Carcinoid syndrome

E4_CARCISDR

Endpoint definition

Endpoint definition steps

FinnGen

Phenotype data

520210

1. Apply sex-specific rule

None

520210

2. Check conditions

None

520210

3. Check pre-conditions, main-only, mode, registry filters

Registry filters:

  • Hospital discharge: ICD-10 E34.0
  • Hospital discharge: ICD-9 2592
  • Cause of death: ICD-10 E34.0
  • Cause of death: ICD-9 2592

2 out of 7 registries used, show all original rules.

315

4. Check minimum number of events

None

315

5. Include endpoints

None

315

6. Filter based on genotype QC (FinnGen only)

315

Control definitions (FinnGen only)

Control exclude
E4_ENDOGLAND

Extra metadata

Level in the ICD hierarchy
4
First used in FinnGen datafreeze
DF2
Parent code in ICD-10
E34
Name in latin
Syndroma carcinoides

Case counts by codes

FinnGen case counts by registry codes:

generic upset plot

Upset plot

Full data table

Summary Statistics

-FinRegistry-

Key figures

All Female Male
Number of individuals
Whole population 1609 854 744
Only index persons 1230 666 564
Unadjusted period prevalence (%)
Whole population 0.02 0.02 0.02
Only index persons 0.02 0.02 0.02
Median age at first event (years)
Whole population 64.12 63.82 64.35
Only index persons 62.75 62.30 63.27

-FinnGen-

Key figures

All Female Male
Number of individuals 315 152 163
Unadjusted period prevalence (%) 0.06 0.05 0.07
Median age at first event (years) 62.00 60.32 63.57

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

No data

CodeWAS (R11)

CodeWAS is a tool for exploring the associations between an endpoint and all of the medical codes and drug codes.

This is a new tool, please reach out using the contact form for feedback and improvement ideas.

First, a cohort is built by matching controls to the endpoint cases using year of birth and sex. Then, a Fisher test is done for all the medical codes and drug codes between the cases and controls of this cohort. Codes are reported in the table below if they have −log10(p-value) ≥ 6.

