Incidence and Relative Survival of Patients with Merkel Cell Carcinoma in North Rhine-Westphalia, Germany, 2008-2021

BACKGROUND

To date, only a few population-representative studies have been carried out on the rare Merkel cell carcinoma (MCC). We provide incidence and survival estimates of MCC, including the conditional relative survival.

METHODS

We analyzed data from the cancer registry of North Rhine-Westphalia, Germany, 2008-2021, covering a population of 18 million. We included all newly diagnosed MCCs and calculated age-standardized (old European Standard population) incidence rates and unconditional and conditional relative survival.

RESULTS

Our analysis included 2164 MCC patients. The age-standardized incidence of MCC was 5.2 (men) and 3.8 (women) per million person-years. The 5-year relative survival was 58.8% (men) and 70.7% (women). Survival was lower among men than women in all age-sex groups and was highest for MCC of the upper extremity in both men (68.2%) and women (79.3%). The sex difference in survival is particularly due to the better survival of women with MCC of the head and neck. In terms of survival, the first two years are particularly critical.

CONCLUSIONS

Our data validate the worse survival among men and highlights a more favorable prognosis for MCCs located on the limbs. The first two years after diagnosis of MCC are the years with the highest excess mortality.

Mortality from prostate cancer in the years 2007-2021 in North Rhine-Westphalia, Germany

BACKGROUND

The crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany.

METHODS

Based on the cause of death statistics and data from the NRW State Cancer Registry on 45,300 deaths in the years 2007-2021, mortality rates, the lifetime mortality risk from prostate cancer, median age at death and years of life lost are presented. Additionally, the 15 most frequent causes of death of 95,013 patients diagnosed with prostate cancer are reported.

RESULTS

With a stable lifetime mortality risk from prostate cancer, age-standardised mortality and years of life lost per capita are decreasing while crude mortality and median age at death are increasing in NRW. Less than half of the patients die from their prostate cancer. Cancers of the urinary bladder and other urinary organs also occur more frequently as a cause of death than it would be expected based on the age-specific risk in the total population.

CONCLUSIONS

More people in North Rhine-Westphalia are dying of prostate cancer over time due to demographic ageing alone. At the same time, the age-specific mortality risk has not increased and when patients die of prostate cancer, it is at an increasingly older age. However, there is a statistical association with deaths from cancers of the lower urinary tract in patients diagnosed with prostate cancer, which demands further evaluation.

Incidence trends and relative survival of colorectal neuroendocrine neoplasms: A population-based study using German cancer registry data

Neuroendocrine neoplasms (NENs) of the colon and rectum are a heterogeneous group of epithelial neoplasms with neuroendocrine differentiation. They include well-differentiated neuroendocrine tumors (NETs), poorly differentiated neuroendocrine carcinomas (NECs) and mixed neuroendocrine-non-neuroendocrine 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-standardized incidence rates, annual percent changes, and the relative 5-year survival probability for the calendar period 2017-2021. 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 <55 years, and in the incidence of MiNENs, and a constant incidence of NECs. The relative five-year survival was high for rectal NETs (95.9%, 95%-CI 94.6; 97.1) and colonic NETs (81.4%, 95%-CI 78.3; 84.5) and low for colonic NECs (20.5%, 95%-CI 17.6; 23.4) and rectal NECs (19.2%, 95%-CI 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.