Appendix cancer epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

Epidemiology of appendix cancer should be discussed with respect to the major histological characteristics of the tumors. Prevalence, risk factors, age distribution as well as prognosis are different in the two major types of appendiceal cancers, adenocarcinoma and carcinoid tumors. The incidence of carcinoid tumor of appendix is approximately 0.075 per 100,000 individuals worldwide. The incidence of adenocarcinoma of the appendix is approximately 0.2 per 100,000 individuals worldwide. Appendiceal neoplasms account for approximately 0.4% of gastrointestinal tumors. The estimated prevalence of appendix cancer is approximately 0.12 cases per 100,000 individuals in the United States.The incidence of appendix cancer increases with age; meanwhile, patients with carcinoid tumors are generally younger than their adenocarcinoma counterparts. The median age at diagnosis is 65 years for adenocarcinoma, compared to 32-43 years (range, 6 to 80 years) for carcinoid tumors. There is no racial predilection to appendiceal cancers. Meanwhile, carcinoid tumors are slightly more prevalent among Caucasians and African-Americans. Generally appendiceal cancers affects men and women equally. While in adenocarcinoma, there is a male dominant pattern of prevalence, females are more commonly affected by appendiceal carcinoids than men.

Epidemiology and Demographics

  • Epidemiology of appendix cancer should be discussed with respect to the major histological characteristics of the tumors.
  • Prevalence, risk factors, age distribution as well as prognosis are different in the two major types of apendiceal cancers.[1]
  • According to the SEER database, adenocarcinoma accounted for 58% of appendiceal tumors.[2]
  • Carcinoid tumors comprise 50-77% of appendiceal malignancies.[3]

Incidence

  • The incidence of carcinoid tumor of appendix is approximately 0.075 per 100,000 individuals, worldwide.[4]
  • The incidence of adenocarcinoma of the appendix is approximately 0.2 per 100,000 individuals, worldwide.[5]

Prevalence

  • Appendiceal neoplasms account for approximately 0.4% of gastrointestinal tumors.[2]
  • The estimated prevalence of appendix cancer is approximately 0.12 cases per 100,000 individuals in the United States.[6]
  • The estimated prevalence of adenocarcinoma of the appendix is 0.2 cases per 100,000 individuals, worldwide.[6]

Age

  • The incidence of appendix cancer increases with age; meanwhile, patients with carcinoid tumors are generally younger than their adenocarcinoma counterparts.
  • The median age at diagnosis is 65 years for adenocarcinoma, compared to 32-43 years (range, 6 to 80 years) for carcinoid tumors.[7][4]
    • The patients with tubular carcinoids are significantly younger than the patients with goblet cell carcinoids.[8]

Race

  • There is no racial predilection to appendiceal cancers.[1]
  • Meanwhile, carcinoid tumors are slightly more prevalent among Caucasians and African-Americans.[9][10]
  • A poorer survival has been reported for the black patients with carcinoid tumors.[10][11]

Gender

  • Generally appendiceal cancers affects men and women equally.
  • While in adenocarcinoma, there is a male dominant pattern of prevalence, females are more commonly affected by appendiceal carcinoids than men.[4][5]
  • This might be because of high incidental appendectomies in women.
  • Nevertheless, in the SEER database, the male to female ratio is approximately 1 to 1.[1][7][5]

References

  1. 1.0 1.1 1.2 Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019
  2. 2.0 2.1 Thomas RM, Sobin LH (1995). "Gastrointestinal cancer". Cancer. 75 (1 Suppl): 154–70. PMID 8000994.
  3. Syracuse DC, Perzin KH, Price JB, Wiedel PD, Mesa-Tejada R (1979). "Carcinoid tumors of the appendix. Mesoappendiceal extension and nodal metastases". Ann Surg. 190 (1): 58–63. PMC 1344458. PMID 464679.
  4. 4.0 4.1 4.2 Modlin IM, Sandor A (1997). "An analysis of 8305 cases of carcinoid tumors". Cancer. 79 (4): 813–29. PMID 9024720.
  5. 5.0 5.1 5.2 Deans GT, Spence RA (1995). "Neoplastic lesions of the appendix". Br J Surg. 82 (3): 299–306. PMID 7795991.
  6. 6.0 6.1 Turaga KK, Pappas SG, Gamblin T (2012). "Importance of histologic subtype in the staging of appendiceal tumors". Ann. Surg. Oncol. 19 (5): 1379–85. doi:10.1245/s10434-012-2238-1. PMID 22302267.
  7. 7.0 7.1 Carr NJ, McCarthy WF, Sobin LH (1995). "Epithelial noncarcinoid tumors and tumor-like lesions of the appendix. A clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors". Cancer. 75 (3): 757–68. PMID 7828125.
  8. Burke AP, Sobin LH, Federspiel BH, Shekitka KM, Helwig EB (1990). "Goblet cell carcinoids and related tumors of the vermiform appendix". Am J Clin Pathol. 94 (1): 27–35. PMID 2163192.
  9. Irvin M. Modlin, Kevin D. Lye & Mark Kidd (2003). "A 5-decade analysis of 13,715 carcinoid tumors". Cancer. 97 (4): 934–959. doi:10.1002/cncr.11105. PMID 12569593. Unknown parameter |month= ignored (help)
  10. 10.0 10.1 Melinda A. Maggard, Jessica B. O'Connell & Clifford Y. Ko (2004). "Updated population-based review of carcinoid tumors". Annals of surgery. 240 (1): 117–122. PMID 15213627. Unknown parameter |month= ignored (help)
  11. Irvin M. Modlin, Kevin D. Lye & Mark Kidd (2003). "A 5-decade analysis of 13,715 carcinoid tumors". Cancer. 97 (4): 934–959. doi:10.1002/cncr.11105. PMID 12569593. Unknown parameter |month= ignored (help)

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