Materiały źródłowe

• #1 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6473503/

  The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. […] Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. […] Identification of hereditary and predisposing conditions, likely to blame for some 20% of cases, may help prevent and treat cancers of the small intestine. […] The small intestine is located between the stomach and the large intestine and is the primary site of end absorption of nutrients from food, including proteins, lipids, and carbohydrates. […] Cancers of the small intestine are primarily of two etiologies: small bowel adenocarcinoma (SBA) which account for 40% of cases, and neuroendocrine tumors, which account for another 40%.

• #2 Epidemiology of cancer of the small intestine

  https://www.wjgnet.com/1948-5204/full/v3/i3/33.htm

  The small intestine represents the longest part of the digestive tract, making up 75% of the length (about 6 m long and 4 times as long as the large intestine) and 90% of the absorptive surface area of the gastrointestinal tract. Malignant tumors of the small intestine are rare all over the world, with a global incidence of less than 1.0 per 100000 population. Cancers of the small intestine or small bowel cancer (SBC) account for only 0.42% of total cancer cases and 2.3% of cancers of digestive system in the United States; while in Canada, 0.37% and 1.78% respectively. Mortality of the cancer is even lower, accounting for only 0.2% of the total cancer deaths in the United States and in Canada. […] International data shows that the incidence is higher in North America, western Europe and Oceania than in Asia. The incidence rises after the age of 40 years for all histological subtypes with the increase much more rapid for carcinoma and carcinoid tumors than for lymphoma. Rates stabilize after the age of 70 years for carcinoid tumors whereas the incidence of sarcomas increases more slowly than other three types and stabilizes after the age of 60 years. Men have higher incidence rates than women, overall and for all histological subtypes of small intestine cancer in most countries.

• #3 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  The small intestine, also known as the small bowel, makes up some 75% of the length of the alimentary canal (or digestive tract) and accounts for about 90% of its mucosal surface. […] Nevertheless, cancers of the small intestine account for less than 5% of all gastrointestinal cancer (GI) cancer cases, and only about 0.6% of all cancer cases in the United States. […] Despite their rarity, small intestine cancers are on the rise in the developed world, with an estimated growth in the incidence of over 100% in the past four decades. […] Survival rates have markedly improved in the past decades, thanks to highly-sensitive means of early diagnosis. […] The efficacy of adjuvant chemotherapy among those getting surgical resection remains controversial. […] Due to its rarity, small intestine cancer has been seldom studied. Nevertheless, as its incidence has been steadily increasing, it has become imperative that we learn to diagnose better, treat, and prevent this atypical neoplasm.

• #4 Small Intestine Cancer — Cancer Stat Facts

  http://seer.cancer.gov/statfacts/html/smint.html

  Estimated New Cases in 2025 13,920. […] % of All New Cancer Cases 0.7%. […] Estimated Deaths in 2025 2,060. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year. […] Small intestine cancer represents 0.7% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 13,920 new cases of small intestine cancer and an estimated 2,060 people will die of this disease. […] Cancer of the small intestine is slightly more common among men than women. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year based on 20182022 cases, age-adjusted. […] For small intestine cancer, death rates increase with age. […] The death rate was 0.4 per 100,000 men and women per year based on 20192023 deaths, age-adjusted.

• #5 Key Statistics for Small Intestine Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/small-intestine-cancer/about/what-is-key-statistics.html

  Although the small intestine makes up the largest part of the gastrointestinal (GI) tract, small intestine cancers are rare in the United States. In fact, they account for fewer than 1 in 10 cancers of the gastrointestinal (GI) tract, and fewer than 1 in 100 cancers overall. […] The American Cancer Society estimates for these cancers in the United States for 2024 are: About 13,920 people will be diagnosed with some type of small intestine cancer. About 2,060 people will die of small intestine cancer. […] Cancers of the small intestine tend to occur more often in older people. They are most often found in people in their 60s and 70s.

• #6 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. […] High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. […] The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival. […] The incidence of SBA is estimated at 3600 new cases per year in Europe. […] Surgical resection with regional lymph node dissection is considered the standard therapy for localised and resectable disease. […] The prognosis of all stages remains poor and the 5-year overall survival (OS) rate is 30%, with a median OS time of 19 months. […] Several studies have investigated the prognostic factors of SBA.

• #7

  https://www.cancervic.org.au/cancer-information/types-of-cancer/small_bowel_cancer/small_bowel_overview.html

  Small bowel cancer is rare. About 530 Australians are diagnosed each year (this is about 2 cases per 100,000 people). It is more likely to be diagnosed in men than women, and in people aged over 60 years. […] Ongoing surveillance for small bowel cancer involves a schedule of ongoing scans and physical examinations. Maintaining a healthy body weight, eating well and being active are all important.

• #8 Small intestine cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer

  There are around 1,900 new small intestine cancer cases in the UK every year, that’s more than 5 every day (2017-2019). […] Small intestine cancer is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] Incidence rates for small intestine cancer in the UK are highest in people aged 85 to 89 (2017-2019). […] Each year around a third (34%) of all new small intestine cancer cases in the UK are diagnosed in people aged 75 and over (2017-2019). […] Since the early 1990s, small intestine cancer incidence rates have increased by more than two-and-a-half times (176%) in the UK. […] Over the last decade, small intestine cancer incidence rates have increased by almost half (46%) in the UK. […] Small intestine cancer incidence rates are projected to rise by 44% in the UK between 2023-2025 and 2038-2040.

• #9 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  The median age for the first diagnosis was 66 years. […] Mortality from neoplasms of the small intestine is 0.5/100,000 for men and 0.3 for women in the United States. […] The corresponding mortality rates for African Americans are 0.7 and 0.5, respectively. […] An estimated 1450 Americans died from small intestine cancer in 2018, which constituted 0.2% of all cancer deaths. […] The 5-year survival for neoplasms of the small intestine in the United States is 67.6%. […] Survival is highly variable based on the stage at diagnosis. […] The incidence of small intestine cancer has been increasing in the developed world over at least the past half-century. […] In 1975, the incidence in the United States was 1.1, relative to 2.4 in 2018. […] This constitutes an increase of 118% over the past 43 years.

• #10 Small Intestine Cancer — Cancer Stat Facts

  http://seer.cancer.gov/statfacts/html/smint.html

  Estimated New Cases in 2025 13,920. […] % of All New Cancer Cases 0.7%. […] Estimated Deaths in 2025 2,060. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year. […] Small intestine cancer represents 0.7% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 13,920 new cases of small intestine cancer and an estimated 2,060 people will die of this disease. […] Cancer of the small intestine is slightly more common among men than women. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year based on 20182022 cases, age-adjusted. […] For small intestine cancer, death rates increase with age. […] The death rate was 0.4 per 100,000 men and women per year based on 20192023 deaths, age-adjusted.

• #11 Small Intestine Cancer — Cancer Stat Facts

  http://seer.cancer.gov/statfacts/html/smint.html

  Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new small intestine cancer cases have been rising on average 2.3% each year over 20132022. […] Age-adjusted death rates have been rising on average 1.8% each year over 20142023.

• #12 Malignant Neoplasms of the Small Intestine: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/282684-overview

  Males represent a slight preponderance of new cases (52%) compared with females (48%). […] The prevalence of small-bowel cancer tends to increase with age, with a mean age at diagnosis of approximately 60 years. Adenocarcinomas, more than the other histologic subtypes, tend to be diagnosed in somewhat older patients.

• #13 Small Intestine Cancer — Cancer Stat Facts

  http://seer.cancer.gov/statfacts/html/smint.html

  Estimated New Cases in 2025 13,920. […] % of All New Cancer Cases 0.7%. […] Estimated Deaths in 2025 2,060. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year. […] Small intestine cancer represents 0.7% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 13,920 new cases of small intestine cancer and an estimated 2,060 people will die of this disease. […] Cancer of the small intestine is slightly more common among men than women. […] The rate of new cases of small intestine cancer was 2.6 per 100,000 men and women per year based on 20182022 cases, age-adjusted. […] For small intestine cancer, death rates increase with age. […] The death rate was 0.4 per 100,000 men and women per year based on 20192023 deaths, age-adjusted.

• #14 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  In 2018, there were an estimated 10,470 small intestine cancer cases in the United States. […] These cases also comprised only 0.6% of all cancer diagnoses in the United States that year. […] According to 2015 data, the lifetime risk of developing small intestine cancer in the United States is about 0.3%, some 2–5 times less than that for cancer of the large intestine. […] While colorectal cancer ranks as the fourth most incident in the United States, small intestine cancer comes in 23rd place. […] Men are more increasingly likely than women to fall ill, with an incidence of 2.6 in 2018 relative to 2.0 for women. […] African Americans are disproportionately affected, with incidences of 4.2 and 3.5 among men and women, respectively, while Native Americans and Asians were the least likely to be diagnosed with the disease.

