this pathology in Japan.

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Recent epidemiology of patients with Gastro-Entero-Pancreatic Neuroendocrine Neoplasms (GEP-NEN) in Japan: a population-based study

10.21203/rs.3.rs-18847/v4 ◽

2020 ◽

Author(s):

Toshihiko Masui ◽

Tetsuhide Ito ◽

Izumi Komoto ◽

Shinji Uemoto ◽

project study group

Keyword(s):

Cancer Registry ◽

Population Data ◽

Population Based ◽

National Registry ◽

Neuroendocrine Neoplasms ◽

Population Based Study ◽

National Cancer Registry ◽

Exact Etiology ◽

Using Data ◽

Population Based Registry

Abstract Background: The worldwide prevalence and incidence of neuroendocrine neoplasms (NEN) have been increasing recently, although few studies have analyzed data on the current situation of NENs in Japan. Here, the Japan Neuroendocrine Tumor Society (JNETS) planned to investigate the recent incidence and distribution of these tumors using data from the national cancer registry started in 2016. This study examined the incidence and distribution of primary sites as well as rate of advanced disease from this population-based registry.Methods: A retrospective, population-based study using data from the national cancer registry in Japan (NCR) was conducted to evaluate patients with gastro-entero-pancreatic NEN (GEP-NEN) in 2016. Associated population data were used to determine annual age-adjusted incidences.Results: A total of 6735 individuals were diagnosed with GEP-NEN in Japan in 2016. Annual onset incidence was 0.70/100,000 for pancreatic NEN and 2.84/100,000 for gastrointestinal NEN. NEN in the ileum accounted for only 1% of total GEP-NENs in Japan. Most NENs in the esophagus or lungs were neuroendocrine carcinomas (NECs), while the majority of those in the duodenum, ileum, appendix and rectum were grade 1 neuroendocrine tumors (NETs). Median age at initial diagnosis was in between 60 to 65. Tumors in the duodenum, appendix and rectum were mostly limited to local, while those in the esophagus, stomach and colon tended to show distant metastasis. In Japan, initial treatment for GEP-NENs was resection even if the tumor was NEC.Conclusions: This is the first report of a national registry-based incidence and distribution of GEP-NEN in Japan. These data will serve as an important first step to determining the exact etiology and trends for this pathology in Japan.

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Increasing trends in the prevalence of prior cancer in newly diagnosed lung, stomach, colorectal, breast, cervical, and corpus uterine cancer patients: a population-based study

BMC Cancer ◽

10.1186/s12885-021-08011-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Akira Sato ◽

Keisuke Matsubayashi ◽

Toshitaka Morishima ◽

Kayo Nakata ◽

Koji Kawakami ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Research ◽

Cancer Patients ◽

Uterine Cancer ◽

Treatment Options ◽

Temporal Trends ◽

Treatment Strategies ◽

Population Based ◽

Trend Test ◽

Newly Diagnosed

Abstract Background Cancer survivors are frequently excluded from clinical research, resulting in their omission from the development of many cancer treatment strategies. Quantifying the prevalence of prior cancer in newly diagnosed cancer patients can inform research and clinical practice. This study aimed to describe the prevalence, characteristics, and trends of prior cancer in newly diagnosed cancer patients in Japan. Methods Using Osaka Cancer Registry data, we examined the prevalence, characteristics, and temporal trends of prior cancer in patients who received new diagnoses of lung, stomach, colorectal, female breast, cervical, and corpus uterine cancer between 2004 and 2015. Site-specific prior cancers were examined for a maximum of 15 years before the new cancer was diagnosed. Temporal trends were evaluated using the Cochran-Armitage trend test. Results Among 275,720 newly diagnosed cancer patients, 21,784 (7.9%) had prior cancer. The prevalence of prior cancer ranged from 3.3% (breast cancer) to 11.1% (lung cancer). In both sexes, the age-adjusted prevalence of prior cancer had increased in recent years (P values for trend < 0.001), especially in newly diagnosed lung cancer patients. The proportion of smoking-related prior cancers exceeded 50% in patients with newly diagnosed lung, stomach, colorectal, breast, and cervical cancer. Conclusions The prevalence of prior cancer in newly diagnosed cancer patients is relatively high, and has increased in recent years. Our findings suggest that a deeper understanding of the prevalence and characteristics of prior cancer in cancer patients is needed to promote more inclusive clinical research and support the expansion of treatment options.

