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Prevalence of Small Intestine Carcinoid Tumors: A US Population-Based Study 2012–2017

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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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Authors and Affiliations

Authors

Contributions

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.

Corresponding author

Correspondence to Gerard Isenberg.

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The authors declare that they have no conflict of interest.

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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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