• #15 Advances in Small Bowel Cancer Generate New NCCN Guidelines

  https://www.onclive.com/view/advances-in-small-bowel-cancer-generate-new-nccn-guidelines

  A new set of recommendations for the treatment of small bowel adenocarcinoma, a relatively rare type cancer of the gastrointestinal tract, have been created by the National Comprehensive Cancer Network. The incidence of small bowel cancers is rising at an annual percent increase of 1.8 in contrast to the downward trend for other GI malignancies such as esophageal, colon, and rectum. It is estimated that 10,590 new cases of small bowel cancer will occur in the United States in 2019, and 1590 patients will die of the disease. SBA accounts for 30% to 40% of cases of small intestinal cancer affecting men and women almost equally, with an incidence of 2.6 per 100,000 men and 2.0 per 100,000 women. […] The NCCN guidelines note that risk factors for SBA are similar to those for CRC and include lifestyle factors, inflammatory bowel disease, and certain familial syndromes, notably Lynch syndrome. We think the immune system plays a protective role because of highly active immunosurveillance in the small intestine, Pedersen said. That might be one reason that fewer people develop SBA to the degree that people develop large intestine cancer. […] Although there have been few established guidelines for SBA to this point, it is hoped that with their creation, patients with these rare cancers may be treated in the best manner possible, said Pedersen.

• #16

  https://link.springer.com/article/10.1007/s10552-005-3635-6

  To examine the demographic and geographic patterns of small bowel cancer incidence in the United States and worldwide. […] Men had higher rates than women for all types of small bowel cancer. […] Blacks had almost double the incidence of carcinomas and carcinoid tumors compared to whites (10.6 vs. 5.6 per million people; 9.2 vs. 5.4 per million people, respectively). […] Small bowel cancer incidence has risen, with the greatest increase for carcinoid tumors (21%) and black men (120%). […] Small bowel cancer incidence in the U.S. is higher in blacks compared to whites, particularly for carcinomas and carcinoid tumors. […] Small bowel cancer incidence is rising, particularly in black men. […] The geographic correlation between large and small bowel cancer suggests shared etiologies.

• #17 Malignant Neoplasms of the Small Intestine: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/282684-overview

  Malignant neoplasms of the small bowel are among the rarest types of cancer, accounting for 3.5% of all GI cancers. […] The American Cancer Society estimates that 13,920 new cases of small intestine cancer and 2060 deaths from it will occur in the United States in 2025. […] In general, small-bowel cancer prevalence is lower in Asia and in less industrialized countries than in Western countries. In addition, several hospital-based series indicate that while adenocarcinomas constitute the majority of small-bowel cancers in developed countries, lymphomas predominate in less-developed countries. […] Population-based studies in the United States have suggested somewhat higher prevalence rates of small-bowel cancer for Blacks than for Whites. According to one study, Blacks have almost twice the incidence of carcinomas than Whites do (10.6 versus 5.6 per million population).

• #18 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  In 2018, there were an estimated 10,470 small intestine cancer cases in the United States. […] These cases also comprised only 0.6% of all cancer diagnoses in the United States that year. […] According to 2015 data, the lifetime risk of developing small intestine cancer in the United States is about 0.3%, some 2–5 times less than that for cancer of the large intestine. […] While colorectal cancer ranks as the fourth most incident in the United States, small intestine cancer comes in 23rd place. […] Men are more increasingly likely than women to fall ill, with an incidence of 2.6 in 2018 relative to 2.0 for women. […] African Americans are disproportionately affected, with incidences of 4.2 and 3.5 among men and women, respectively, while Native Americans and Asians were the least likely to be diagnosed with the disease.

• #19 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  The median age for the first diagnosis was 66 years. […] Mortality from neoplasms of the small intestine is 0.5/100,000 for men and 0.3 for women in the United States. […] The corresponding mortality rates for African Americans are 0.7 and 0.5, respectively. […] An estimated 1450 Americans died from small intestine cancer in 2018, which constituted 0.2% of all cancer deaths. […] The 5-year survival for neoplasms of the small intestine in the United States is 67.6%. […] Survival is highly variable based on the stage at diagnosis. […] The incidence of small intestine cancer has been increasing in the developed world over at least the past half-century. […] In 1975, the incidence in the United States was 1.1, relative to 2.4 in 2018. […] This constitutes an increase of 118% over the past 43 years.

• #20 Malignant Neoplasms of the Small Intestine: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/282684-overview

  Males represent a slight preponderance of new cases (52%) compared with females (48%). […] The prevalence of small-bowel cancer tends to increase with age, with a mean age at diagnosis of approximately 60 years. Adenocarcinomas, more than the other histologic subtypes, tend to be diagnosed in somewhat older patients.

• #21 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  According to the United States (US) National Cancer Database, there has been a rapid rise in the incidence of small bowel tumors, from 11.8 cases/million in 1973 to 22.7 cases/million in 2004. The lifetime risk of developing SBA in the US was only about 0.3% in 2015, and this was 2-5 times less than the risk of developing CRC. African Americans show disproportionate gender affliction, with incidences of 4.2 and 3.5 among men and women, respectively, while Native Americans and Asians are the least likely to be diagnosed with SBA. Duodenal primaries constitute about 50% of SBA, while jejunal and ileal primaries contribute to 30% and 20% of SBAs, respectively. The median age at diagnosis is around 60 years, of which over 85% present above 50 years of age and with a relatively higher incidence among males (relative risk: 2.6 for males, 2 for female). SBA is mostly diagnosed in the late stage. This highlights that SBA is difficult to diagnose and enlightens the lack of adequate screening programs, even for the high-risk individuals.

• #22 Small intestine cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer/incidence

  Small intestine cancer is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] In females in the UK, small intestine cancer is not among the 20 most common cancers (less than 1% of all new female cancer cases). In males in the UK, it is not among the 20 most common cancers (less than 1% of all new male cancer cases). […] Small intestine cancer incidence rates (European age-standardised (AS) rate) for persons are similar to the UK average in all the UK constituent countries. […] In the UK in 2017-2019, on average each year around a third of new cases (34%) were in people aged 75 and over. […] For small intestine cancer, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time.

• #23 Small intestine cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer

  There are around 1,900 new small intestine cancer cases in the UK every year, that’s more than 5 every day (2017-2019). […] Small intestine cancer is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] Incidence rates for small intestine cancer in the UK are highest in people aged 85 to 89 (2017-2019). […] Each year around a third (34%) of all new small intestine cancer cases in the UK are diagnosed in people aged 75 and over (2017-2019). […] Since the early 1990s, small intestine cancer incidence rates have increased by more than two-and-a-half times (176%) in the UK. […] Over the last decade, small intestine cancer incidence rates have increased by almost half (46%) in the UK. […] Small intestine cancer incidence rates are projected to rise by 44% in the UK between 2023-2025 and 2038-2040.

• #24 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6473503/

  The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. […] Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. […] Identification of hereditary and predisposing conditions, likely to blame for some 20% of cases, may help prevent and treat cancers of the small intestine. […] The small intestine is located between the stomach and the large intestine and is the primary site of end absorption of nutrients from food, including proteins, lipids, and carbohydrates. […] Cancers of the small intestine are primarily of two etiologies: small bowel adenocarcinoma (SBA) which account for 40% of cases, and neuroendocrine tumors, which account for another 40%.

• #25 Epidemiology and clinical features of small bowel neoplasms – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-clinical-features-of-small-bowel-neoplasms

  Epidemiology and clinical features of small bowel neoplasms […] The diagnosis of small bowel tumors is often difficult due to the rarity of these lesions and the nonspecific and variable nature of the presenting signs and symptoms. Thus, delay in diagnosis is common, which may result in the discovery of disease at a late stage and a poor treatment outcome. […] Several tumors can arise within the small bowel, both malignant (adenocarcinomas, neuroendocrine tumors, lymphomas, and sarcomas) and benign (adenomas, leiomyomas, lipomas). Epidemiology, clinical manifestations, and specific tumor types will be reviewed here. Diagnosis, staging, and management of small bowel tumors are discussed separately. […] The distribution of histologic types of small bowel malignant tumors is changing, largely because of the increasing incidence of neuroendocrine tumors (NETs). In 1987, the most common histologic types of malignant tumors of the small intestine in population-based registry data from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (NCI) were adenocarcinoma 45 percent, NET 29 percent, lymphoma 16 percent, and sarcoma 10 percent.

• #26 Epidemiology and clinical features of small bowel neoplasms – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-clinical-features-of-small-bowel-neoplasms

  In the year 2000, NETs surpassed adenocarcinomas as the most common small bowel tumor reported to the National Cancer Database (NCDB). Between 1985 and 2005, the proportion of patients with NETs increased from 28 to 44 percent, while the proportion of adenocarcinoma decreased from 42 to 33 percent. The proportion of patients with stromal tumors and lymphoma remained essentially stable (17 and 8 percent, respectively).

