© 1996 Oxford University Press
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A Population-Based Study of the Incidence of Malignant Small Bowel Tumours: SEER, 1973–1990
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*Lenox Hill Hospital New York, NY, USA.
**Harvard University Medical School Cambridge, MA, USA.
Department of Medicine and School of Public Health, College of Physicians and Surgeons, Columbia University New York, NY, USA.
Reprint requests to: Dr Alfred I Neugut, Division of Medical Oncology, Columbia-Presbyterian Medical Center, 630 W 168th St, New York, NY 10032, USA.
BACKGROUND: Litttle is known about the incidence of cancers of the small bowel.
METHODS: Data from cancer registries participating In the Surveillance, Epidemiology, and End-Results (SEER) Program from 1973 to 1990 were analysed to determine the incidence of the four major histological types of cancer occuring in the small intestine: adenocarcinomas, malignal carcinoid tumours, lymphomas and sarcomas. In addition, the Incidence rate of lymphomas arising from the small instestine ans stomach and adenocarcinomas from the small intestine, stomach and colon were compared over time.
RESULTS: Small bowel tumours occured rarely, with an average annual incidence rate of 9.9 per million people. Carcinoid tumours and adenocarcinomas were the most common histogical subtype, with average annual incidence of 3.6 and 3.7 per million people respectively, followed by lymphomas (1.1 per million people) and sarcomas (1.3 per million people). For all histological subtypes, men had higher rates than women. Most tumours occured in older adults; over 90% of cases occured in people over the age of 40. During the 18-year study period, the incidence of small bowel tumours has risen slowly. In white men, black men and black women, rises in the incidence of adenocarcinomas, malignant carcinoids and lymphomas contributed to this trend. In white women, the Incidence of adenocarcinomas, was stable white malignant carcinoids and lymphomas rose. The incidence of sarcomas was steady for all groups except black women, for which it fell. The histological types were distributed by anatomical subsite; adenocarcinomas were distributed more proximally on average whereas lymphomas were more common distally. In addition, there was an association between the incidence trends of adenocarcinomas occuring in the duodenum and colon suggesting similar risk factors for cancers in these regions. There was no similar correlation for tumours in the jejunum and ileum. The incidence of lymphomas over time rose in all areas of the small intestine, paralleling a similar rise in lymphomas of the stomach.
CONCLUSIONS: Cancers of the small bowel are rare despite a slow increase over the past two decades, especially among lymphomas. Higher rates in males and whites deserves further investigation.
Keywords small bowel, small intestine, malignancy, epidemiology, adenocarcinoma, carcinoid tumour, lymphoma, sarcoma
Revised 1 November 1995
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