Incidence and survival of neuroendocrine neoplasia in England 1995–2018: A retrospective, population-based study

Benjamin E. White*, Brian Rous, Kandiah Chandrakumaran, Kwok Wong, Catherine Bouvier, Mieke Van Hemelrijck, Gincy George, Beth Russell, Rajaventhan Srirajaskanthan, John K. Ramage

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Background: Neuroendocrine neoplasia (NEN) incidence is rising internationally. We aimed to evaluate the epidemiology of NEN in England and examine changes in survival over time. Methods: A retrospective, population-based study using nationally representative data between 1995 and 2018 from the National Cancer Registry and Analysis Service (NCRAS) in England was conducted on 63,949 tumours. Age-standardized incidence was calculated using Office for National Statistics (ONS) data. Overall survival (OS) was calculated using the Kaplan-Meier estimator. Multivariable analysis was performed using an accelerated failure time model. Findings: Of 63,949 cases, 50.5% (32,309) were female. Age-adjusted incidence increased 3.7-fold between 1995 and 2018 from 2.35 to 8.61 per 100,000. In 2018, highest incidence occurred in lung (1.47 per 100,000), small intestine (1.46 per 100,000), pancreas (1.00 per 100,000) and appendix (0.95 per 100,000). In multivariable analysis, age, sex, morphology, stage, site and deprivation were independent predictors of survival (p < 0.001). Survival of the entire cohort, and by primary site, is improving over time. Interpretation: NEN incidence continues to rise in England with survival improving over time. Relatively high survival compared to other cancers is an issue for long-term outcomes and funding of care. Funding: Data were extracted and transferred using a grant from Neuroendocrine cancer UK.

Original languageEnglish
Article number100510
JournalThe Lancet Regional Health - Europe
Publication statusPublished - Dec 2022


  • Carcinoid
  • Epidemiology
  • Incidence
  • Neuroendocrine neoplasia
  • Neuroendocrine tumour
  • Predictors of survival
  • Survival


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