Matched cohort

Matched cases
292
Matched controls
2918
Code
Vocabulary
Description
Odds Ratio
-log10(p)
N matched cases
N matched controls
E34.0
ICD-10 Finland
Carcinoid syndrome
+∞
323.0
276
*
H01CB02
ATC
octreotide; parenteral
1907.0
129.4
116
*
130
Kela drug reimbursment
Malignant tumour
31.2
126.0
184
151
C17.9
ICD-10 Finland
Malignant neoplasm: Small intestine, unspecified
892.3
122.7
112
*
H01CB03
ATC
lanreotide; parenteral
417.5
92.5
88
*
C78.7
ICD-10 Finland
Secondary malignant neoplasm of liver and intrahepatic bile duct
46.8
73.2
89
27
JN7AQ
NOMESCO Finland
Somatostatin receptor SPET med low dose CT
463.5
73.1
70
*
XX7JT
NOMESCO Finland
Somatostatin isotope ablative therapy
428.0
68.6
66
*
JFB00
NOMESCO Finland
Partial resection of small intestine
64.4
63.9
73
15
JN3CD
NOMESCO Finland
Abdominal CT examination both without and with contrast
29.7
63.8
87
41
JN4BD
NOMESCO Finland
Extensive body CT
11.5
63.3
136
205
C79.8
ICD-10 Finland
Secondary malignant neoplasm of other specified sites
23.3
55.8
82
48
JN5ER
NOMESCO Finland
PET-CT of receptors in whole body
329.7
55.2
54
*
C17.2
ICD-10 Finland
Malignant neoplasm: Ileum
322.3
54.1
53
*
JN3BD
NOMESCO Finland
Extensive abdominal CT
10.2
52.4
117
179
JN4CD
NOMESCO Finland
Very extensive body CT
14.3
48.5
87
84
8240/3-C17.9
ICD-O-3
Neuroendocrine tumor, NOS, of small intestine, NOS
539.8
47.8
46
*
JN4AD
NOMESCO Finland
Body CT examination
10.3
42.9
92
125
D77
ICPC
Malignant digestive neopl other/NOS
129.0
42.0
44
*
XX9AN
NOMESCO Finland
Complementary isotope examination or additional picture
167.3
42.0
43
*
L01AX03
ATC
temozolomide; systemic
162.8
40.9
42
*
D37.2
ICD-10 Finland
Neoplasm of uncertain or unknown behaviour: Small intestine
73.6
39.4
44
7
WD225
NOMESCO Finland
Demanding therapy of methastized malignancy with hormones
39.6
35.2
44
13
WD305
NOMESCO Finland
Simple therapy of methastized malignancy with biomodifiers
35.2
35.1
45
15
302
Kela drug reimbursment
Interferon alfa
+∞
34.0
32
*
A03FA01
ATC
metoclopramide; systemic, rectal
5.3
33.3
127
370
JFB30
NOMESCO Finland
Right hemicolectomy
26.3
28.3
39
17
L03AB05
ATC
interferon alfa-2b; parenteral
111.1
28.2
30
*
JJ2AT
NOMESCO Finland
Biopsy of liver with ultrasound guidance
16.6
26.7
43
30
C17.8
ICD-10 Finland
Malignant neoplasm: Overlapping lesion of small intestine
+∞
26.5
25
*
WZC20
NOMESCO Finland
Multidisciplinary treatment meeting
8.7
25.3
57
79
L01BC06
ATC
capecitabine; oral
12.0
25.2
47
46
JN7SN
NOMESCO Finland
Somatostatin receptor SPECT
272.3
25.1
25
*
WX302
NOMESCO Finland
Thoracal epidural anesthesy
8.3
24.9
58
85
D37.7
ICD-10 Finland
Neoplasm of uncertain or unknown behaviour: Other digestive organs
13.8
24.7
43
36
E34.9
ICD-10 Finland
Endocrine disorder, unspecified
+∞
24.3
23
*
T73
ICPC
Neoplasm endocrine other/unspecified
+∞
24.3
23
*
R10.4
ICD-10 Finland
Other and unspecified abdominal pain
3.7
23.9
148
633
JN1AE
NOMESCO Finland
Ultrasound examination of upper part of abdomen
5.7
22.9
72
159
A09AA02
ATC
multienzymes (lipase, protease etc.)
20.1
22.8
34
19
JN7AN
NOMESCO Finland
Somatostatin receptor isotope imaging
237.0
21.9
22
*
JKA20
NOMESCO Finland
Cholecystectomy
12.0
21.7
40
38
C10AC01
ATC
colestyramine; oral
15.2
20.6
34
25
C25.4
ICD-10 Finland
Malignant neoplasm: Endocrine pancreas
+∞
20.0
19
*
A04AA02
ATC
granisetron; systemic, transdermal
7.0
19.9
51
85
8240/3-C17.2
ICD-O-3
Neuroendocrine tumor, NOS, of ileum
213.9
19.8
20
*
D37.6
ICD-10 Finland
Neoplasm of uncertain or unknown behaviour: Liver, gallbladder and bile ducts
15.5
19.6
32
23
133
Kela drug reimbursment
Severe chronic pancreatic insufficiency
22.7
19.0
27
13
JN1CG
NOMESCO Finland
Extensive MRI examination of upper part of abdomen with high intensity magnet
11.5
18.8
35
34
XX9AD
NOMESCO Finland
Complementary CT
+∞
17.9
17
*
WX408
