University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.
BJS Open. 2022 Jul 7;6(4). doi: 10.1093/bjsopen/zrac103.
Recent data suggest that the incidence of malignant appendiceal tumours is increasing. This study aimed to determine temporal trends in the incidence of malignant appendiceal tumours within England and a possible influence by demographic factors.
All incident cases of appendiceal tumours in patients aged 20 years and above were identified from the National Cancer Registration and Analysis Service database between 1995 and 2016 using ICD-9/10 codes. Cancers were categorized according to histology. Joinpoint regression analysis was used to investigate changes in age-standardized incidence rates by age, sex, histological subtype and index of multiple deprivation quintiles, based on socioeconomic domains (income, employment, education, health, crime, barriers to housing and services and living environment). Average annual per cent changes (AAPCs) were estimated by performing Monte-Carlo permutation analysis.
A total of 7333 tumours were diagnosed and 7056 patients were analysed, comprising 3850 (54.6 per cent) neuroendocrine tumours (NETs), 1892 (26.8 per cent) mucinous adenocarcinomas and 1314 (18.6 per cent) adenocarcinoma (not otherwise specified). The overall incidence of appendiceal tumours increased from 0.3 per 100 000 to 1.6 per 100 000 over the study interval. Incidence rate increases of comparable magnitude were observed across all age groups, but the AAPC was highest among patients aged 20-29 years (15.6 per cent, 95 per cent c.i 12.7-18.6 per cent) and 30-39 years (14.2 per cent, 12.2-16.2 per cent) and lowest among those aged 70-79 years (6.8 per cent, 5.7-8.0 per cent). Similar incidence rate increases were reported across all socioeconomic deprivation quintiles and in both sexes. Analysis by grade of NET showed that grade 1 tumours accounted for 63 per cent between 2010 and 2013, compared with 2 per cent between 2000 and 2003.
The incidence rate of malignant appendiceal tumours has increased significantly since 1995 and is mainly attributed to an increase in NETs. The increased diagnosis of low-grade NETs may in part be due to changes in pathological classification systems.
最近的数据表明，恶性阑尾肿瘤的发病率正在上升。本研究旨在确定英格兰恶性阑尾肿瘤发病率的时间趋势，以及人口统计学因素的可能影响。
使用 ICD-9/10 代码，通过国家癌症登记和分析服务数据库，在 1995 年至 2016 年期间确定年龄在 20 岁及以上的所有阑尾肿瘤患者的发病病例。根据组织学将癌症分类。根据社会经济领域（收入、就业、教育、健康、犯罪、住房和服务障碍以及生活环境），基于年龄、性别、组织学亚型和多重剥夺五分位数指数，使用 Joinpoint 回归分析来研究年龄标准化发病率的变化。通过执行蒙特卡罗置换分析来估计平均年度百分比变化（AAPC）。
共诊断出 7333 个肿瘤，分析了 7056 名患者，其中 3850 名（54.6%）为神经内分泌肿瘤（NET），1892 名（26.8%）为黏液性腺癌，1314 名（18.6%）为腺癌（非特指）。研究期间，阑尾肿瘤的总发病率从 0.3/100000 上升至 1.6/100000。在所有年龄组中，发病率均呈相似的增长趋势，但在 20-29 岁和 30-39 岁的患者中 AAPC 最高（分别为 15.6%、95%可信区间 12.7-18.6%和 14.2%、95%可信区间 12.2-16.2%），而在 70-79 岁的患者中最低（6.8%、95%可信区间 5.7-8.0%）。在所有社会经济剥夺五分位数和两性中均报告了类似的发病率增长。NET 分级分析显示，2010 年至 2013 年期间，1 级肿瘤占 63%，而 2000 年至 2003 年期间仅占 2%。
自 1995 年以来，恶性阑尾肿瘤的发病率显著上升，主要归因于 NET 的增加。低级别 NET 诊断的增加可能部分归因于病理分类系统的变化。