• #27 Epidemiology and clinical features of small bowel neoplasms – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-clinical-features-of-small-bowel-neoplasms

  Epidemiology and clinical features of small bowel neoplasms […] The diagnosis of small bowel tumors is often difficult due to the rarity of these lesions and the nonspecific and variable nature of the presenting signs and symptoms. Thus, delay in diagnosis is common, which may result in the discovery of disease at a late stage and a poor treatment outcome. […] Several tumors can arise within the small bowel, both malignant (adenocarcinomas, neuroendocrine tumors, lymphomas, and sarcomas) and benign (adenomas, leiomyomas, lipomas). Epidemiology, clinical manifestations, and specific tumor types will be reviewed here. Diagnosis, staging, and management of small bowel tumors are discussed separately. […] The distribution of histologic types of small bowel malignant tumors is changing, largely because of the increasing incidence of neuroendocrine tumors (NETs). In 1987, the most common histologic types of malignant tumors of the small intestine in population-based registry data from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (NCI) were adenocarcinoma 45 percent, NET 29 percent, lymphoma 16 percent, and sarcoma 10 percent.

• #28 Epidemiology and clinical features of small bowel neoplasms – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-clinical-features-of-small-bowel-neoplasms

  In the year 2000, NETs surpassed adenocarcinomas as the most common small bowel tumor reported to the National Cancer Database (NCDB). Between 1985 and 2005, the proportion of patients with NETs increased from 28 to 44 percent, while the proportion of adenocarcinoma decreased from 42 to 33 percent. The proportion of patients with stromal tumors and lymphoma remained essentially stable (17 and 8 percent, respectively).

• #29 Epidemiology of cancer of the small intestine

  https://www.wjgnet.com/1948-5204/full/v3/i3/33.htm

  The US SEER registries data of long-term surveillance show an increase in incidence rates of the small intestine from 1.18 in 1973 to 2.27 per 100000 population in 2004, with the increase more than 4-fold for carcinoid tumors and less dramatic increases for adenocarcinomas and lymphomas. The increase occurred in both men and women and in both whites and blacks, but may be most pronounced among black males. […] Because of the rarity of SBC, relatively little is known about risk factors for SBC. However, the international correlation between rates of colon cancer and small intestine cancer suggests that some of the same factors which affect colon cancer incidence may be operative for small intestine cancers. […] Cancers of the small intestine are rare. They are comprised of 4 major histological types (adenocarcinomas, carcinoid tumors, lymphomas and sarcomas). The incidence of small intestine cancer has increased over the past several decades, with the increase more than 4-fold for carcinoid tumors and less profound for adenocarcinoma and lymphoma and relatively stable for sarcomas. Currently, with the possible exceptions of obesity and cigarette smoking, there are no established modifiable risk factors which might provide the foundation for a prevention program aimed at reducing the incidence and mortality of cancers of the small intestine. More research with better quality and sufficient statistical power is needed to get better understanding of the etiology and biology of this cancer.

• #30 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  According to the United States (US) National Cancer Database, there has been a rapid rise in the incidence of small bowel tumors, from 11.8 cases/million in 1973 to 22.7 cases/million in 2004. The lifetime risk of developing SBA in the US was only about 0.3% in 2015, and this was 2-5 times less than the risk of developing CRC. African Americans show disproportionate gender affliction, with incidences of 4.2 and 3.5 among men and women, respectively, while Native Americans and Asians are the least likely to be diagnosed with SBA. Duodenal primaries constitute about 50% of SBA, while jejunal and ileal primaries contribute to 30% and 20% of SBAs, respectively. The median age at diagnosis is around 60 years, of which over 85% present above 50 years of age and with a relatively higher incidence among males (relative risk: 2.6 for males, 2 for female). SBA is mostly diagnosed in the late stage. This highlights that SBA is difficult to diagnose and enlightens the lack of adequate screening programs, even for the high-risk individuals.

• #31 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 12% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. […] The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. […] Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. […] The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. […] Multivariate analysis revealed performance status 34, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS).

• #32 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  In turn, survival rates have improved in par with increasing incidence. […] The 5-year survival was 33.1% in 1975, compared to 67.6% in 2015. […] This constitutes a doubling in average survival over a span of 40 years. […] The increase in incidence may be partially due to better surveillance and diagnostics, but may also have been fueled by lifestyles, such as the rise in obesity, smoking, and consumption of alcohol and red and processed meats. […] Some 20% of cases are likely due to underlying hereditary or predisposing conditions. […] However, studies of risk factors and treatments for small intestine cancers have been limited by the rarity of the disease, and the best course of action is preventing and treating the deadly and elusive neoplasm.

• #33 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6473503/

  Survival rates have markedly improved in the past decades, thanks to highly-sensitive means of early diagnosis. […] The efficacy of adjuvant chemotherapy among those getting surgical resection remains controversial. […] The incidence of small intestine cancer has been increasing in the developed world over at least the past half-century. […] The 5-year survival for neoplasms of the small intestine in the United States is 67.6%. […] Survival is highly variable based on the stage at diagnosis. […] The incidence of small intestine cancer has been increasing in the developed world over at least the past half-century. […] The increase in incidence may be partially due to better surveillance and diagnostics, but may also have been fueled by lifestyles, such as the rise in obesity, smoking, and consumption of alcohol and red and processed meats.

• #34 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6473503/

  The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. […] Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. […] Identification of hereditary and predisposing conditions, likely to blame for some 20% of cases, may help prevent and treat cancers of the small intestine. […] The small intestine is located between the stomach and the large intestine and is the primary site of end absorption of nutrients from food, including proteins, lipids, and carbohydrates. […] Cancers of the small intestine are primarily of two etiologies: small bowel adenocarcinoma (SBA) which account for 40% of cases, and neuroendocrine tumors, which account for another 40%.

• #35 Epidemiology of cancer of the small intestine

  https://www.wjgnet.com/1948-5204/full/v3/i3/33.htm

  Cancer of the small intestine is very uncommon. The incidence of small intestine cancer has increased over the past several decades with a four-fold increase for carcinoid tumors, less dramatic rises for adenocarcinoma and lymphoma and stable sarcoma rates. Very little is known about its etiology. An increased risk has been noted for individuals with Crohns disease, celiac disease, adenoma, familial adenomatous polyposis and Peutz-Jeghers syndrome. The prognosis for carcinomas of the small intestine cancer is poor (5 years relative survival 30%), better for lymphomas and sarcomas, and best for carcinoid tumors. Currently, with the possible exceptions of obesity and cigarette smoking, there are no established modifiable risk factors which might provide the foundation for a prevention program aimed at reducing the incidence and mortality of cancers of the small intestine. More research with better quality and sufficient statistical power is needed to get better understanding of the etiology and biology of this cancer.

• #36 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. […] Mortality has grown at a slower pace, thanks to improvements in early diagnosis and treatment, as well as a shift in the etiology of neoplasms affecting the small intestine. […] Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. […] Identification of hereditary and predisposing conditions, likely to blame for some 20% of cases, may help prevent and treat cancers of the small intestine. […] Studies of the neoplasm have been limited by small sample sizes due to the rarity of the disease, leaving many questions about prevention and treatment yet to be answered.

• #37 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 12% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. […] The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. […] Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. […] The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. […] Multivariate analysis revealed performance status 34, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS).

• #38 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  About 60% of patients are symptomatic at presentation, and the most common symptom is related to stenosis. Symptomatic presentation was more common for jejuno-ileal primaries (84%) as compared to duodenum (54%). For duodenal primaries, patients present with complaints suggestive of both stenosis or bleeding. […] The disease staging of SBA is similar to CRC and the prognosis is directly related to the stage of the disease. Approximately 10% of the patients present with stage I disease, 30% with stage II, 25% with stage III, and 35% with stage IV disease, which reflects the delay in diagnosis. The 5-year overall survival (OS) for SBA is around 20%-30%. The stage-wise 5-year OS is 55%, 50%, 30%, and 5% for Stages I, II, III, and IV, respectively. Moreover, the 5-year disease-free survival (DFS) in stage III patients is related to the number of lymph nodes involved. The DFS is 58% with two or less positive lymph nodes vs 35% with three or more. In general, the prognosis of SBA is worse than CRC but better than gastric cancer. Other factors associated with poor prognosis are advanced age, poor performance status, duodenal primary, low serum albumin, high carcinoembryonic antigen (CEA) or cancer antigen 19-9 (CA 19.9), poorly differentiated tumor, and positive surgical margins. Those with duodenal primary have the worst prognosis, probably related to under-staging and incomplete lymph node dissection.