NOMESCO Finland
General anesthesy, balanced
3.1
17.4
125
562
C17.0
ICD-10 Finland
Malignant neoplasm: Duodenum
+∞
16.8
16
*
JN3AE
NOMESCO Finland
Abdominal ultrasound examination
4.0
16.8
75
232
JN4DD
NOMESCO Finland
Scout CT scan of torso
95.6
16.8
18
*
8249/3-C17.9
ICD-O-3
Neuroendocrine tumor, grade 2 of small intestine, NOS
179.8
16.7
17
*
UJD10
NOMESCO Finland
Esophagoscopy, gastroscopy and duodenoscopy
3.0
16.6
127
590
N02AA05
ATC
oxycodone; systemic
3.7
15.8
79
268
8246/3-C17.9
ICD-O-3
Neuroendocrine carcinoma, NOS, of small intestine, NOS
+∞
15.8
15
*
UJF32
NOMESCO Finland
Coloscopy
3.0
15.7
114
509
GD1AA
NOMESCO Finland
Thorax X-ray examination
2.7
15.3
170
984
WZC00
NOMESCO Finland
Planning of intervention or health care consultation
2.8
15.1
131
651
C18.19
ICD-10 Finland
Malignant tumor in appendix other or unspecified histology
+∞
14.7
14
*
C25.0
ICD-10 Finland
Malignant neoplasm: Head of pancreas
23.7
14.4
20
9
WD125
NOMESCO Finland
Demanding cystostatic therapy of methastized malignancy
6.4
14.2
38
67
FM1EE
NOMESCO Finland
Extensive structural and functional ultrasound examination of heart
2.9
13.8
107
490
C18.99
ICD-10 Finland
Malignant tumor in unspecified location in the colon other or unspecified histology
146.5
13.6
14
*
JFB20
NOMESCO Finland
Ileocaecal resection
25.7
12.6
17
7
2592A
ICD-9 Finland
Other endocrine disorders, Carcinoid syndrome
+∞
12.6
12
*
K56.6
ICD-10 Finland
Other and unspecified intestinal obstruction
7.0
12.6
31
49
C18.90
ICD-10 Finland
Malignant tumor in unspecified location in the colon without histology
135.6
12.5
13
*
WX602
NOMESCO Finland
Repeated or continuing anesthesia shots throug a catheter
4.5
12.2
44
110
JN3DG
NOMESCO Finland
Very extensive MRI examination with high intensity magnet
48.8
12.0
14
*
JAH00
NOMESCO Finland
Laparotomy
7.4
12.0
28
41
SPAT1256
SPAT
Intramuscular and subcutaneous injection
2.4
11.8
153
914
C18.09
ICD-10 Finland
Malignant tumor of caecum other or unspecified histology
67.7
11.7
13
*
Z51.5
ICD-10 Finland
Palliative care
4.6
11.5
41
101
JN3AD
NOMESCO Finland
Abdominal CT examination
4.3
11.1
42
110
A55
ICPC
General and Unspecified, Local injection/infiltration
29.3
10.8
14
5
ZXE10
NOMESCO Finland
More than one and less than three hours
2.4
10.7
133
765
C17.1
ICD-10 Finland
Malignant neoplasm: Jejunum
62.3
10.7
12
*
D76
ICPC
Malignant neoplasm pancreas
113.9
10.5
11
*
8249/3-C17.2
ICD-O-3
Neuroendocrine tumor, grade 2 of ileum
+∞
10.5
10
*
D37.9
ICD-10 Finland
Neoplasm of uncertain or unknown behaviour: Digestive organ, unspecified
33.9
10.4
13
*
B03BA03
ATC
hydroxocobalamin; parenteral
4.7
10.2
35
83
A79
ICPC
Malignancy NOS
10.6
10.2
19
19
TPH15
NOMESCO Finland
Insertion of central venous catheter through external or internal jugular vein
4.3
10.0
37
95
C25.9
ICD-10 Finland
Malignant neoplasm: Pancreas, unspecified
15.7
9.6
15
10
JF1BD
NOMESCO Finland
Very extensive small bowel CT
18.3
9.5
14
8
8240/3-C34.9
ICD-O-3
Neuroendocrine tumor, NOS, of lung, NOS
+∞
9.4
9
*
E340, C179
ICD-10 Finland
NA
+∞
9.4
9
*
JN5DR
NOMESCO Finland
PET-CT of upper body metabolism
11.2
9.4
17
16
R11
ICD-10 Finland
Nausea and vomiting
4.1
9.3
36
96
JAH01
NOMESCO Finland
Laparoscopy
6.1
9.1
24
42
ZXD05
NOMESCO Finland
Urgent procedure
2.3
9.1
109
606
JN3CG
NOMESCO Finland
Extensive MRI examination of abdomen with high intensity magnet
19.4
9.0
13
7
B01AB10
ATC
tinzaparin; parenteral
3.7
8.8
38
112
8240/3-C18.2
ICD-O-3
Neuroendocrine tumor, NOS, of ascending colon
51.6
8.7
10
*
N02AB03
ATC
fentanyl; nasal, sublingual, transdermal
5.5
8.7
25
49
A02BC05
ATC
esomeprazole; systemic
2.1
8.6
132
814
J01MA12
ATC
levofloxacin; systemic
2.6
8.6
72
330
L01CB01
ATC
etoposide; systemic
28.5
8.5
11
*
JN3AA
NOMESCO Finland
Abdominal X-ray examination without contrast
4.6
8.5
29
69
601
Kela drug reimbursment
