Increased gastrointestinal stromal tumor (GIST) screening programs have caused a shift in diagnosis from the regional to the localized stage, leading to improved cancer-specific survival, according to a recently published study in BMJ Open.
GIST accounts for approximately 3% of gastrointestinal malignancies. Since implementing GIST-specific histology in 2001, most studies have focused on identifying risk factors, the researchers said. There needs to be more literature regarding survival trends and treatment patterns during the next decade, the authors noted.
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“This retrospective epidemiological analysis aimed to systematically characterize trends of the incidence and prevalence rates of GIST in the United States of America during the last decade, and describe the stage distribution, survival trend and patterns of initial treatment,” the authors wrote.
The investigators used data from the Surveillance, Epidemiology, and End Results database, identifying over 5000 patients with a confirmed GIST diagnosis.
The stomach was the most frequent cancer location in the studied population, followed by the small intestine. The authors observed that the age-standardized incidence rate (ASIR) had significantly risen in the last decade with an increase of approximately 30%; the annual prevalence showed a similar trend.
Most patients (over 60%) had a localized stage, and 20% had a distant stage. This represents a 58% increase in localized-stage patients in previous decades.
The 5-year survival rate was 92% for localized disease and 79% for the regional stage. Close to half of the patients in the study received only surgery as a treatment, 12% received only systemic therapy, and 35% received both systemic therapy and surgery. Radiotherapy was rarely used in the context of GIST.
“This study provides a substantial reference for updated epidemiology of GIST in the last decade. In this study, the ASIR of GIST increased significantly from 2010 to 2019, and across age and sex subgroups,” the authors wrote.
“A stage shift from regional stage to localized stage at diagnosis may reflect the increased cancer screening programs through endoscopy and endoscopic ultrasonography, and the stage shift may also be related to the improved period CSS rates,” they added.
Zhu H, Yang G, Ma Y, et al. Update of epidemiology, survival and initial treatment in patients with gastrointestinal stromal tumour in the USA: a retrospective study based on SEER database. BMJ Open. Published online July 7, 2023. doi: 10.1136/bmjopen-2023-072945