Introduction: Sex differences have been noted at different sites of Neuroendocrine Neoplasia in previous registry studies across different countries. Analysis of National Cancer Registry and Analysis Service (NCRAS) data can help to clarify the significance and importance of this factor in England.
Aim: To examine neuroendocrine neoplasia incidence and survival by sex, site and stage.
Method: A population-based, cohort study was performed. Data were requested from NCRAS for 1995-2018 and analysed. Goblet cell carcinoma were excluded from all analyses. NEN diagnoses registered between 2012–2018 were included in main descriptive and survival analyses due to accuracy of recording. Eight main sites were included. Merkel cell and adenoneuroendocrine were excluded from survival analyses. Grade was missing in 31% therefore ‘derived morphology’ groups were formed termed neuroendocrine tumour(NET) and neuroendocrine carcinoma(NEC).
Results: 19,952 NEN between 2012-2018 met criteria for analysis. Of 19,952 tumours, 51.9% were female. Females had slightly more NET (54.1%) and Males more NEC (54.9%). There is a striking preponderance of females in Appendix and Lung NEN. Across main NEN sites the predominant sex were, appendix; female 61.5%, caecum; female 55.6%, colon; male 57.8%, lung; female 60.3%, pancreas; male 54.5%, rectum; male 55.2%, small intestine; male 56.3%, stomach; male 52.1%. Overall survival was 5.17(95% C.I; 5.10–5.24) years for males and 6.01(5.945–6.08) for females. Being female conferred a significant survival advantage in Cox-Regression Multivariate Analysis. Worse survival in males was seen in multiple sites, such as pancreatic NEN (P = 0.001). There were significant survival differences by sex in appendix, lung, pancreas, rectum and stomach (P = 0.001).
Conclusion: There are large sex differences in incidence at certain sites of NEN in England. These appear to have a significant association with survival. This sex difference is not reflected in data from other types of cancers at the same site, for example adenocarcinoma of the pancreas, where males and females have similar survival. Being male confers significantly worse survival in NEN, particularly in NEN of the pancreas, rectum and stomach. Work is needed to explore the reasons behind this.