Severe malabsorption of nutrients, mainly fats
13.3
8.5
14
11
8240/3-C20.9
ICD-O-3
Neuroendocrine tumor, NOS, of rectum, NOS
+∞
8.4
8
*
JN1DG
NOMESCO Finland
Very extensive MRI examination of upper part of abdomen with high intensity magnet
8.5
8.2
17
21
JJB10
NOMESCO Finland
Atypcal resection of liver
34.4
8.1
10
*
C77.2
ICD-10 Finland
Secondary and unspecified malignant neoplasm: Intra-abdominal lymph nodes
34.4
8.1
10
*
FM1AE
NOMESCO Finland
Standard cardiac ultrasound examination
2.5
8.0
73
349
A50
ICPC
General and Unspecified, Medication/prescr/renewal
6.4
8.0
20
33
107
Kela drug reimbursment
Pernicious anaemia
8.1
8.0
17
22
ZXE20
NOMESCO Finland
More than three and less than five hours
2.6
7.9
61
269
Z51.88
ICD-10 Finland
Other specified medical care
9.8
7.9
15
16
158
Kela drug reimbursment
Everolimus
46.2
7.8
9
*
JF1AB
NOMESCO Finland
Passage examination of small bowell with X-ray
8.4
7.7
16
20
JLC30
NOMESCO Finland
Pancreatoduodenectomy
19.0
7.7
11
6
SPAT1254
SPAT
Administration of medicine
2.6
7.6
57
248
ZXF10
NOMESCO Finland
Interruption caused by technical failure of equipment
82.1
7.5
8
*
E21.09
ICD-10 Finland
Other primary hyperparathyroidism
+∞
7.3
7
*
1522B
ICD-9 Finland
Malignant neoplasm of small intestine, including duodenum, Ileum[NEOPLASMA MALIGNUM ILEI,ALIA DEFINITA SEU NUD]
+∞
7.3
7
*
8249/3-C80.9
ICD-O-3
Neuroendocrine tumor, grade 2 of unknown primary site
+∞
7.3
7
*
L01XE10
ATC
[U] everolimus; oral
+∞
7.3
7
*
L03AA04
ATC
NA
+∞
7.3
7
*
A04AA01
ATC
ondansetron; systemic, rectal
3.7
7.3
31
91
C78.6
ICD-10 Finland
Secondary malignant neoplasm of retroperitoneum and peritoneum
16.3
7.3
11
7
C25.2
ICD-10 Finland
Malignant neoplasm: Tail of pancreas
30.8
7.2
9
*
UJF45
NOMESCO Finland
Flexible sigmoidoscopy with biopsy
3.2
7.1
37
128
R4190
NOMESCO Finland
Nutritional therapy
5.1
7.0
21
44
D13.1
ICD-10 Finland
Benign neoplasm: Stomach
6.4
6.9
17
28
166
Kela drug reimbursment
Dalteparin and tinzaparin (treatment for more than 6 months)
23.1
6.7
9
*
-55
ICPC
Local injection/infiltration
23.1
6.7
9
*
K56.5
ICD-10 Finland
Intestinal adhesions [bands] with obstruction
8.1
6.7
14
18
-50
ICPC
Medication/prescr/renewal
3.9
6.7
26
71
B81
ICPC
Anaemia vit B12/folate deficiency
4.4
6.7
23
56
D75
ICPC
Malignant neoplasm colon/rectum
12.6
6.6
11
9
UJF30
NOMESCO Finland
Ileoscopy through colon
2.9
6.6
39
147
TPH04
NOMESCO Finland
Cathetrisation of vein
2.1
6.5
78
424
8240/3-C16.9
ICD-O-3
Neuroendocrine tumor, NOS, of stomach, NOS
71.3
6.5
7
*
340
Kela drug reimbursment
Everolimus
71.3
6.5
7
*
I36.1
ICD-10 Finland
Nonrheumatic tricuspid (valve) insufficiency
9.6
6.3
12
13
JL1AT
NOMESCO Finland
Biopsy of pancreas with ultrasound guidance
+∞
6.3
6
*
E21.0
ICD-10 Finland
Primary hyperparathyroidism
+∞
6.3
6
*
8246/3-C80.9
ICD-O-3
Neuroendocrine carcinoma, NOS, of unknown primary site
+∞
6.3
6
*
C26.0
ICD-10 Finland
Malignant neoplasm: Intestinal tract, part unspecified
+∞
6.3
6
*
8246/3-C25.9
ICD-O-3
Neuroendocrine carcinoma, NOS, of pancreas, NOS
+∞
6.3
6
*
JN5SR
NOMESCO Finland
Very extensive PET-CT of receptors in upper body
+∞
6.3
6
*
1CB02
NOMESCO Finland
NA
+∞
6.3
6
*
8249/3-C25.9
ICD-O-3
Neuroendocrine tumor, grade 2 of pancreas, NOS
+∞
6.3
6
*
WZC30
NOMESCO Finland
Teaching
2.4
6.3
52
238
JJA20
NOMESCO Finland
Open biopsy of liver
27.3
6.3
8
*
UJF92
NOMESCO Finland
Capsular endoscopy
6.5
6.2
15
24
B01AB05
ATC
enoxaparin; parenteral
1.9
6.2
107
671
D37.4
ICD-10 Finland
Neoplasm of uncertain or unknown behaviour: Colon
7.9
6.2
13
17
ZX120
NOMESCO Finland
Intravenous
2.8
6.1
39
153
ZXK00
NOMESCO Finland
Conversion from percutaneous endoscopic to open procedure
12.9
6.1
10
8
WD115
NOMESCO Finland
Multiple cystostatic therapy of methastized malignancy
10.3
6.1
11
11
WF049
NOMESCO Finland
Radiotherapy of metastasis
4.1
6.0
22
57