• #39 Survival statistics for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/prognosis-and-survival/survival-statistics

  Survival statistics for small intestine cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, a 5-year net survival statistic is reported for small intestine cancer. The 5-year net survival for small intestine cancer is 54%. This means that about 54% of people diagnosed with small intestine cancer will survive for at least 5 years. […] Survival varies with each stage and type of small intestine cancer, as well as whether or not it can be completely removed with surgery (is resectable). The following factors can also affect survival for small intestine cancer. […] Generally, the earlier small intestine cancer is diagnosed and treated, the better the outcome.

• #40 Small intestine cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer

  There could be around 4,500 new cases of small intestine cancer every year in the UK by 2038-2040, projections suggest. […] Small intestine cancer is not among the 20 most common causes of cancer death in the UK, accounting for less than 1% of all cancer deaths (2017-2019). […] Mortality rates for small intestine cancer in the UK are highest in people aged 85 to 89 (2017-2019). […] Since the early 1970s, small intestine cancer mortality rates have increased by almost half (45%) in the UK. […] Small intestine cancer mortality rates are projected to rise by 1% in the UK between 2023-2025 and 2038-2040. […] More than half (53.0%) of people diagnosed with small intestine cancer in England survive their disease for five years or more, it is predicted (2016-2020). […] Five-year relative survival for small intestine cancer is below or similar to the European average in the UK. […] Nearly 1 in 250 UK females and 1 in 240 UK males will be diagnosed with small intestine cancer in their lifetime (born in 1961).

• #41 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 12% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. […] The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. […] Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. […] The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. […] Multivariate analysis revealed performance status 34, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS).

• #42 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  About 60% of patients are symptomatic at presentation, and the most common symptom is related to stenosis. Symptomatic presentation was more common for jejuno-ileal primaries (84%) as compared to duodenum (54%). For duodenal primaries, patients present with complaints suggestive of both stenosis or bleeding. […] The disease staging of SBA is similar to CRC and the prognosis is directly related to the stage of the disease. Approximately 10% of the patients present with stage I disease, 30% with stage II, 25% with stage III, and 35% with stage IV disease, which reflects the delay in diagnosis. The 5-year overall survival (OS) for SBA is around 20%-30%. The stage-wise 5-year OS is 55%, 50%, 30%, and 5% for Stages I, II, III, and IV, respectively. Moreover, the 5-year disease-free survival (DFS) in stage III patients is related to the number of lymph nodes involved. The DFS is 58% with two or less positive lymph nodes vs 35% with three or more. In general, the prognosis of SBA is worse than CRC but better than gastric cancer. Other factors associated with poor prognosis are advanced age, poor performance status, duodenal primary, low serum albumin, high carcinoembryonic antigen (CEA) or cancer antigen 19-9 (CA 19.9), poorly differentiated tumor, and positive surgical margins. Those with duodenal primary have the worst prognosis, probably related to under-staging and incomplete lymph node dissection.

• #43 Specific survival nomograms based on SEER database for small intestine adenocarcinoma – Wang – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/74309/html

  This study built and verified nomograms to predict OS and CSS for rare SIA, which appear to be excellent tools to augment the clinically available evidence to facilitate the discussion between SIA patients and clinicians regarding therapeutic choice. […] This study developed and effectively validated prognostic OS and CSS nomograms for patients with SIA that could be better incorporated into clinical practice to guide surveillance and management strategies based on tumor and demographic variables. […] The study demonstrated that tumor location was associated with survival rates. […] Based on the American Joint Committee on Cancer (AJCC) staging system, the tumor stage is the single most important prognostic factor in small bowel adenocarcinomas. […] The nomograms displayed that missed surgery was the worst prognostic factor, even worse than metastatic disease.

• #44 Small Intestine Cancer — Cancer Stat Facts

  http://seer.cancer.gov/statfacts/html/smint.html

  Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new small intestine cancer cases have been rising on average 2.3% each year over 20132022. […] Age-adjusted death rates have been rising on average 1.8% each year over 20142023.

• #45 Small intestine cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer

  There could be around 4,500 new cases of small intestine cancer every year in the UK by 2038-2040, projections suggest. […] Small intestine cancer is not among the 20 most common causes of cancer death in the UK, accounting for less than 1% of all cancer deaths (2017-2019). […] Mortality rates for small intestine cancer in the UK are highest in people aged 85 to 89 (2017-2019). […] Since the early 1970s, small intestine cancer mortality rates have increased by almost half (45%) in the UK. […] Small intestine cancer mortality rates are projected to rise by 1% in the UK between 2023-2025 and 2038-2040. […] More than half (53.0%) of people diagnosed with small intestine cancer in England survive their disease for five years or more, it is predicted (2016-2020). […] Five-year relative survival for small intestine cancer is below or similar to the European average in the UK. […] Nearly 1 in 250 UK females and 1 in 240 UK males will be diagnosed with small intestine cancer in their lifetime (born in 1961).

• #46 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6473503/

  Some 20% of cases are likely due to underlying hereditary or predisposing conditions. […] However, studies of risk factors and treatments for small intestine cancers have been limited by the rarity of the disease, and the best course of action is preventing and treating the deadly and elusive neoplasm.

• #47 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  In turn, survival rates have improved in par with increasing incidence. […] The 5-year survival was 33.1% in 1975, compared to 67.6% in 2015. […] This constitutes a doubling in average survival over a span of 40 years. […] The increase in incidence may be partially due to better surveillance and diagnostics, but may also have been fueled by lifestyles, such as the rise in obesity, smoking, and consumption of alcohol and red and processed meats. […] Some 20% of cases are likely due to underlying hereditary or predisposing conditions. […] However, studies of risk factors and treatments for small intestine cancers have been limited by the rarity of the disease, and the best course of action is preventing and treating the deadly and elusive neoplasm.

• #48 Risk Estimates of Small Bowel Cancer in Inflammatory Bowel

  https://www.esmo.org/oncology-news/risk-estimates-of-small-bowel-cancer-in-inflammatory-bowel-disease

  Findings from a large, prospective cohort study of patients with inflammatory bowel disease diagnosed in Norway and Sweden Date: 16 Mar 2022 Topics: Population Risk Factor Tumour Site: Gastrointestinal Cancers […] A population-based cohort study of all patients with inflammatory bowel disease diagnosed in Norway and Sweden from 1987 through 2016 was conducted to quantify the risk of small bowel adenocarcinoma and neuroendocrine tumours in patients with ulcerative colitis and Crohns disease. Patients with Crohns disease experienced an 8-fold increased risk of small bowel adenocarcinomas, while patients with both ulcerative colitis and Crohns disease experienced an about 2-fold increased risk of neuroendocrine tumours, and patients with ulcerative colitis experienced 2-fold increased risk of small bowel adenocarcinoma.

• #49 Epidemiology of cancer of the small intestine

  https://www.wjgnet.com/1948-5204/full/v3/i3/33.htm

  Cancer of the small intestine is very uncommon. The incidence of small intestine cancer has increased over the past several decades with a four-fold increase for carcinoid tumors, less dramatic rises for adenocarcinoma and lymphoma and stable sarcoma rates. Very little is known about its etiology. An increased risk has been noted for individuals with Crohns disease, celiac disease, adenoma, familial adenomatous polyposis and Peutz-Jeghers syndrome. The prognosis for carcinomas of the small intestine cancer is poor (5 years relative survival 30%), better for lymphomas and sarcomas, and best for carcinoid tumors. Currently, with the possible exceptions of obesity and cigarette smoking, there are no established modifiable risk factors which might provide the foundation for a prevention program aimed at reducing the incidence and mortality of cancers of the small intestine. More research with better quality and sufficient statistical power is needed to get better understanding of the etiology and biology of this cancer.

• #50 Risks for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/risks

  People with Crohn’s disease have an increased risk of small intestine cancer, especially in the last part of the small intestine (called the ileum). […] People with celiac disease have an increased risk of small intestine cancer. […] People who had colorectal cancer have a higher risk of developing small intestine cancer. Having other cancers, such as ovarian, soft tissue sarcoma and pancreatic cancer, also increases the risk for small intestine cancer, but the overall risk is still low. […] Having certain genetic conditions increases the risk of developing small intestine cancer.

• #51 Risk Estimates of Small Bowel Cancer in Inflammatory Bowel

  https://www.esmo.org/oncology-news/risk-estimates-of-small-bowel-cancer-in-inflammatory-bowel-disease

  Findings from a large, prospective cohort study of patients with inflammatory bowel disease diagnosed in Norway and Sweden Date: 16 Mar 2022 Topics: Population Risk Factor Tumour Site: Gastrointestinal Cancers […] A population-based cohort study of all patients with inflammatory bowel disease diagnosed in Norway and Sweden from 1987 through 2016 was conducted to quantify the risk of small bowel adenocarcinoma and neuroendocrine tumours in patients with ulcerative colitis and Crohns disease. Patients with Crohns disease experienced an 8-fold increased risk of small bowel adenocarcinomas, while patients with both ulcerative colitis and Crohns disease experienced an about 2-fold increased risk of neuroendocrine tumours, and patients with ulcerative colitis experienced 2-fold increased risk of small bowel adenocarcinoma.

