Incidence, mortality and survival analysis of small intestine cancer in Shanghai population-based study from 2002 to 2016

doi:10.16139/j.1007-9610.2023.03.011

Abstract

Abstract:

Objective: To investigate the incidence, mortality and survival of small intestine cancer in Shanghai from 2002 to 2016. Methods: Data of new small intestine cancer cases and deaths from 2002 to 2016 were obtained from the population-based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention. The incidence and mortality of small intestine cancer stratified by year of diagnosis or death, gender and age-group were analyzed. Cases or deaths, proportion, crude rate, age-specific rate, age-standardized rate and others were calculated. Trends of cases or deaths, crude rate, age-specific rate and age-standardized rate of incidence and mortality with follow-up information were estimated. The annual percent change (APC) of age-standardized rates of incidence and mortality was estimated by Joinpoint analysis. The new cases and proportions with selected diagnostic character of small intestine cancer in different diagnosis years were also calculated. Age-standardized rates were calculated using Segi’s 1960 world standard population. The 1- to 5-year observed survival rates were calculated based on the life table. The probabilities of surviving from 0 to 99 years old were estimated according to the Elandt-Johnson model, and then the cumulative expected survival rates were calculated according to the Ederer Ⅱ method. Finally, the 1- to 5-year relative survival rates were calculated. Results: The age-standardized rates of incidence and mortality of small intestine cancer were stable in Shanghai from 2002 to 2016. The new average cases and deaths of small intestine cancer were 280 and 174 per year in Shanghai. The crude rate of incidence was 2.02/10⁵, and the age-standardized rate was 0.96/10⁵. The crude rate of mortality was 1.25/10⁵, and the age-standardized rate was 0.54/10⁵. The age-standardized rates of incidence and mortality in males were higher than those in females. The age-specific cases or deaths and rates of incidence and mortality increased with aging. Duodenum cancer was the dominant anatomical site. Adenocarcinoma was the most histopathological type, and the proportion of gastrointestinal stromal tumors was increasing. The 5-year observed survival rate of small intestine cancer diagnosed from 2002 to 2013 was 36.34% in Shanghai, and the 5-year relative survival rate was 39.98%. All survival rates of male were lower than those of female. The 5-year observed and relative survival rates were stable. And those decreased with the increase of diagnostic years and stages. Relative to other sites, the rates of the duodenum cancer were the lowest. Relative to other histopathological types, those of gastrointestinal stromal tumors were the highest. Conclusions: The diagnostic level of small intestine cancer has been improved in Shanghai, continuously. But the survival rates have not been improved with the times. The proportion of stage Ⅰ was low and without improvement for a long time. This study provides useful information to further research, control and prevention of small intestine cancer. Improvement of the surveillance and research on small intestine cancer will help to promote more efficient control and prevention strategies then decrease cancer burden.

Key words: Small intestine cancer, Incidence, Mortality, Survival, Epidemiology, Shanghai

CLC Number:

R735.32

WU Chunxiao, GU Kai, PANG Yi, WANG Chunfang, SHI Liang, XIANG Yongmei, GONG Yangming, DOU Jianming, SHI Yan, FU Chen. Incidence, mortality and survival analysis of small intestine cancer in Shanghai population-based study from 2002 to 2016[J]. Journal of Surgery Concepts & Practice, 2023, 28(03): 240-248.

Figures/Tables 7

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Category	Gender	Average number	Proportion /%	Crude rate /10^-5	ASR/10^-5	TASR/10^-5	Cumulative rate /%
Category	Gender	Average number	Proportion /%	Crude rate /10^-5	ASR/10^-5	35-64 years	0-64 years	0-74 years	0-84 years
Incidence	Both	280	0.49	2.02	0.96	1.52	0.05	0.11	0.20
	Male	152	0.49	2.19	1.09	1.73	0.06	0.13	0.22
	Female	128	0.48	1.84	0.83	1.30	0.05	0.10	0.17
Mortality	Both	174	0.52	1.25	0.54	0.68	0.02	0.06	0.13
	Male	98	0.48	1.40	0.66	0.84	0.03	0.07	0.16
	Female	76	0.58	1.10	0.44	0.51	0.02	0.05	0.11

