Abstract
Background and Aims
Most carcinoid tumors of the gastrointestinal tract are located in the small bowel (SB). Epidemiological studies of these tumors have been limited by small sample sizes. Our aim was to evaluate the epidemiology of SB carcinoids (SBCs) using a large database.
Methods
We queried a commercial database (Explorys), an aggregate of electronic health data from 26 US healthcare systems. We identified patients with SBCs between 2012 and 2017. We evaluated the epidemiology of SBC and identified possible risk factors.
Results
Of the 35,798,290 individuals in the database between 2012 and 2017, we identified 3280 patients with SBCs, with a prevalence of 9.2/100,000. Prevalence was higher in men [odds ratio (OR) 1.23, 95% confidence interval (CI) 1.153–1.322, p < 0.0001], whites [OR 2.031, 95% CI 1.872–2.203, p < 0.0001], and elderly (aged > 65) [OR 4.856, 95% CI 4.533–5.203, p < 0.0001]. Patients with SBCs were more likely to have a history of smoking [OR 2.749, 95% CI 2.549–2.970, p < 0.0001], alcohol use [OR 2.031, 95% CI 1.864–2.21, p < 0.0001], obesity (BMI > 30) [OR 3.476, 95% CI 3.213–3.761, p < 0.0001], diabetes mellitus [OR 4.198, 95% CI 3.900–4.519, p < 0.0001], and a family history of cancer [OR 5.902, 95% CI 5.396–6.456, p < 0.0001].
Conclusions
This is one of the largest studies done on the prevalence of SBC. The prevalence of 9.2/100,000 individuals is higher than previously reported. Further genetic and environmental studies are needed to understand the potential mechanisms for the risk factors identified in this study.
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Abbreviations
- BMI:
-
Body mass index
- CD:
-
Crohn’s disease
- CI:
-
Confidence interval
- DM:
-
Diabetes mellitus
- EHR:
-
Electronic health record
- FTT:
-
Failure to thrive
- GI:
-
Gastrointestinal
- HDG:
-
Health data gateway
- HIPAA:
-
Health Insurance Portability and Accountability Act
- IBD:
-
Inflammatory bowel disease
- IRB:
-
Institutional review board
- MEN1:
-
Multiple endocrine neoplasia type 1
- NCI:
-
National Cancer Institute
- NET:
-
Neuroendocrine tumor
- OR:
-
Odds ratio
- SB:
-
Small bowel
- SBC:
-
Small bowel carcinoid
- SEER:
-
Surveillance, Epidemiology, and End Results
- SNOMED-CT:
-
Systematized Nomenclature of Medicine-Clinical Terms
- UC:
-
Ulcerative colitis
- US:
-
United States
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MAS, EM, and MA were involved in study conception and design; MAS and EM contributed to acquisition of data; MAS, EM, and GI analysed and interpreted the data; MAS, EM, MA, and GI drafted the manuscript; GI was involved in critical revision; MAS and EM were involved in statistical analysis; GI supervised the study.
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Abou Saleh, M., Mansoor, E., Anindo, M. et al. Prevalence of Small Intestine Carcinoid Tumors: A US Population-Based Study 2012–2017. Dig Dis Sci 64, 1328–1334 (2019). https://doi.org/10.1007/s10620-018-5402-z
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DOI: https://doi.org/10.1007/s10620-018-5402-z