• #52 Increased risk of small bowel cancer in individuals with celiac disease – but absolute numbers are low | Karolinska Institutet

  https://news.ki.se/increased-risk-of-small-bowel-cancer-in-individuals-with-celiac-disease-but-absolute-numbers-are-low

  Through a unique database, KI researchers have studied the risk of small bowel cancer in individuals with celiac disease. The study compared risk of small bowel cancer in 48,119 individuals with celiac disease and 239,249 reference individuals. The researchers could also differentiate between different types of small bowel cancers and found that risk of small bowel adenocarcinomas was increased three-fold in celiac patients compared to reference individuals whereas risk of carcinoids was not increased. The study further showed that celiac patients were also at increased risk of small bowel adenomas (precursors of adenocarcinomas). Absolute risk in celiac patients was however low and could be described as 1 extra case of small bowel adenocarcinoma in every 2944 patients with celiac disease followed for 10 years.

• #53 Risks for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/risks

  People with Crohn’s disease have an increased risk of small intestine cancer, especially in the last part of the small intestine (called the ileum). […] People with celiac disease have an increased risk of small intestine cancer. […] People who had colorectal cancer have a higher risk of developing small intestine cancer. Having other cancers, such as ovarian, soft tissue sarcoma and pancreatic cancer, also increases the risk for small intestine cancer, but the overall risk is still low. […] Having certain genetic conditions increases the risk of developing small intestine cancer.

• #54 Increased risk of small bowel cancer in individuals with celiac disease – but absolute numbers are low | Karolinska Institutet

  https://news.ki.se/increased-risk-of-small-bowel-cancer-in-individuals-with-celiac-disease-but-absolute-numbers-are-low

  Through a unique database, KI researchers have studied the risk of small bowel cancer in individuals with celiac disease. The study compared risk of small bowel cancer in 48,119 individuals with celiac disease and 239,249 reference individuals. The researchers could also differentiate between different types of small bowel cancers and found that risk of small bowel adenocarcinomas was increased three-fold in celiac patients compared to reference individuals whereas risk of carcinoids was not increased. The study further showed that celiac patients were also at increased risk of small bowel adenomas (precursors of adenocarcinomas). Absolute risk in celiac patients was however low and could be described as 1 extra case of small bowel adenocarcinoma in every 2944 patients with celiac disease followed for 10 years.

• #55 Current Advance in Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?number=6345

  Recently we reported the overall frequency of small intestinal tumors as 4.3% in Korean national cohort of wireless capsule endoscopy (WCE) which was performed with indications including obscure gastrointestinal bleeding (OGIB), abdominal pain, weight loss, diarrhea, and so on. […] This raises the possibility of increasing incidence of SB tumor in clinical practice with advance of new diagnostic technology. […] On the bases of known risk factors for small intestinal malignant tumors, patients at risk might have benefit from proper surveillance. […] Patients with familial and nonfamilial polyposis syndrome are at increased risk of small intestinal cancer as well as colorectal cancer. […] The risk of small intestinal adenocarcinoma varies according to the types of polyposis syndrome.

• #56 Risks for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/risks

  People with Crohn’s disease have an increased risk of small intestine cancer, especially in the last part of the small intestine (called the ileum). […] People with celiac disease have an increased risk of small intestine cancer. […] People who had colorectal cancer have a higher risk of developing small intestine cancer. Having other cancers, such as ovarian, soft tissue sarcoma and pancreatic cancer, also increases the risk for small intestine cancer, but the overall risk is still low. […] Having certain genetic conditions increases the risk of developing small intestine cancer.

• #57 Current Advance in Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?number=6345

  HNPCC is caused by germ line mutations of one of the mis-match repair genes, usually MLH1, MSH2, and MSH6. […] For patients with HNPCC, the cumulative risk of small intestinal adenocarcinoma was estimated as 3-4% and it is more than 100 times the risk of the general population. […] Routine screening for upper gastrointestinal tract and colon is recommended, beginning at the age of 18, with 2-3 year interval. […] Recent proposal recommends small intestinal surveillance with WCE, beginning at the age of 18, with 3 year interval. […] Early diagnosis and treatment of small intestinal adenoma/cancer in patients with HNPCC syndrome will probably improve prognosis. […] In patients with cutaneous melanoma, intestinal metastasis is not uncommon condition and early detection of intestinal metastasis can possibly improve the chance of cure.

• #58 Adenocarcinoma of the small bowel | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/adenocarcinoma-of-the-small-bowel?lang=us

  Primary adenocarcinoma of the small bowel is about 50 times less common than colon adenocarcinoma. […] Risk factors include a history of Crohn disease, sprue, Peutz-Jeghers syndrome, Lynch syndrome, congenital bowel duplication, ileostomy, or duodenal or jejunal bypass surgery.

• #59 Risks for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/risks

  Certain behaviours, substances or conditions can affect your risk, or chance, of developing cancer. Some things increase your risk and some things decrease it. Most cancers are the result of many risks. But sometimes cancer develops in people who don’t have any risks. […] The risk of developing small intestine cancer increases with age. Most people are diagnosed when they are 60 years or older. […] Slightly more men than women develop small intestine cancer. […] Small intestine cancer occurs in Black people (including people of African or Caribbean ancestry) more often than people of other ethnicities. […] The following can increase your risk for small intestine cancer. None of these risks can be changed. Until we learn more about other risks, there are no specific ways you can lower your risk for small intestine cancer.

• #60 Risks for small intestine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/small-intestine/risks

  People with Crohn’s disease have an increased risk of small intestine cancer, especially in the last part of the small intestine (called the ileum). […] People with celiac disease have an increased risk of small intestine cancer. […] People who had colorectal cancer have a higher risk of developing small intestine cancer. Having other cancers, such as ovarian, soft tissue sarcoma and pancreatic cancer, also increases the risk for small intestine cancer, but the overall risk is still low. […] Having certain genetic conditions increases the risk of developing small intestine cancer.

• #61 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  In turn, survival rates have improved in par with increasing incidence. […] The 5-year survival was 33.1% in 1975, compared to 67.6% in 2015. […] This constitutes a doubling in average survival over a span of 40 years. […] The increase in incidence may be partially due to better surveillance and diagnostics, but may also have been fueled by lifestyles, such as the rise in obesity, smoking, and consumption of alcohol and red and processed meats. […] Some 20% of cases are likely due to underlying hereditary or predisposing conditions. […] However, studies of risk factors and treatments for small intestine cancers have been limited by the rarity of the disease, and the best course of action is preventing and treating the deadly and elusive neoplasm.

• #62 Small-Intestine Cancer, IBD, and the Role of Gut Dysbiosis

  https://www.uspharmacist.com/article/smallintestine-cancer-ibd-and-the-role-of–gut-dysbiosis

  Pharmacists should note that with regard to decreasing the incidence and mortality rates of cancer of the small intestine, obesity and cigarette smoking may be the only established modifiable risk factors that provide a basis for prevention recommendations. […] Cancers of the small intestine are more common in individuals with a number of IBDs and other conditions.

• #63 Can Small Intestine Cancer (Adenocarcinoma) Be Found Early? | American Cancer Society

  https://www.cancer.org/cancer/types/small-intestine-cancer/detection-diagnosis-staging/detection.html

  Screening is testing for diseases like cancer in people who do not have any symptoms. Screening tests can find some types of cancer early, when treatment is most likely to be effective. But small intestine adenocarcinomas are rare, and no effective screening tests have been found for these cancers, so routine testing for people without any symptoms is not recommended. […] For people with certain inherited genetic syndromes who are at increased risk of small intestine cancer, doctors might recommend regular tests to look for cancer early, especially in the duodenum (the first part of the small intestine). Tests that might be done include upper endoscopy (in which a long tube with a tiny video camera on the end is passed down the throat, through the stomach, and into the duodenum), CT scans, and endoscopic ultrasound (EUS).

• #64

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gastrointestinal/small-bowel-malignancies

  Malignancies that arise from the small intestine are quite rare. They include many histologic subtypes including: adenocarcinoma, lymphoma, sarcoma, and neuroendocrine tumours. This section addresses adenocarcinomas arising from the duodenum, jejunum and ileum. Please refer to the linked sections for management of all other subtypes. […] Due to the rarity of malignancies arising from the small bowel, there are no recommended screening guidelines. […] Due to the rarity of these tumours, clinical trials are lacking, and most treatments are based on consensus opinion. […] Due to the rarity of malignancies arising from the small bowel, there are no recommended surveillance guidelines. […] Patients with a small bowel adenocarcinoma are known to have a higher incidence of secondary malignancies involving the colon, rectum, ampulla of Vater, endometrium and ovary which warrants early investigation of any worrisome symptoms.

