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Racial and Ethnic Variation in the Incidence of Small-Bowel Cancer Subtypes in the United States, 1995–2008

Goodman, Marc T. Ph.D.; Matsuno, Rayna K. Ph.D.; Shvetsov, Yurii B. Ph.D.

Diseases of the Colon & Rectum: April 2013 - Volume 56 - Issue 4 - p 441–448
doi: 10.1097/DCR.0b013e31826b9d0a
Original Contribution: Colorectal/Anal Neoplasia

BACKGROUND: Small-bowel cancer is uncommon and, accordingly, little is known about the epidemiology of this malignancy, especially by race and subtype.

OBJECTIVE: The objective of this analysis was to describe the distribution of small-bowel cancer in the United States by demographic, pathological, and clinical features.

DESIGN: This study was retrospective in design.

SETTING: Data from 26 population-based cancer registries in the United States from 1995 to 2008 were used.

PATIENTS: Patients diagnosed with small-bowel cancer (topography codes C17.0–17.3 and C17.8–17.9) were included.

MAIN OUTCOME MEASURES: The primary outcomes measured were race- and histology-specific incidence (age-adjusted rate trends and age-specific rates) of small-bowel cancer.

RESULTS: A total of 56,223 men and women diagnosed with small-bowel cancer were identified. The overall age-adjusted incidence rates for small-bowel cancer were 26.1 in men and 17.7 in women. Neuroendocrine tumors were the most common histological types of small-bowel cancer in men and women, followed by carcinoma, lymphoma, and sarcoma. In comparison with whites, the rate of small-bowel cancer was 42% greater in black men, 46% greater in black women, 34% lower in Asian-Pacific Islander men, and 37% lower in Asian-Pacific Islander women. Rates of small-bowel cancer were 24% lower in Hispanic men and 15% lower in Hispanic women than rates in non-Hispanics. The excess of small-bowel cancer in blacks and the deficit in Asian-Pacific Islanders were attributable mainly to the incidence of adenocarcinoma and carcinoid tumors. The incidence of GI stromal tumor was significantly higher among Asian-Pacific Islanders.

CONCLUSIONS: This is one of the largest studies of small-bowel cancer to date. These cancer registry data showed substantial racial and ethnic variation in the incidence of histological subtypes of small-bowel malignancy that suggest possible etiologic diversity and/or disparities in detection.

Epidemiology Program, Cancer Center, University of Hawaii, Honolulu, Hawaii

Funding/Support: This work was supported by the Centers for Disease Control and Prevention under cooperative agreement U75/CCU515998 to the North American Association of Central Cancer Registries and by the National Cancer Institute’s Surveillance, Epidemiology, and End-Results Program under contract N01-CN-67001 from the National Institutes of Health, Department of Health and Human Services.

Financial Disclosure: None reported.

Correspondence: Marc T. Goodman, Ph.D., Epidemiology Program, Cancer Center, University of Hawaii, 1236 Lauhala St, Honolulu, HI 96813. E-mail:

© The ASCRS 2013