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They include well\u2010differentiated neuroendocrine tumors (NETs), poorly differentiated neuroendocrine carcinomas (NECs) and mixed neuroendocrine\u2010non\u2010neuroendocrine neoplasms (MiNENs). Our aim was to calculate incidence, incidence trends and relative survival for colonic and rectal NETs, NECs, and MiNENs. We analyzed data covering the entire German population recorded between 2009 and 2021, calculating age\u2010standardized incidence rates, annual percent changes, and the relative 5\u2010year survival probability for the calendar period 2017\u20132021. Our comprehensive analyses included 12,602 NEN cases, with 59% located in the rectum. NECs, MiNENs and tumors with colonic location showed higher stages. We observed an increase in the incidence of NETs, particularly in patients aged &lt;55\u2009years, and in the incidence of MiNENs, and a constant incidence of NECs. The relative five\u2010year survival was high for rectal NETs (95.9%, 95%\u2010CI 94.6; 97.1) and colonic NETs (81.4%, 95%\u2010CI 78.3; 84.5) and low for colonic NECs (20.5%, 95%\u2010CI 17.6; 23.4) and rectal NECs (19.2%, 95%\u2010CI 15.7; 22.6). The increase in the incidence of NETs might be partly due to colorectal cancer screening, improved diagnostics, and changes in classification of NETs. We attribute the increase in incidence of MiNENs to the recent introduction of this morphological category. Higher stages at diagnosis, a higher proportion of NECs and higher median age at diagnosis may contribute to the less favorable survival probabilities associated with colonic as opposed to rectal location.<\/jats:p>","DOI":"10.1002\/ijc.35372","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T12:39:28Z","timestamp":1740055168000},"page":"116-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Incidence trends and relative survival of colorectal neuroendocrine neoplasms: A population\u2010based study using German cancer registry data"],"prefix":"10.1002","volume":"157","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1090-9595","authenticated-orcid":false,"given":"Lennart","family":"M\u00f6ller","sequence":"first","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"},{"name":"Faculty of Medicine University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7892-2422","authenticated-orcid":false,"given":"Andras","family":"Szentkir\u00e1lyi","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4702-6235","authenticated-orcid":false,"given":"Christine","family":"Eisfeld","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1831-2542","authenticated-orcid":false,"given":"Ina","family":"Wellmann","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4140-8912","authenticated-orcid":false,"given":"Franziska","family":"Rees","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5375-2869","authenticated-orcid":false,"given":"Kevin","family":"Claa\u00dfen","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"},{"name":"Department of Medical Statistics and Epidemiology Medical School Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5840-8274","authenticated-orcid":false,"given":"Florian","family":"Oesterling","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3729-4447","authenticated-orcid":false,"given":"Hiltraud","family":"Kaj\u00fcter","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6363-9061","authenticated-orcid":false,"given":"Andreas","family":"Stang","sequence":"additional","affiliation":[{"name":"Cancer Registry of North Rhine Westphalia  Bochum Germany"},{"name":"Institute of Medical Informatics, Biometry and Epidemiology University Hospital Essen  Essen Germany"},{"name":"School of Public Health, Department of Epidemiology Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010018\u20100110\u2010y"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0589"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31124"},{"key":"e_1_2_9_5_1","volume-title":"Digestive System Tumours [Internet]","author":"WHO Classification of Tumours Editorial Board","year":"2019"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13975"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335594"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443166"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010017\u20101273\u2010x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC\u201013\u20100125"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912\u2010021\u201001172\u20101"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv505"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4377"},{"key":"e_1_2_9_14_1","volume-title":"Ver\u00e4nderung der vertrags\u00e4rztlichen Leistungsinanspruchnahme w\u00e4hrend der COVID\u2010Krise. 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