Incidence and Survival Outcomes of Gastrointestinal Stromal Tumors

• Published in: JAMA network open 2024-08, Vol.7 (8), p.e2428828
• Main Authors: Alvarez, Christian S, Piazuelo, M Blanca, Fleitas-Kanonnikoff, Tania, Ruhl, Jennifer, Pérez-Fidalgo, J Alejandro, Camargo, M Constanza
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cohort analysis; Cohort Studies; Epidemiology; Esophagus; Ethnicity; Female; Gastroenterology and Hepatology; Gastrointestinal cancer; Gastrointestinal Neoplasms - epidemiology; Gastrointestinal Neoplasms - mortality; Gastrointestinal Stromal Tumors - epidemiology; Gastrointestinal Stromal Tumors - ethnology; Gastrointestinal Stromal Tumors - mortality; Humans; Incidence; Male; Middle Aged; Mortality; Online Only; Original Investigation; Pacific Islander people; Race; SEER Program; Small intestine; Trends; Tumors; United States - epidemiology
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2024.28828

The incidence of gastrointestinal stromal tumors (GISTs) increased after the implementation of GIST-specific histology coding in 2001, but updated data on trends and survival are lacking. To examine the evolving epidemiology of GISTs in major organ sites. This descriptive, population-based cohort study used nationally representative data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program, including the SEER-22 and SEER-17 registries. Data were from evaluated patients aged 20 years or older with GISTs diagnosed between January 1, 2000, and December 31, 2019. Analyses were last updated on October 29, 2023. Organ site-specific trends in age-standardized incidence rates and annual percent changes (APCs) in rates were estimated by race and ethnicity and, when possible, by sex, age, and primary indicator. Multivariable Cox proportional hazards regression models were used to examine racial and ethnic differences in overall and GIST-specific survival by site. The SEER-22 and SEER-17 datasets contained 23 001 and 12 109 case patients with GISTs, respectively. Patients in the SEER-22 registry had a mean (SD) age of 64 (13) years and 51.3% were men. With regard to race and ethnicity, 9.7% of patients were Asian or Pacific Islander, 12.3% were Hispanic, 19.6% were non-Hispanic Black, and 57.7% were non-Hispanic White. Overall incidence rates of GISTs in the SEER-22 cohort increased substantially over time for all organ sites but the colon (APCs: esophagus, 7.3% [95% CI, 4.4% to 10.2%]; gastric, 5.1% [95% CI, 4.2% to 6.1%]; small intestine, 2.7% [95% CI, 1.8% to 3.7%]; colon, -0.2% [95% CI, -1.3% to 0.9%]; and rectum, 1.9% [95% CI, 0.1% to 3.8%]). There were similar increasing trends by age groups (