Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

Benjamin E. White; Beth Russell; Sebastiaan Remmers; Brian Rous; Kandiah Chandrakumaran; Kwok F. Wong; Mieke Van Hemelrijck; Rajaventhan Srirajaskanthan; John K. Ramage

doi:10.3390/cancers15061863

Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

Benjamin E. White^*, Beth Russell, Sebastiaan Remmers, Brian Rous, Kandiah Chandrakumaran, Kwok F. Wong, Mieke Van Hemelrijck, Rajaventhan Srirajaskanthan, John K. Ramage

^*Corresponding author for this work

Urology

Research output: Contribution to journal › Article › Academic › peer-review

11 Citations (Scopus)

23 Downloads (Pure)

Abstract

Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.

Original language	English
Article number	1863
Journal	Cancers
Volume	15
Issue number	6
DOIs	https://doi.org/10.3390/cancers15061863
Publication status	Published - 20 Mar 2023

Bibliographical note

Funding Information:
The data were extracted, processed and securely transferred by NCRAS using a grant of £10,000 from Neuroendocrine Cancer UK. B.E.W.’s salary was funded jointly by Hampshire Hospitals NHS Foundation Trust and the National Institute for Health Research.

Publisher Copyright:
© 2023 by the authors.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/cancers15061863Licence: CC BY

Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018Final published version, 438 KBLicence: CC BY

Cite this

@article{8d1348ff8d0946cebf0b6ffaa97f462d,

title = "Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study",

abstract = "Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England{\textquoteright}s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.",

author = "White, {Benjamin E.} and Beth Russell and Sebastiaan Remmers and Brian Rous and Kandiah Chandrakumaran and Wong, {Kwok F.} and {Van Hemelrijck}, Mieke and Rajaventhan Srirajaskanthan and Ramage, {John K.}",

note = "Funding Information: The data were extracted, processed and securely transferred by NCRAS using a grant of £10,000 from Neuroendocrine Cancer UK. B.E.W.{\textquoteright}s salary was funded jointly by Hampshire Hospitals NHS Foundation Trust and the National Institute for Health Research. Publisher Copyright: {\textcopyright} 2023 by the authors.",

year = "2023",

month = mar,

day = "20",

doi = "10.3390/cancers15061863",

language = "English",

volume = "15",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "6",

}

TY - JOUR

T1 - Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018

T2 - A Retrospective, Population-Based Study

AU - White, Benjamin E.

AU - Russell, Beth

AU - Remmers, Sebastiaan

AU - Rous, Brian

AU - Chandrakumaran, Kandiah

AU - Wong, Kwok F.

AU - Van Hemelrijck, Mieke

AU - Srirajaskanthan, Rajaventhan

AU - Ramage, John K.

N1 - Funding Information: The data were extracted, processed and securely transferred by NCRAS using a grant of £10,000 from Neuroendocrine Cancer UK. B.E.W.’s salary was funded jointly by Hampshire Hospitals NHS Foundation Trust and the National Institute for Health Research. Publisher Copyright: © 2023 by the authors.

PY - 2023/3/20

Y1 - 2023/3/20

N2 - Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.

AB - Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.

UR - http://www.scopus.com/inward/record.url?scp=85151482978&partnerID=8YFLogxK

U2 - 10.3390/cancers15061863

DO - 10.3390/cancers15061863

M3 - Article

C2 - 36980749

AN - SCOPUS:85151482978

SN - 2072-6694

VL - 15

JO - Cancers

JF - Cancers

IS - 6

M1 - 1863

ER -

Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

Abstract

Bibliographical note

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this