• #65 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  About 60% of patients are symptomatic at presentation, and the most common symptom is related to stenosis. Symptomatic presentation was more common for jejuno-ileal primaries (84%) as compared to duodenum (54%). For duodenal primaries, patients present with complaints suggestive of both stenosis or bleeding. […] The disease staging of SBA is similar to CRC and the prognosis is directly related to the stage of the disease. Approximately 10% of the patients present with stage I disease, 30% with stage II, 25% with stage III, and 35% with stage IV disease, which reflects the delay in diagnosis. The 5-year overall survival (OS) for SBA is around 20%-30%. The stage-wise 5-year OS is 55%, 50%, 30%, and 5% for Stages I, II, III, and IV, respectively. Moreover, the 5-year disease-free survival (DFS) in stage III patients is related to the number of lymph nodes involved. The DFS is 58% with two or less positive lymph nodes vs 35% with three or more. In general, the prognosis of SBA is worse than CRC but better than gastric cancer. Other factors associated with poor prognosis are advanced age, poor performance status, duodenal primary, low serum albumin, high carcinoembryonic antigen (CEA) or cancer antigen 19-9 (CA 19.9), poorly differentiated tumor, and positive surgical margins. Those with duodenal primary have the worst prognosis, probably related to under-staging and incomplete lymph node dissection.

• #66 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 12% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. […] The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. […] Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. […] The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. […] Multivariate analysis revealed performance status 34, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS).

• #67 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  In this study, we conducted a multicentre observational study to clarify the clinical characteristics, current status, prognostic factors, and outcome of primary SBA. […] Most previous studies followed a single-centre retrospective design, which were likely limited by selection bias. […] In this study, primary SBA was most common in men in their 60s, and was located in the duodenum in 72.7% of patients. […] Most SBA patients are diagnosed after symptom onset. […] However, stenosis-related symptoms are rarely identified in early SBA patients, because the small intestinal products are liquid and, therefore, less likely to obstruct. […] As a result, most SBA patients are diagnosed with advanced disease. […] In this study, when focusing only on duodenal adenocarcinoma, 40% of patients were diagnosed with asymptomatic, early-stage disease.

• #68 Can Small Intestine Cancer (Adenocarcinoma) Be Found Early? | American Cancer Society

  https://www.cancer.org/cancer/types/small-intestine-cancer/detection-diagnosis-staging/detection.html

  Screening is testing for diseases like cancer in people who do not have any symptoms. Screening tests can find some types of cancer early, when treatment is most likely to be effective. But small intestine adenocarcinomas are rare, and no effective screening tests have been found for these cancers, so routine testing for people without any symptoms is not recommended. […] For people with certain inherited genetic syndromes who are at increased risk of small intestine cancer, doctors might recommend regular tests to look for cancer early, especially in the duodenum (the first part of the small intestine). Tests that might be done include upper endoscopy (in which a long tube with a tiny video camera on the end is passed down the throat, through the stomach, and into the duodenum), CT scans, and endoscopic ultrasound (EUS).

• #69 Current Advance in Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?number=6345

  HNPCC is caused by germ line mutations of one of the mis-match repair genes, usually MLH1, MSH2, and MSH6. […] For patients with HNPCC, the cumulative risk of small intestinal adenocarcinoma was estimated as 3-4% and it is more than 100 times the risk of the general population. […] Routine screening for upper gastrointestinal tract and colon is recommended, beginning at the age of 18, with 2-3 year interval. […] Recent proposal recommends small intestinal surveillance with WCE, beginning at the age of 18, with 3 year interval. […] Early diagnosis and treatment of small intestinal adenoma/cancer in patients with HNPCC syndrome will probably improve prognosis. […] In patients with cutaneous melanoma, intestinal metastasis is not uncommon condition and early detection of intestinal metastasis can possibly improve the chance of cure.

• #70 The Usefulness of Capsule Endoscopy for Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2016.49.1.21

  VCE is recommended as an adequate surveillance method as well as MRE in European guidelines. […] Small bowel screening using VCE is recommended to be performed every 3 years if polyps are found at the initial examination, from age of 8 years, or earlier if the patient is symptomatic. […] High-risk group of small bowel tumors includes patients with FAP, PJS, Lynch syndrome, and lymphoma and skin melanoma. VCE as well as MRE/CTE are promising in small bowel surveillance.

• #71 The Usefulness of Capsule Endoscopy for Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2016.49.1.21

  VCE is recommended as an adequate surveillance method as well as MRE in European guidelines. […] Small bowel screening using VCE is recommended to be performed every 3 years if polyps are found at the initial examination, from age of 8 years, or earlier if the patient is symptomatic. […] High-risk group of small bowel tumors includes patients with FAP, PJS, Lynch syndrome, and lymphoma and skin melanoma. VCE as well as MRE/CTE are promising in small bowel surveillance.

• #72 Capsule Endoscopy Not Recommended for Small Bowel Cancer Screening

  https://www.gastroenterologyadvisor.com/news/capsule-endoscopy-not-recommended-for-small-bowel-cancer-screening/

  Small-bowel cancer surveillance using capsule endoscopy may not be effective for screening Lynch syndrome. […] Using capsule endoscopy for small bowel cancer screening in patients with asymptomatic Lynch syndrome is not recommended, according to study findings published in Digestive and Liver Disease. […] The estimated pooled diagnostic yield was 8% (95% CI, 4-12%) for capsule endoscopy pathological findings, such as suspected adenoma or adenocarcinoma. […] However, when limiting the results to pathological findings with confirmed histology via endoscopy or surgical specimens in the next investigation, the estimated pooled diagnostic yield decreased to 2% (95% CI 0-6%). […] When limiting the results to pathological findings with confirmed histology, the estimated pooled diagnostic yield of capsule endoscopy was 0% (95% CI 0%-6%). […] Hence, the results of our analysis do not support the use of CE for SB cancer screening in asymptomatic LS individuals as a standard protocol, strengthening the level of evidence on which current guidelines rely.

• #73 The Usefulness of Capsule Endoscopy for Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2016.49.1.21

  Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. […] Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. […] Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. […] Small bowel tumor surveillance in high-risk group can result in early detection of disease and make the prognosis better. […] Inherited polyposis syndromes, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are well known high-risk groups of small bowel tumors. […] Small bowel surveillance strategies are on the table for FAP and PJS.

• #74 The Usefulness of Capsule Endoscopy for Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2016.49.1.21

  Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. […] Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. […] Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. […] Small bowel tumor surveillance in high-risk group can result in early detection of disease and make the prognosis better. […] Inherited polyposis syndromes, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are well known high-risk groups of small bowel tumors. […] Small bowel surveillance strategies are on the table for FAP and PJS.

• #75 The Usefulness of Capsule Endoscopy for Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?doi=10.5946/ce.2016.49.1.21

  Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. […] Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. […] Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. […] Small bowel tumor surveillance in high-risk group can result in early detection of disease and make the prognosis better. […] Inherited polyposis syndromes, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are well known high-risk groups of small bowel tumors. […] Small bowel surveillance strategies are on the table for FAP and PJS.

• #76 Current Advance in Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?number=6345

  HNPCC is caused by germ line mutations of one of the mis-match repair genes, usually MLH1, MSH2, and MSH6. […] For patients with HNPCC, the cumulative risk of small intestinal adenocarcinoma was estimated as 3-4% and it is more than 100 times the risk of the general population. […] Routine screening for upper gastrointestinal tract and colon is recommended, beginning at the age of 18, with 2-3 year interval. […] Recent proposal recommends small intestinal surveillance with WCE, beginning at the age of 18, with 3 year interval. […] Early diagnosis and treatment of small intestinal adenoma/cancer in patients with HNPCC syndrome will probably improve prognosis. […] In patients with cutaneous melanoma, intestinal metastasis is not uncommon condition and early detection of intestinal metastasis can possibly improve the chance of cure.

• #77 Frequency, prognosis and treatment modalities of newly diagnosed small bowel cancer with liver metastases | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-020-01487-6

  Population-based analysis for the liver metastases of small bowel cancer is currently lacking. This study aimed to analyze the frequency, prognosis and treatment modalities for newly diagnosed small bowel cancer patients with liver metastases. […] A certain proportion of small bowel cancer patients presented with evidence of distant metastases at the initial diagnosis, wherein liver exhibited the most common metastatic organ. Evidently, the presence of liver metastases served as an important predictor for worse prognosis of small bowel cancer, which may due to the increasing tumor burden and impairment of vital organ function caused by disease progression. […] The current study described the frequency and prognosis of small bowel cancer patients with liver metastases at their initial diagnosis by using available data from the SEER database. We also explored the predictive indicators for the presence of liver metastases, and sought its optimal treatment modalities based on the survival data, with an attempt to better understand the clinical significance of liver metastases.