Category	2002—2006		2007—2011		2012—2016
Category	Cases	%	Cases	%	Cases	%
Morphological verification	793	72.09	1 108	76.31	1 273	76.78
Anatomic site
Duodenum	726	66.00	949	65.36	1 117	67.37
Jejunum	47	4.27	51	3.51	71	4.28
Ileum	54	4.91	66	4.55	65	3.92
Others and unspecified	273	24.82	386	26.58	405	24.43
Histological type
Adenocarcinoma, unspecified	335	30.45	486	33.47	604	36.43
Adenocarcinoma, specified	172	15.64	196	13.50	146	8.81
GIST	56	5.09	192	13.22	290	17.49
Other mesenchymal tumors	148	13.45	139	9.57	17	1.03
Neuroendocrine carcinoma	22	2.00	35	2.41	44	2.65
Others and unspecified	367	33.36	404	27.82	557	33.59
Stage
Ⅰ	71	6.45	107	7.37	95	5.73
Ⅱ	130	11.82	164	11.29	182	10.98
Ⅲ	101	9.18	128	8.82	131	7.90
Ⅳ	161	14.64	202	13.91	245	14.78
Unknown	637	57.91	851	58.61	1 005	60.62

Gender	Observed cases	Observed survival rate/%					MST¹	Relative survival rate/%
Gender	Observed cases	1-year	2-year	3-year	4-year	5-year	(years)	1-year	2-year	3-year	4-year	5-year
Total	3 210	61.97	48.98	43.25	39.02	36.34	1.92	63.45	51.05	45.87	42.13	39.98
Male	1 743	59.53	46.49	40.42	35.95	33.31	1.73	61.08	48.65	43.17	39.17	37.07
Female	1 467	64.85	51.92	46.58	42.62	39.90	2.36	66.35	53.99	49.18	45.75	43.54

Category	Observed cases	5-year observed survival rate (95% CI)/%	5-year relative survival rate (95% CI)/%
Total	3 210	36.34 （34.63-38.05）	39.98 (38.10-41.86)
Gender
Male	1 743	33.31 (31.03-35.59)	37.07 (34.54-39.61)
Female	1 467	39.90 (37.34-42.46)	43.54 (40.75-46.34)
Diagnostic period
2002—2004	596	36.00 (31.97-40.03)	39.40 (34.99-43.81)
2005—2007	760	37.47 (33.98-40.97)	40.96 (37.14-44.78)
2008—2010	869	37.87 (34.59-41.15)	41.59 (37.99-45.19)
2011—2013	985	34.30 (31.24-37.36)	38.00 (34.61-41.39)
Age group/year
15-45	169	60.97 (53.41-68.53)	61.28 (53.69-68.88)
45-54	466	54.85 (50.22-59.48)	55.66 (50.96-60.36)
55-64	785	45.86 (42.31-49.42)	47.25 (43.59-50.92)
65-74	868	34.56 (31.31-37.81)	37.73 (34.18-41.27)
≥75	922	15.74 (13.29-18.19)	22.28 (18.81-25.76)
Anatomic site
Duodenum	2 124	30.17 (28.16-32.19)	33.33 (31.10-35.55)
Jejunum	122	49.65 (40.51-58.78)	53.85 (43.94-63.76)
Ileum	150	40.89 (32.92-48.85)	46.07 (37.09-55.05)
Others and unspecified	814	49.27 (45.77-52.76)	53.69 (49.87-57.50)
Histological type
Adenocarcinoma, unspecified	1 055	28.05 (25.26-30.85)	30.44 (27.41-33.47)
Adenocarcinoma, specified	437	37.08 (32.40-41.76)	40.35 (35.25-45.45)
GIST	373	74.65 (70.12-79.19)	80.32 (75.44-85.19)
Other mesenchymal tumors	294	68.33 (62.91-73.75)	73.25 (67.43-79.06)
Neuroendocrine carcinoma	76	66.28 (55.50-77.06)	71.25 (59.66-82.84)
Others and unspecified	975	17.97 (15.48-20.46)	21.16 (18.23-24.10)
Stage
Ⅰ	220	62.47 (55.91-69.03)	68.16 (61.01-75.32)
Ⅱ	374	51.29 (46.15-56.44)	55.47 (49.90-61.04)
Ⅲ	293	33.54 (27.89-39.20)	36.44 (30.30-42.57)
Ⅳ	459	17.08 (13.47-20.70)	18.23 (14.37-22.09)
Unknown	1 864	35.23 (33.01-37.45)	39.22 (36.75-41.69)