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Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-019-51801-w ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Chan Soon Park ◽

Eue-Keun Choi ◽

Bongseong Kim ◽

Kyung-Do Han ◽

So-Ryoung Lee ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Atrial Fibrillation ◽

Mycobacterial Infection ◽

Population Based ◽

Newly Diagnosed ◽

Increased Risk ◽

Significant Difference ◽

Risk Patients ◽

The Impact

Abstract NTM infection demonstrates an increasing incidence and prevalence. We studied the impact of NTM in cardiovascular events. Using the Korean nationwide database, we included newly diagnosed 1,730 NTM patients between 2005 and 2008 and followed up for new-onset atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), ischemic stroke (IS), and death. Covariates-matched non-NTM subjects (1:5, n = 8,650) were selected and analyzed. Also, NTM infection was classified into indolent or progressive NTM for risk stratification. During 4.16 ± 1.15 years of the follow-up period, AF, MI, HF, IS, and death were newly diagnosed in 87, 125, 121, 162, and 468 patients. In multivariate analysis, NTM group showed an increased risk of AF (hazard ratio [HR] 2.307, 95% confidence interval [CI] 1.560–3.412) and all-cause death (HR 1.751, 95% CI 1.412–2.172) compared to non-NTM subjects, whereas no significant difference in MI (HR 0.868, 95% CI 0.461–1.634), HF (HR 1.259, 95% CI 0.896–2.016), and IS (HR 1.429, 95% CI 0.981–2.080). After stratification, 1,730 NTM patients were stratified into 1,375 (79.5%) indolent NTM group and 355 (20.5%) progressive NTM group. Progressive NTM showed an increased risk of AF and mortality than indolent NTM group. Screening for AF and IS prevention would be appropriate in these high-risk patients.

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Recent epidemiology of patients with Gastro-Entero-Pancreatic Neuroendocrine Neoplasms (GEP-NEN) in Japan: a population-based study

10.21203/rs.3.rs-18847/v5 ◽

2020 ◽

Author(s):

Toshihiko Masui ◽

Tetsuhide Ito ◽

Izumi Komoto ◽

Shinji Uemoto ◽

project study group

Keyword(s):

Cancer Registry ◽

Population Data ◽

Population Based ◽

National Registry ◽

Neuroendocrine Neoplasms ◽

Population Based Study ◽

National Cancer Registry ◽

Exact Etiology ◽

Using Data ◽

Population Based Registry

Abstract Background: The worldwide prevalence and incidence of neuroendocrine neoplasms (NEN) have been increasing recently, although few studies have analyzed data on the current situation of NENs in Japan. Here, the Japan Neuroendocrine Tumor Society (JNETS) planned to investigate the recent incidence and distribution of these tumors using data from the national cancer registry started in 2016. This study examined the incidence and distribution of primary sites as well as rate of advanced disease from this population-based registry.Methods: A retrospective, population-based study using data from the national cancer registry in Japan (NCR) was conducted to evaluate patients with gastro-entero-pancreatic NEN (GEP-NEN) in 2016. Associated population data were used to determine annual age-adjusted incidences.Results: A total of 6735 individuals were diagnosed with GEP-NEN in Japan in 2016. Annual onset incidence was 0.70/100,000 for pancreatic NEN and 2.84/100,000 for gastrointestinal NEN. NEN in the ileum accounted for only 1% of total GEP-NENs in Japan. Most NENs in the esophagus or lungs were neuroendocrine carcinomas (NECs), while the majority of those in the duodenum, ileum, appendix and rectum were grade 1 neuroendocrine tumors (NETs). Median age at initial diagnosis was in between 60 to 65. Tumors in the duodenum, appendix and rectum were mostly limited to local, while those in the esophagus, stomach and colon tended to show distant metastasis. In Japan, initial treatment for GEP-NENs was resection even if the tumor was NEC.Conclusions: This is the first report of a national registry-based incidence and distribution of GEP-NEN in Japan. These data will serve as an important first step to determining the exact etiology and trends for this pathology in Japan.

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