• #78 Frequency, prognosis and treatment modalities of newly diagnosed small bowel cancer with liver metastases | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-020-01487-6

  In summary, this study provided investigation of the frequency for liver metastases of small bowel cancer at initial diagnosis. Primary tumor presented with lower part of small intestine, poor tumor grade, larger tumor size, later N staging, and presence of more extrahepatic metastatic sites had increased propensity of developing liver metastases. The combined predictor had a good ability to predict the presence of liver metastases. Patients with liver metastases had significant poorer survival than those without liver metastases. In addition, combination of surgery and chemotherapy conferred the optimal survival for patients with adenocarcinoma, while the optimal treatment options for NEC and GISS seemed to be surgery alone and chemotherapy alone, respectively.

• #79 Small bowel adenocarcinoma: An overview

  https://www.wjgnet.com/1948-5204/full/v14/i2/413.htm

  The prognosis of SBA remains poor even after surgical resection. The 5-year survival ranges from 20%-50%. The pattern of relapse is predominantly systemic. In a study by Dabaja et al, out of 146 patients who underwent curative resection, 58 patients had disease recurrence. The patterns of recurrence were: distant, carcinomatosis, abdominal wall, and local recurrence in 33, 11, 4, and 10 patients, respectively. Since SBA is a rare disease, randomized controlled trials (RCTs) on the use of adjuvant therapy are largely lacking. The role of adjuvant treatment in SBA is still not clear. The use of chemotherapy in the adjuvant setting has been extrapolated from colon cancers because of clinicopathological and molecular similarities.

• #80

  https://journals.lww.com/ajg/fulltext/2020/10001/s1289_incidence_of_small_bowel_cancer_in_the.1290.aspx

  Small bowel cancers (SBC) cases are growing since 1973. The last review of incidence, pathology race and sex distribution using the Surveillance, Epidemiology, and End Results (SEER) database was done in 2004. The goal of the study to detect major changes and trends of SBC incidence. […] The incidence rate for SBC for steadily rising since 1973, between both males and females, and among all races, P 0.001. Levels for most common SBO cancers (adenocarcinoma, carcinoid, lymphoma, GIST, sarcomas) were rising for all races and genders except lymphoma rates for black males, females, and Asian/Alaskan Native/Pacific Islanders males which remained stable over the time. […] The incidence was rising for all cancer morphologies with advanced patient`s age (P 0.05) and peaked at the age 75. […] The results of the study correspond to previous studies. However, discovered that the incidence of the carcinoid (14.45 cpm) overcame adenocarcinoma (7.5 cpm) almost twice. It also provided an in-depth incidence analysis between races and sexes. Due to the recognition of GIST in the separate group, we now clearly observe a steady decrease in sarcoma number of cases.

• #81

  https://journals.lww.com/ajg/fulltext/2020/10001/s1289_incidence_of_small_bowel_cancer_in_the.1290.aspx

  Small bowel cancers (SBC) cases are growing since 1973. The last review of incidence, pathology race and sex distribution using the Surveillance, Epidemiology, and End Results (SEER) database was done in 2004. The goal of the study to detect major changes and trends of SBC incidence. […] The incidence rate for SBC for steadily rising since 1973, between both males and females, and among all races, P 0.001. Levels for most common SBO cancers (adenocarcinoma, carcinoid, lymphoma, GIST, sarcomas) were rising for all races and genders except lymphoma rates for black males, females, and Asian/Alaskan Native/Pacific Islanders males which remained stable over the time. […] The incidence was rising for all cancer morphologies with advanced patient`s age (P 0.05) and peaked at the age 75. […] The results of the study correspond to previous studies. However, discovered that the incidence of the carcinoid (14.45 cpm) overcame adenocarcinoma (7.5 cpm) almost twice. It also provided an in-depth incidence analysis between races and sexes. Due to the recognition of GIST in the separate group, we now clearly observe a steady decrease in sarcoma number of cases.

• #82

  https://journals.lww.com/ajg/fulltext/2020/10001/s1289_incidence_of_small_bowel_cancer_in_the.1290.aspx

  Small bowel cancers (SBC) cases are growing since 1973. The last review of incidence, pathology race and sex distribution using the Surveillance, Epidemiology, and End Results (SEER) database was done in 2004. The goal of the study to detect major changes and trends of SBC incidence. […] The incidence rate for SBC for steadily rising since 1973, between both males and females, and among all races, P 0.001. Levels for most common SBO cancers (adenocarcinoma, carcinoid, lymphoma, GIST, sarcomas) were rising for all races and genders except lymphoma rates for black males, females, and Asian/Alaskan Native/Pacific Islanders males which remained stable over the time. […] The incidence was rising for all cancer morphologies with advanced patient`s age (P 0.05) and peaked at the age 75. […] The results of the study correspond to previous studies. However, discovered that the incidence of the carcinoid (14.45 cpm) overcame adenocarcinoma (7.5 cpm) almost twice. It also provided an in-depth incidence analysis between races and sexes. Due to the recognition of GIST in the separate group, we now clearly observe a steady decrease in sarcoma number of cases.

• #83

  https://journals.lww.com/ajg/fulltext/2020/10001/s1289_incidence_of_small_bowel_cancer_in_the.1290.aspx

  Small bowel cancers (SBC) cases are growing since 1973. The last review of incidence, pathology race and sex distribution using the Surveillance, Epidemiology, and End Results (SEER) database was done in 2004. The goal of the study to detect major changes and trends of SBC incidence. […] The incidence rate for SBC for steadily rising since 1973, between both males and females, and among all races, P 0.001. Levels for most common SBO cancers (adenocarcinoma, carcinoid, lymphoma, GIST, sarcomas) were rising for all races and genders except lymphoma rates for black males, females, and Asian/Alaskan Native/Pacific Islanders males which remained stable over the time. […] The incidence was rising for all cancer morphologies with advanced patient`s age (P 0.05) and peaked at the age 75. […] The results of the study correspond to previous studies. However, discovered that the incidence of the carcinoid (14.45 cpm) overcame adenocarcinoma (7.5 cpm) almost twice. It also provided an in-depth incidence analysis between races and sexes. Due to the recognition of GIST in the separate group, we now clearly observe a steady decrease in sarcoma number of cases.

• #84 Small intestine cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer/incidence

  Small intestine cancer European age-standardised (AS) incidence rates for females and males combined increased by 176% in the UK between 1993-1995 and 2017-2019. […] Small intestine cancer incidence rates have increased overall in all broad age groups in females and males combined in the UK since the early 1990s. […] The most common specific location for small intestine cancers in the UK is the duodenum (2016-2018). […] The number of new small intestine cancer cases on average each year in the UK is projected to rise from around 2,600 cases in 2023-2025 to around 4,500 cases in 2038-2040. […] Small intestine cancer incidence rates are projected to rise by 44% in the UK between 2023-2025 and 2038-2040, to 6 cases per 100,000 people on average each year by 2038-2040. […] Small intestine cancer incidence rates (European age-standardised (AS) rates) in England in females are similar in the most deprived quintile compared with the least, and in males are 22% higher in the most deprived quintile compared with the least (2013-2017).

• #85 Small intestine cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/small-intestine-cancer

  There could be around 4,500 new cases of small intestine cancer every year in the UK by 2038-2040, projections suggest. […] Small intestine cancer is not among the 20 most common causes of cancer death in the UK, accounting for less than 1% of all cancer deaths (2017-2019). […] Mortality rates for small intestine cancer in the UK are highest in people aged 85 to 89 (2017-2019). […] Since the early 1970s, small intestine cancer mortality rates have increased by almost half (45%) in the UK. […] Small intestine cancer mortality rates are projected to rise by 1% in the UK between 2023-2025 and 2038-2040. […] More than half (53.0%) of people diagnosed with small intestine cancer in England survive their disease for five years or more, it is predicted (2016-2020). […] Five-year relative survival for small intestine cancer is below or similar to the European average in the UK. […] Nearly 1 in 250 UK females and 1 in 240 UK males will be diagnosed with small intestine cancer in their lifetime (born in 1961).

• #86 Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention

  https://www.mdpi.com/2076-3271/7/3/46

  The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. […] Mortality has grown at a slower pace, thanks to improvements in early diagnosis and treatment, as well as a shift in the etiology of neoplasms affecting the small intestine. […] Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. […] Identification of hereditary and predisposing conditions, likely to blame for some 20% of cases, may help prevent and treat cancers of the small intestine. […] Studies of the neoplasm have been limited by small sample sizes due to the rarity of the disease, leaving many questions about prevention and treatment yet to be answered.

