Risk factors associated with neuroendocrine tumors: A U.S.-based case-control study

Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
International Journal of Cancer (Impact Factor: 5.09). 08/2008; 123(4):867-73. DOI: 10.1002/ijc.23529
Source: PubMed


Carcinoids are rare neuroendocrine tumors (NETs); however, their incidence has significantly increased in the United States over the past 30 years. Little is known about the epidemiology of these cancers and their associated risk factors. We evaluated the independent effects of multiple risk factors associated with NETs arising at 5 disease sites (small intestine, stomach, lung, pancreas and rectum). We conducted a retrospective, hospital-based, case-control study involving 740 patients with histologically confirmed NETs and 924 healthy controls. Information on different risk factors was collected, and unconditional logistic regression analysis was used to determine adjusted odds ratios (AORs) and 95% confidence interval (CI) by the maximum-likelihood method. Smoking and alcohol consumption were not associated with NETs development in either men or women. However, a family history of cancer was a significant risk factor for all NETs. A long-term history of diabetes mellitus was a significant risk factor for gastric NETs (AOR = 5.6; 95% CI, 2.1-14.5), particularly in women (AOR = 8.4; 95% CI, 1.9-38.1). Diabetes modified the risk among women with a positive family history of cancer for the development of gastric NETs (AOR = 52.2; 95% CI, 5.5-491.5). Our results suggest that the risk of NETs may mostly explained by genetic factors. The increased risk of gastric NETs in women with both diabetes and a positive family history of cancer suggest that women may have a greater genetic susceptibility to NETs than men.

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Available from: Donghui Li, Mar 30, 2015
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    • ". Moreover, a positive correlation with diabetes in patients with gastric carcinoids was established [6]. An epidemiologic study on the Swedish population revealed an increased risk of carcinoid tumors in individuals with a parental history of carcinoid. "

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    • "They present in up to 20% of patients with ZES and MEN- 1. Whilst type I lesions are limited to the mucosa of the gastric body and fundus, type II lesions have occasionally been described in the antrum [13] [14]. Type III is a sporadic disease associated with normal gastrin levels; it has the highest rate of metastases (>50%), thus the worst prognosis [15]. Unlike the other two types of gastric carcinoids, it has been shown to have a higher frequency in men. "
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    ABSTRACT: Gastric carcinoid tumors (GCs) are rare lesions representing less than 10% of carcinoid tumors and less than 1% of all stomach neoplasms. There are three distinct types of gastric carcinoids; type I includes the vast majority (70-85%) of these neoplasms that are closely linked to chronic atrophic gastritis. Type II which accounts for 5-10 %, is associated with Zollinger-Ellison syndrome and often occurs in the context of multiple endocrine neoplasia type 1. Type III, finally, represents 15-25% of gastric carcinoids and is characterized by a far more aggressive course. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size, and number of carcinoids. While there is universal agreement about the surgical treatment of type III GCs, current options for type I and II include simple surveillance, endoscopic polypectomy, surgical excision associated with or without surgical antrectomy, or total gastrectomy. Moreover, the introduction of somatostatin analogues could represent another therapeutic option.
    Gastroenterology Research and Practice 12/2012; 2012(3):287825. DOI:10.1155/2012/287825 · 1.75 Impact Factor
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    • "This has been mainly attributed to the increasing use of endoscopy and immunohistochemistry. Other risk factors for small intestinal carcinoids include alcohol, female gender, and positive family history [6]. Small intestinal carcinoids also occur with an increased frequency in a few inherited syndromes such as MEN1. "
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    ABSTRACT: Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS) revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.
    Case Reports in Gastroenterology 05/2012; 6(1):135-42. DOI:10.1159/000337870
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