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The Rise in Appendiceal Cancer Incidence: 2000–2009

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

Appendiceal cancer is a rare and potentially aggressive malignancy. The objectives of this study were to characterize secular demographic patterns of disease and to determine survival by using a population-based data source.

Methods

Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of patients treated from 2000–2009.

Results

We identified 4765 patients with appendiceal cancer. The incidence of appendiceal cancer increased by 54 % from 2000 (0.63 per 100,000) to 2009 (0.97 per 100,000 population). Incidence rates increased across all tumor types, stages, age groups, and gender. The most common malignancies were mucinous adenocarcinoma (38 %), followed by carcinoids (28 %), adenocarcinoma-not otherwise specified (NOS) (27 %), and signet ring cell adenocarcinoma (7 %). Larger tumor size and older patient age were significantly associated with higher relative odds of distant disease at diagnosis (P < 0.0001). Patient and demographic characteristics were significantly associated with higher relative hazard of death (P < 0.0001).

Conclusions

Although appendiceal cancer is rare, the incidence increased significantly in the USA from 2000 to 2009. The cause of this trend is not obvious. We did not observe increases differentially associated with stage, histology, or demographic characteristics. Further investigation is needed to examine factors underlying this increase.

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Funding for this study

This research was generously supported by the Betti Boers Maloney Appendiceal Cancer Research Fund at the University of Minnesota Foundation

Conflicts of interest

No financial disclosures/conflicts of interest.

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Authors

Corresponding author

Correspondence to Schelomo Marmor.

Appendix

Appendix

Stepwise Ascertainment of Final Pool of Patients

  • Start: Appendiceal cancer cases diagnoses 2000–2009 (code 8013, 8240, 8241, 8243, 8244, 8245, 8246, 8249, 8574, 8140, 8144, 8210, 8211, 8220, 8255, 8260, 8261, 8262, 8263, 8440, 8000, 8010, 8470, 8471, 8480, 8481, 8490): 4876

  • After excluding cases diagnosed in a nursing home, by autopsy, or on death certificate: 4839

  • After excluding in situ cases and cases without microscopic confirmation: 4768

  • After excluding cases from Alaska and Rural Georgia (<5 cases): 4765

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Marmor, S., Portschy, P.R., Tuttle, T.M. et al. The Rise in Appendiceal Cancer Incidence: 2000–2009. J Gastrointest Surg 19, 743–750 (2015). https://doi.org/10.1007/s11605-014-2726-7

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  • DOI: https://doi.org/10.1007/s11605-014-2726-7

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