• #87

  https://www.cancervic.org.au/cancer-information/statistics/small-bowel-cancer.html

  Figure 3 shows that for males between 1982 to 2022 the incidence of small bowel cancer increased by an average of 3.4% per year. For females between 1982 to 2022 the incidence of small bowel cancer increased by an average of 3.5% per year. […] Figure 8 shows the change in 5-year survival for small bowel cancer, and the 5-year survival trend for all cancers over the same time period. It demonstrates that five-year relative survival has increased for small bowel cancer between 1982-1986 and 2017-2021 from 49% to 68%.

• #88 Epidemiology and clinical features of small bowel neoplasms – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-clinical-features-of-small-bowel-neoplasms

  Epidemiology and clinical features of small bowel neoplasms […] The diagnosis of small bowel tumors is often difficult due to the rarity of these lesions and the nonspecific and variable nature of the presenting signs and symptoms. Thus, delay in diagnosis is common, which may result in the discovery of disease at a late stage and a poor treatment outcome. […] Several tumors can arise within the small bowel, both malignant (adenocarcinomas, neuroendocrine tumors, lymphomas, and sarcomas) and benign (adenomas, leiomyomas, lipomas). Epidemiology, clinical manifestations, and specific tumor types will be reviewed here. Diagnosis, staging, and management of small bowel tumors are discussed separately. […] The distribution of histologic types of small bowel malignant tumors is changing, largely because of the increasing incidence of neuroendocrine tumors (NETs). In 1987, the most common histologic types of malignant tumors of the small intestine in population-based registry data from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (NCI) were adenocarcinoma 45 percent, NET 29 percent, lymphoma 16 percent, and sarcoma 10 percent.

• #89 Risk Estimates of Small Bowel Cancer in Inflammatory Bowel

  https://www.esmo.org/oncology-news/risk-estimates-of-small-bowel-cancer-in-inflammatory-bowel-disease

  Because the absolute risk increase is so small, surveillance programmes that aim to detect small bowel cancer in early, asymptomatic stages are unlikely to generate a measurable, cost-effective mortality benefit according to Prof. Hans-Olov Adami of the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet in Stockholm, Sweden and colleagues, who published the results on 8 March 2022 in the Annals of Oncology. […] The authors concluded that in patients with Crohns disease a likely causal association exists with an 8-fold increased risk of small bowel adenocarcinoma. Whether the 2-fold increased risk of developing neuroendocrine tumours reflects a causal association or arises due to ascertainment bias is currently uncertain. Patients with ulcerative colitis probably experience a 2-fold increased risk of both small bowel adenocarcinomas and neuroendocrine tumours which may be confined to those with extensive disease. The small absolute excess cancer risk suggests that active surveillance to diagnose small bowel cancer early is unlikely to be cost-effective.

• #90 Increased risk of small bowel cancer in individuals with celiac disease – but absolute numbers are low | Karolinska Institutet

  https://news.ki.se/increased-risk-of-small-bowel-cancer-in-individuals-with-celiac-disease-but-absolute-numbers-are-low

  The study supports a strong but not statistically significant association with lower risk of small bowel adenocarcinoma in individuals that reach mucosal healing at follow-up biopsy. The researchers concluded that the results do not imply a need for surveillance but celiac individuals with signs or symptoms of malignancy should merit further investigation for small bowel adenocarcinoma. […] Our study found no association with carcinoids, which suggests that lead-time and detection biases are limited.

• #91 Current Advance in Small Bowel Tumors

  https://www.e-ce.org/journal/view.php?number=6345

  HNPCC is caused by germ line mutations of one of the mis-match repair genes, usually MLH1, MSH2, and MSH6. […] For patients with HNPCC, the cumulative risk of small intestinal adenocarcinoma was estimated as 3-4% and it is more than 100 times the risk of the general population. […] Routine screening for upper gastrointestinal tract and colon is recommended, beginning at the age of 18, with 2-3 year interval. […] Recent proposal recommends small intestinal surveillance with WCE, beginning at the age of 18, with 3 year interval. […] Early diagnosis and treatment of small intestinal adenoma/cancer in patients with HNPCC syndrome will probably improve prognosis. […] In patients with cutaneous melanoma, intestinal metastasis is not uncommon condition and early detection of intestinal metastasis can possibly improve the chance of cure.

• #92 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  In this study, we conducted a multicentre observational study to clarify the clinical characteristics, current status, prognostic factors, and outcome of primary SBA. […] Most previous studies followed a single-centre retrospective design, which were likely limited by selection bias. […] In this study, primary SBA was most common in men in their 60s, and was located in the duodenum in 72.7% of patients. […] Most SBA patients are diagnosed after symptom onset. […] However, stenosis-related symptoms are rarely identified in early SBA patients, because the small intestinal products are liquid and, therefore, less likely to obstruct. […] As a result, most SBA patients are diagnosed with advanced disease. […] In this study, when focusing only on duodenal adenocarcinoma, 40% of patients were diagnosed with asymptomatic, early-stage disease.

• #93 The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study | British Journal of Cancer

  https://www.nature.com/articles/bjc2017338

  These patients were diagnosed incidentally by screening via EGD, which is widely performed in Japan, as directed by the national healthcare system, for detection of gastric cancer. […] Considering the low prevalence of SBA, EGD for the detection of duodenal cancer may not be a reasonable approach. […] However, our findings suggest that when EGD is performed, regardless of the reason, observing the duodenum with the intention of detecting duodenal cancer is recommended. […] The OS of 36.9 months in the combined modality therapy group was clearly long, highlighting the benefit of this treatment protocol.

• #94 Epidemiology of cancer of the small intestine

  https://www.wjgnet.com/1948-5204/full/v3/i3/33.htm

  The US SEER registries data of long-term surveillance show an increase in incidence rates of the small intestine from 1.18 in 1973 to 2.27 per 100000 population in 2004, with the increase more than 4-fold for carcinoid tumors and less dramatic increases for adenocarcinomas and lymphomas. The increase occurred in both men and women and in both whites and blacks, but may be most pronounced among black males. […] Because of the rarity of SBC, relatively little is known about risk factors for SBC. However, the international correlation between rates of colon cancer and small intestine cancer suggests that some of the same factors which affect colon cancer incidence may be operative for small intestine cancers. […] Cancers of the small intestine are rare. They are comprised of 4 major histological types (adenocarcinomas, carcinoid tumors, lymphomas and sarcomas). The incidence of small intestine cancer has increased over the past several decades, with the increase more than 4-fold for carcinoid tumors and less profound for adenocarcinoma and lymphoma and relatively stable for sarcomas. Currently, with the possible exceptions of obesity and cigarette smoking, there are no established modifiable risk factors which might provide the foundation for a prevention program aimed at reducing the incidence and mortality of cancers of the small intestine. More research with better quality and sufficient statistical power is needed to get better understanding of the etiology and biology of this cancer.

• #95

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gastrointestinal/small-bowel-malignancies

  Malignancies that arise from the small intestine are quite rare. They include many histologic subtypes including: adenocarcinoma, lymphoma, sarcoma, and neuroendocrine tumours. This section addresses adenocarcinomas arising from the duodenum, jejunum and ileum. Please refer to the linked sections for management of all other subtypes. […] Due to the rarity of malignancies arising from the small bowel, there are no recommended screening guidelines. […] Due to the rarity of these tumours, clinical trials are lacking, and most treatments are based on consensus opinion. […] Due to the rarity of malignancies arising from the small bowel, there are no recommended surveillance guidelines. […] Patients with a small bowel adenocarcinoma are known to have a higher incidence of secondary malignancies involving the colon, rectum, ampulla of Vater, endometrium and ovary which warrants early investigation of any worrisome symptoms.

• #96

  https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/267555

  Treatment strategies are evolving; surgical resection remains the mainstay for localized disease, augmented by systemic therapies and targeted agents for advanced stages. […] This review emphasizes the importance of early detection and individualized treatment approaches in improving outcomes for SBT patients. […] It addresses the need for ongoing research and innovation in managing these tumors.

• #97 Small bowel cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer/small-bowel-cancer

  Small bowel cancer is rare. About 1,800 people in the UK are diagnosed with it each year. […] People who have had colon cancer or rectal cancer have an increased risk of developing small bowel cancer. […] Small bowel cancer can be diagnosed in different ways. […] The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. […] A team of specialists will meet to discuss the best possible treatment for you. This team is called a multidisciplinary team (MDT). […] Surgery is the most common treatment for small bowel cancer. […] Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the cancer cells. […] Targeted therapy drugs find and attack cancer cells. […] This treatment is not commonly used for small bowel cancer. […] You will have regular check-ups during and after your treatment. […] Small bowel cancer and its treatment can affect your sex life. […] It can take time to recover after small bowel cancer treatment.

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