TY - JOUR
T1 - Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018
T2 - A Retrospective, Population-Based Study
AU - White, Benjamin E.
AU - Russell, Beth
AU - Remmers, Sebastiaan
AU - Rous, Brian
AU - Chandrakumaran, Kandiah
AU - Wong, Kwok F.
AU - Van Hemelrijck, Mieke
AU - Srirajaskanthan, Rajaventhan
AU - Ramage, John K.
N1 - Funding Information:
The data were extracted, processed and securely transferred by NCRAS using a grant of £10,000 from Neuroendocrine Cancer UK. B.E.W.’s salary was funded jointly by Hampshire Hospitals NHS Foundation Trust and the National Institute for Health Research.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/3
Y1 - 2023/3
N2 - Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.
AB - Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.
KW - carcinoid
KW - epidemiology
KW - incidence
KW - neuroendocrine neoplasia
KW - neuroendocrine tumour
KW - predictors of survival
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85151482978&partnerID=8YFLogxK
U2 - 10.3390/cancers15061863
DO - 10.3390/cancers15061863
M3 - Article
AN - SCOPUS:85151482978
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 6
M1 - 1863
ER -
