Skip to main content
ACG 2023 Annual Meeting Posters Main banner
Back
Rate ePoster

Sunday Poster Session

Category: Stomach

P1346 - The Epidemiology of Gastric Neuroendocrine Tumors in the United States: A Population-Based Study

Sunday, October 22, 2023
3:30 PM – 7:00 PM PT
Location: Exhibit Hall
Thabet Qapaja, MD1, Khaled Alsabbagh Alchirazi, MD1, Antoine Boustany, MD, MPH2, Prabhat Kumar, MD2, Somtochukwu Onwuzo, MD3, Prashanthi N. Thota, MD2
1Cleveland Clinic, Cleveland, OH; 2Cleveland Clinic Foundation, Cleveland, OH; 3Cleveland Clinic Foundation, Fairview Park, OH

Introduction: Gastric neuroendocrine tumors (gNET) are neoplasms that arise from the enterochromaffin-like cells in the gastric mucosa. They are rare lesions with an indolent behavior and neuroendocrine differentiation. Although uncommon, their diagnosis is increasing, due to the widespread use of upper endoscopy. In this study, we aim to evaluate the epidemiology and identify underlying associations of gNET in the U.S.

Methods: Our data was obtained using a validated, large, multicenter database (Explorys Inc, Cleveland, OH, USA), an aggregate of pooled outpatient and inpatient records of 26 different healthcare systems, consisting of a total of 360 hospitals in the United States, and utilizing Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for coding. A cohort of patients with a SNOMED CT of neuroendocrine tumors was identified between the 1999-2022. The prevalence rate was calculated and age-, gender- and race-based distributions were described. Associated conditions were also reported. For all analyses, a 2-sided P value of < 0.05 was considered statistically significant.

Results: Among the 69,502,120 individuals in the database above age 18, 2,400 had a diagnosis of gNET with a prevalence rate of 3.4 per 100,000. Within the gNET cohort, patients were more likely to be elderly, female, and Caucasian (Table 1). Patients with gNET were more likely to experience nausea, vomiting, abdominal pain, diarrhea, flushing, GI bleeding, obstruction, and perforation compared to patients without gNET. Patients with gNET were also more likely to have MEN 1, primary GI malignancy, family history of GI malignancy, IBD, atrophic gastritis, chronic gastritis, and gastric ulcers (Table 1).

Discussion: To our best knowledge, this is one of the largest studies evaluating the epidemiology of gNETs in the U.S. In our study, we found the estimated prevalence rate of gNETs to be 3.4/100,000 in the database. gNET were more common in Caucasians, females, and elderly population. MEN 1, primary GI malignancy, IBD, atrophic gastritis, chronic gastritis, and gastric ulcers were amongst the most common associated conditions.

 

gNET

n=2,400 (%)

No gNET

n=69,499,720 (%)

OR (95% CI)

p-value

Age

 >65

1,540 (64%)

20,577,670 (30%)

4.26 (3.92-4.63)

< 0.0001

Sex

Female

1,490 (62%)

38,057,370 (55%)

1.35 (1.25-1.47)

< 0.0001

Race

White

1,690 (70%)

37,393,880 (54%)

2.04 (1.87-2.23)

< 0.0001

Comorbidities

HTN

1,810 (75%)

14,749,420 (21%)

11.39 (10.38-12.50)

< 0.0001

HLD

1,520 (63%)

11,818,150 (17%)

8.43 (7.76-9.16)

< 0.0001

Obesity

760 (32%)

5,465,430 (8%)

5.43 (4.98-5.92)

< 0.0001

T2DM

1,020 (42%)

5,675,570 (8%)

8.31 (7.67-9.01)

< 0.0001

Metabolic syndrome X

50 (2%)

240,400 (0.3%)

6.13 (4.63-8.11)

< 0.0001

Symptoms/Complications

Nausea

550 (23%)

2,921,940 (4%)

6.77 (6.16-7.45)

< 0.0001

Vomiting

660 (27%)

4,060,600 (6%)

6.11 (5.59-6.69)

< 0.0001

Abdominal pain

1,320 (55%)

9,698,650 (14%)

7.54 (6.95-8.17)

< 0.0001

Flushing

60 (3%)

163,130 (0.2%)

10.90 (8.43-14.08)

< 0.0001

Diarrhea

40 (2%)

191,150 (0.3%)

6.15 (4.5-8.4)

< 0.0001

GI obstruction

330 (14%)

792,650 (1%)

13.82 (12.3-15.52)

< 0.0001

GI bleed

580 (24%)

1,886,940 (3%)

11.42 (10.4-12.54)

< 0.0001

GI perforation

60 (3%)

137,590 (0.2%)

12.93 (10-16.70)

< 0.0001

Volvulus

10 (0.4%)

32,900 (0.1%)

8.84 (4.75-16.44)

< 0.0001

Gastric hemorrhage

120 (5%)

150,020 (0.2%)

24.33 (20.25-29.24)

< 0.0001

Perforation of stomach

 

10 (0.4%)

12,810 (0.02%)

22.80 (12.19-42.25)

 

< 0.0001

Risk factors

Primary GI cancer

620 (26%)

359,450 (0.5%)

66.99 (61.14-73.42)

< 0.0001

MEN 1

20 (0.8%)

1,220 (0.002%)

478.71 (307.18-746.02)

< 0.0001

UC

30 (1%)

209,490 (0.3%)

4.19 (2.92-6.00)

< 0.0001

CD

40 (2%)

250,060 (0.4%)

4.69 (3.43-6.42)

< 0.0001

Family history of GI cancer

170 (7%)

595,740 (1%)

8.82 (7.54-10.31)

< 0.0001

Atrophic gastritis

610 (25%)

263,230 (0.4%)

89.64 (81.76-98.27)

< 0.0001

Gastric ulcer

250 (10%)

359,710 (0.5%)

22.35 (19.61-25.48)

< 0.0001

Chronic gastritis

770 (32%)

455,450 (0.7%)

71.61 (65.73-78.03)

< 0.0001


Table: Table 1: Gastric Neuroendocrine Tumors (gNET) Demographics, Comorbidities, Symptoms, and Risk Factors
Abbreviations: HTN: Hypertension, HLD: Hyperlipidemia, T2DM: Type 2 diabetes mellitus, MEN 1: Multiple endocrine neoplasia 1, UC: Ulcerative colitis, CD: Crohn's Disease


Disclosures:
Thabet Qapaja indicated no relevant financial relationships.
Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.
Antoine Boustany indicated no relevant financial relationships.
Prabhat Kumar indicated no relevant financial relationships.
Somtochukwu Onwuzo indicated no relevant financial relationships.
Prashanthi Thota indicated no relevant financial relationships.


Thabet Qapaja, MD1, Khaled Alsabbagh Alchirazi, MD1, Antoine Boustany, MD, MPH2, Prabhat Kumar, MD2, Somtochukwu Onwuzo, MD3, Prashanthi N. Thota, MD2. P1346 - The Epidemiology of Gastric Neuroendocrine Tumors in the United States: A Population-Based Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.