title: Increased incidence trend of low-grade and high-grade neuroendocrine neoplasms.
abstract: OBJECTIVE
  The incidence of neuroendocrine neoplasms is increasing. This work aimed at: (i) establishing worldwide incidence trend of low-grade neuroendocrine neoplasms; (ii) defining the incidence and temporal trend of high-grade neuroendocrine neoplasms in USA utilizing the Surveillance Epidemiology and End Results database; (iii) comparing trends for low-grade vs. high-grade neuroendocrine neoplasms.
  
  
  METHODS
  We conducted a literature search on MEDLINE and Scopus databases and incidence trends were plotted for 1973-2012. The Surveillance Epidemiology and End Results database was used to identify incidence rates in USA for 1973-2012. Incidence rates were stratified according to histological grade, gender and ethnicity. Trends were summarized as annual percent change and corresponding 95% confidence interval.
  
  
  RESULTS
  11 studies were identified involving 72,048 cases; neuroendocrine neoplasm incidence rates increased over time in all countries for all sites, except for appendix. In Surveillance Epidemiology and End Results low-grade neuroendocrine neoplasm incidence rate increased from 1.09 in 1973 to 3.51 per 100,000 in 2012. During this interval, high-grade neuroendocrine neoplasm incidence rate increased from 2.54 to 10.52 per 100,000. African Americans had the highest rates of digestive neuroendocrine neoplasms with male prevalence in high-grade.
  
  
  CONCLUSIONS
  Our data indicate an increase in the incidence of neuroendocrine neoplasms as a worldwide phenomenon, affecting most anatomical sites and involving both low-grade and high-grade neoplasms.
authors.affiliation: Section of Hygiene, Institute of Public Health, Rome, 00168, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Leoncini
authors.affiliation: Tisch Cancer Institute, New York, NY, 10029, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Departments of Surgery and Neoplastic Diseases, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
authors.forename: Michail
authors.initials: M
authors.lastname: Shafir
authors.affiliation: Section of Hygiene, Institute of Public Health, Rome, 00168, Italy.
authors.forename: Katina
authors.initials: K
authors.lastname: Aleksovska
authors.affiliation: Section of Hygiene, Institute of Public Health, Rome, 00168, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Boccia
authors.affiliation: Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Rome, 00168, Italy. guido.rindi@unicatt.it.|European NeuroEndocrine Tumor Society (ENETS) Center of Excellence, Rome, Italy. guido.rindi@unicatt.it.
authors.forename: Guido
authors.identifier: http://orcid.org/0000-0003-2996-4404
authors.initials: G
authors.lastname: Rindi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D018358:Neuroendocrine Tumors / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D018426:SEER Program; D014481:United States / Q000453:epidemiology
keywords: Cancer; High-grade; Incidence; Low-grade; Neuroendocrine