Mortality – FinRegistry

Association

Association between endpoint E4_CARCISDR and mortality.

Females

Parameter HR [95% CI] p-value
E4_CARCISDR 4.015 [3.24, 4.98] < 0.001
Birth year 0.993 [0.98, 1.0] 0.136

During the follow-up period (1.1.1998 — 31.12.2019), 304 out of 704 females with E4_CARCISDR died.

Males

Parameter HR [95% CI] p-value
E4_CARCISDR 3.911 [3.06, 4.99] < 0.001
Birth year 0.989 [0.98, 1.0] 0.034

During the follow-up period (1.1.1998 — 31.12.2019), 305 out of 623 males with E4_CARCISDR died.

Mortality risk

Mortality risk for people of age

years, who have E4_CARCISDR.

N-year risk Females Males
1 0.313% 0.692%
5 2.093% 4.777%
10 5.068% 11.321%
15 9.75% 20.778%
20 16.571% 33.927%

Relationships between endpoints

Index endpoint: E4_CARCISDR – Carcinoid syndrome

GWS hits: 1

Endpoint
Case Overlap
Survival Analysis
Genetic Correlations
Genetic Signals
N (Jaccard index)
HR [CI]
Extremity
rg [CI]
Extremity
Hits
Coloc Hits
FinRegistry
FinnGen
FinRegistry
FinnGen
FinnGen
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