O42 Incidence of neuroendocrine neoplasms in England 2015–2017

Introduction Previously published National Cancer Registration and Analysis Service (NCRAS) data showed a higher than expected rise in incidence of Neuroendocrine Neoplasms (NENs) between 2001 and 2015 (Genus et al 2019). We aimed to analyse and report new NCRAS data in England including years 2015 – 2017 as coding (ICD-O-3) quality improves. We hypothesized incidence of NENs would continue to rise and increased accuracy of coding would lead to more accurate tumour classification. Methods Public Health England data for incidence and prevalence of NEN from NCRAS were analysed, broken down by age group, site, morphology and grade. Statistical analysis was performed using STATA to give age-standardised incidence rates (per 100,000 population) and upper and lower confidence intervals. Results During 2015 – 2017, 14,138 NENs were diagnosed in England; 7093 (50.17%) female. In 2016, NEN incidence in England was 9.37 per 100,000, an all-time high. Incidence remained the same in 2017. Incidence is trending upward in all agegroups. Incidence is higher in females in 0–54 agegroup, but in males in aged 65+. NEN incidence increased for most sites except lung NET which levelled off after previous yearly rises. Small intestine NET continued to rise sharply with a male preponderance. Pancreatic NET incidence continues to rise steadily. ‘Neuroendocrine tumour NOS (not otherwise specified)’ incidence reduced whilst ‘Carcinoid tumour’ and ‘Atypical carcinoid tumour’ rose, possibly due to recoding. NEC G3 incidence decreased, continuing a trend since 2011, with NET G1/G2 continuing to rise. 23-year prevalence for NENs in England was 26,735 (survival of 108,554 cases). 2017 prevalence was 48 per 100,000 (mid-year population of 55,619,430). Conclusions Age standardised incidence of NEN has risen above 9 per 100,000 for the first time. Rising incidence of NET remains unexplained, and with increasing survival with chronic symptoms, will become increasingly important. Differing male and female incidence in agegroup and certain sites, for example small intestine NET being greater in males, needs further analysis. Incidence of lung NET reduced for the first time. Improved coding of data may explain the reduction in non-specific ‘NOS’ numbers. NEC G3 incidence decreased whilst NEC G1/G2 increased, again likely due to coding changes. Prevalence is now higher than many other cancers. As coding continues to improve, more work on NCRAS data is needed to establish a true reflection of the NET landscape.