Incidence and relative survival of pancreatic adenocarcinoma and pancreatic neuroendocrine neoplasms in Germany, 2009-2018. An in-depth analysis of two population-based cancer registries

Andreas Stang; Ina Wellmann; Bernd Holleczek; Barbara Fell; Stephanie Terner; Manfred Paul Lutz; Hiltraud Kajüter

doi:10.1016/j.canep.2022.102204

Incidence and relative survival of pancreatic adenocarcinoma and pancreatic neuroendocrine neoplasms in Germany, 2009-2018. An in-depth analysis of two population-based cancer registries

Cancer Epidemiol. 2022 Aug:79:102204. doi: 10.1016/j.canep.2022.102204. Epub 2022 Jun 28.

Authors

Andreas Stang¹, Ina Wellmann², Bernd Holleczek³, Barbara Fell⁴, Stephanie Terner⁵, Manfred Paul Lutz⁶, Hiltraud Kajüter⁷

Affiliations

¹ Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany; School of Public Health, Department of Epidemiology, Boston University, Boston, USA; Cancer Registry of North Rhine-Westphalia, Bochum, Germany. Electronic address: [email protected].
² Cancer Registry of North Rhine-Westphalia, Bochum, Germany. Electronic address: [email protected].
³ Saarland Cancer Registry, Saarbrücken, Germany. Electronic address: [email protected].
⁴ Saarland Cancer Registry, Saarbrücken, Germany. Electronic address: [email protected].
⁵ Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany. Electronic address: [email protected].
⁶ CaritasKlinikum Saarbrücken St. Theresia, Saarbrücken, Germany. Electronic address: [email protected].
⁷ Cancer Registry of North Rhine-Westphalia, Bochum, Germany. Electronic address: [email protected].

PMID: 35777306
DOI: 10.1016/j.canep.2022.102204

Abstract

Background: Pancreatic neuroendocrine neoplasms are categorized as neuroendocrine tumors and neuroendocrine carcinomas. Until now, cancer registry reporting of pancreatic cancers does not include a stratification by these two subgroups. We studied the incidence and survival of pancreatic cancer with a special focus on pancreatic neuroendocrine neoplasms.

Methods: We analyzed data from the population-based cancer registries of North Rhine-Westphalia (NRW) and Saarland (SL), Germany, of the years 2009-2018. We included primary malignant pancreatic tumors and report morphology-specific age-standardized (World Standard population) incidence rates for ages 0-79 years and age-standardized relative survival (period approach, ICSS standard). All analyses were restricted to non-death certificate only cases.

Results: We analyzed 23,037 patients with a newly diagnosed primary pancreatic cancer. Among morphologically specified cancers, adenocarcinoma (92 %) and neuroendocrine neoplasms (7 %) were the most common morphologies. The age-standardized incidence rates of adenocarcinoma, neuroendocrine tumors and neuroendocrine carcinomas were 4.0-5.5 (in NRW and SL), 0.1-0.3, and 0.1-0.3 per 100,000 person-years, respectively. Neuroendocrine tumors had the highest age-standardized 5-year relative survival with 75.5 % (standard error, SE 2.3) in NRW and 90.6 % (SE 10.2) in SL followed by neuroendocrine carcinomas (NRW: 30.0 %, SE 3.1; SL: 32.3 %, SE 8.7) and adenocarcinomas (NRW: 11.3 %, SE 0.4; SL: 10.2 %, SE 1.5).

Discussion: The distinction between neuroendocrine tumors and neuroendocrine carcinomas by the WHO divides neuroendocrine neoplasms into two prognostically clearly distinct subgroups that should be separately analyzed in terms of survival. The first year after diagnosis of pancreatic cancer is the most critical year in terms of survival.

Keywords: Adenocarcinoma; Carcinoma; Germany; Incidence; Neuroendocrine; Neuroendocrine tumors; Pancreatic neoplasms; Registries; Survival.

MeSH terms

Adenocarcinoma* / epidemiology
Adenocarcinoma* / pathology
Adolescent
Adult
Aged
Carcinoma, Neuroendocrine* / epidemiology
Carcinoma, Neuroendocrine* / pathology
Child
Child, Preschool
Germany / epidemiology
Humans
Incidence
Infant
Infant, Newborn
Middle Aged
Neuroendocrine Tumors* / epidemiology
Pancreatic Neoplasms*
Registries
Survival Rate
Young Adult