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Small Bowel Adenocarcinoma: a Nationwide Population-Based Study

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Abstract

Purpose

Small intestinal cancers have a non-specific clinical presentation and hence a delayed diagnosis. The prevalence of small intestinal cancers is low, and there are no cost-effective methods of screening. This study aimed to identify clinical characteristics of duodenal and jejunal adenocarcinomas that can assist in the early detection and diagnosis of disease.

Methods

Duodenal adenocarcinoma and jejunal adenocarcinoma in Explorys database (1999–2019) were compared using odds ratio (OR) with 95% confidence intervals. Data on demographic characteristics, risk factors, clinical features, and treatment were collected.

Results

Out of a total of 8100 patients with a diagnosis of primary adenocarcinoma of the small intestine, 5110 are primary adenocarcinoma of duodenum (63%), and 600 are primary adenocarcinoma of jejunum (7.4%). Patients with jejunal adenocarcinoma when compared with patients with duodenal adenocarcinoma are more obese (OR, 1.36) and have a significantly higher prevalence of malignant neoplasm of colon (OR, 3.07), Crohn’s disease (OR, 4.42), and celiac disease (OR, 2.48). Jejunal adenocarcinoma patients presented more frequently with intestinal obstruction (OR, 1.99), whereas duodenal adenocarcinoma patients more commonly presented with iron deficiency anemia (OR, 0.16). Patients with jejunal adenocarcinoma are less likely to undergo therapy with anti-neoplastic agents when compared with duodenal adenocarcinoma (OR, 0.81). There are no differences in patients undergoing surgical intervention or a combination of surgical intervention and antineoplastic therapy.

Conclusions

Jejunal adenocarcinoma is more commonly associated with colorectal cancer, celiac disease, and Crohn’s disease. They also had lower odds of requiring chemotherapeutic agents.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA

    Abdul Mohammed, Neethi Paranji & Nisheet Waghray

  2. Department of Internal Medicine, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA

    Sophie Trujillo & Sara Ghoneim

Authors
  1. Abdul Mohammed
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  2. Sophie Trujillo
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  3. Sara Ghoneim
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  4. Neethi Paranji
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  5. Nisheet Waghray
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Contributions

All the authors contributed to the study conception and design. Abdul Mohammed, Sophie Trujillo, and Sara Ghoneim performed the material preparation, analysis, and preparation of the manuscript. Critical review of the manuscript and final editing were performed by Neethi Paranji and Nisheet Waghray. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Abdul Mohammed or Nisheet Waghray.

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Ethics Approval

This is an observational study. The MetroHealth Research Ethics Committee has confirmed that no ethical approval is required.

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The authors declare no competing interests.

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Mohammed, A., Trujillo, S., Ghoneim, S. et al. Small Bowel Adenocarcinoma: a Nationwide Population-Based Study. J Gastrointest Canc 54, 67–72 (2023). https://doi.org/10.1007/s12029-021-00653-7

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  • DOI: https://doi.org/10.1007/s12029-021-00653-7

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