Incidence, Risk Factors, and Temporal Trends of Small Intestinal Cancer: A Global Analysis of Cancer Registries

Junjie Huang; Sze Chai Chan; Yat Ching Fung; Fung Yu Mak; Veeleah Lok; Lin Zhang; Xu Lin; Don Eliseo Lucero-Prisno 3rd; Wanghong Xu; Zhi-Jie Zheng; Edmar Elcarte; Mellissa Withers; Martin C S Wong; NCD Global Health Research Group, Association of Pacific Rim Universities

doi:10.1053/j.gastro.2023.05.043

Incidence, Risk Factors, and Temporal Trends of Small Intestinal Cancer: A Global Analysis of Cancer Registries

Gastroenterology. 2023 Sep;165(3):600-612. doi: 10.1053/j.gastro.2023.05.043. Epub 2023 Jun 3.

Collaborators

NCD Global Health Research Group, Association of Pacific Rim Universities:
Mellissa Withers¹², Martin C S Wong¹³, Junjie Huang¹³, Edmar Elcarte⁹, Sze Chai Chan¹³, Yat Ching Fung¹³, Fung Yu Mak¹³, Veeleah Lok¹⁴, Lin Zhang¹⁵, Xu Lin¹⁶, Don Eliseo Lucero-Prisno 3rd¹⁷, Wanghong Xu¹⁸, Zhi-Jie Zheng¹⁹

Affiliations

¹ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China; Center for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
² The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
³ Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁴ The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁶ Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁷ School of Public Health, Fudan University, Shanghai, China.
⁸ Department of Global Health, School of Public Health, Peking University, Beijing, China.
⁹ University of the Philippines, Manila, the Philippines.
¹⁰ Department of Population and Health Sciences, Institute for Global Health, University of Southern California, Los Angeles, California.
¹¹ The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China; Center for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Global Health, School of Public Health, Peking University, Beijing, China. Electronic address: wong_martin@cuhk.edu.hk.
¹² University of Southern California, Los Angeles, California.
¹³ Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁴ Karolinska Institute, Stockholm, Sweden.
¹⁵ The University of Melbourne, Victoria, Australia.
¹⁶ Zhejiang University.
¹⁷ London School of Hygiene and Tropical Medicine, London, United Kingdom.
¹⁸ Fudan University, Shanghai, China.
¹⁹ Peking University, Beijing, China.

PMID: 37277079
DOI: 10.1053/j.gastro.2023.05.043

Abstract

Background & aims: Small intestinal cancer is a rare cancer, with limited studies exploring its epidemiology. To our knowledge, this study is the first effort to comprehensively analyze the incidence, risk factors, and trends for small intestinal cancer by sex, age, and country.

Methods: Global Cancer Observatory, Cancer Incidence in Five Continents Plus, and Global Burden of Disease were accessed to estimate the age-standardized rates of small intestinal cancer incidence (International Classification of Diseases, 10th Revision, Clinical Modification: C17) and prevalence of lifestyle risk factors, metabolic risk factors, and inflammatory bowel disease (IBD). Risk factor associations were assessed by linear and logistic regressions. Average annual percent change was calculated using joinpoint regression.

Results: A total of 64,477 small intestinal cancer cases (age-standardized rate, 0.60 per 100,000) were estimated globally in 2020, with a higher disease burden found in North America (1.4). Higher small intestinal cancer incidence was associated with higher human development index; gross domestic product; and prevalence of smoking, alcohol drinking, physical inactivity, obesity, diabetes, lipid disorder, and IBD (β = 0.008-0.198; odds ratios, 1.07-10.01). There was an overall increasing trend of small intestinal cancer incidence (average annual percent change, 2.20-21.67), and the increasing trend was comparable among the 2 sexes but more evident in the older population aged 50-74 years than in the younger population aged 15-49 years.

Conclusion: There was a substantial geographic disparity in the burden of small intestinal cancer, with higher incidence observed in countries with higher human development index; gross domestic product; and prevalence of unhealthy lifestyle habits, metabolic disorders, and IBD. There was an overall increasing trend in small intestinal cancer incidence, calling for the development of preventive strategies.

Keywords: Epidemiology; Malignancy; Small Bowel.

MeSH terms

Adolescent
Adult
Aged
Female
Humans
Incidence
Intestinal Neoplasms* / epidemiology
Male
Middle Aged
Risk Factors
Young Adult