{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:14:22Z","timestamp":1783487662526,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neuroendocrine neoplasms (NEN) are rare and heterogeneous epithelial tumors, occurring throughout the body. For gastroenteropancreatic (GEP)\u2010NEN, rising incidence rates were reported for the last decades, with underlying causes remaining largely unexplained. We evaluated NEN trends stratifying by their histologic subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Incident cases of GEP\u2010NEN diagnosed between 2005 and 2019 were retrieved from the prospective, population\u2010based Bavarian Cancer Registry. GEP\u2010NEN were divided in their histologic subtypes, that is, neuroendocrine tumors (NET) G1, NET G2\/G3, other NET versus small\u2010cell neuroendocrine carcinoma (NEC), large\u2010cell NEC, and other NEC. We calculated annual age\u2010standardized incidence rates (ASIRs) per 100,000 persons for the total of GEP\u2010NEN, NEN histologic subtypes, and tumor sites. We used an annual percentage change (APC) approach including a joinpoint analysis to investigate NEN incidence trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ASIR of GEP\u2010NEN rose from 2.2 in 2005 to 4.8 in 2019, characterized by a significant increase until 2012 (APC 2005\u20132012: 10.1%), followed by modest rise (APC 2012\u20132019: 1.5%). In the last decade, this increase was mainly driven by the rise of NET G1 and G2\/G3, while incidence for NEC declined. Over the study period, ASIR increased significantly for all GEP\u2010sites except the colon. APCs were largest for the stomach, the appendix, the pancreas, and the rectum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found a significant increase in the incidence of GEP\u2010NET. Though this development may partially be attributable to the increased use of advanced detection techniques and changes in NEN classification, further research should also focus on the identification of NEN risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6510","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T09:34:52Z","timestamp":1695375292000},"page":"19949-19958","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Site\u2010specific trends in gastroenteropancreatic neuroendocrine neoplasms in Bavaria, Germany"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5715-2406","authenticated-orcid":false,"given":"Nina","family":"Grundmann","sequence":"first","affiliation":[{"name":"Bavarian Cancer Registry, Bavarian Health and Food Safety Authority  Nuremberg 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