neuroendocrine carcinoma epidemiology forecast

Neuroendocrine Carcinoma (NEC) Insights and Trends

• According to DelveInsight’s estimates, in 2025, NEC cases were distributed across the 7MM, with the highest share observed in the United States, followed by the EU4 & UK, while Japan accounted for a comparatively smaller proportion of cases.
• NEC is more incident in countries due to the high burden of tobacco smoking, aging populations, and prolonged exposure to environmental and occupational carcinogens.
• Males face a higher lifetime risk of developing NEC and experience a greater disease burden compared to females. This disparity is largely attributed to historically higher tobacco smoking prevalence, greater cumulative exposure to carcinogens, and other smoking-related risk factors.
• The distribution of diagnosed NEC cases in the United States in 2025 was highest for extensive-stage NEC (ES-NEC), followed by limited-stage NEC (LS-NEC). This pattern is primarily attributed to the aggressive nature of NEC, rapid disease progression, and the absence of early symptoms, resulting in most patients being diagnosed at an advanced stage.
• SCLC remains the dominant contributor to the NEC burden in Japan, with incident cases projected to increase modestly from 18,669 in 2025 to 19,061 by 2036 (CAGR: 0.2%), primarily driven by Japan's aging population despite declining smoking rates (SCLC is predominantly a disease of older adults).
• In 2025, Japan reported 5,430 total incident cases of Neuroendocrine neoplasms (NENs), reflecting a measurable burden of these heterogeneous tumors within the country. By 2036, these incident cases is projected to increase with a CAGR of 0.97% during the forecast period.
• In 2025, Japan accounted for 2,474 incident cases of EP-NEC (excluding NEPC), representing a notable proportion of high-grade neuroendocrine malignancies within the broader NEN landscape. By 2036, the number of cases is expected to grow to 2,752 reflecting an increasing recognition of EP-NEC.
• The persistent global burden of NEC, coupled with increasing adoption of immunotherapy and targeted therapies, is expected to support steady growth of the NEC market over the next decade. Expanding access to innovative treatments, favorable regulatory approvals, and continued development of DLL3- and B7-H3-targeted therapies, antibody-drug conjugates (ADCs), and bispecific T-cell engagers will remain key drivers of future market expansion and improved patient outcomes.

Neuroendocrine Carcinoma (NEC) Epidemiology Forecast in the 7MM

• 2025 Incidence Cases of NEC: ~XXXX million
• NEC Growth Rate (2026–2036): ~XX% CAGR

DelveInsight's ‘Neuroendocrine Carcinoma (NEC) – Epidemiology Forecast – 2036’ report delivers an in-depth understanding of the NEC, historical and forecasted epidemiology in the United States, EU4 (Germany, Spain, Italy, and France) and the United Kingdom, and Japan.

Neuroendocrine Carcinoma (NEC) Understanding and Diagnosis Algorithm

Neuroendocrine Carcinoma (NEC) Overview and Diagnosis

NEC is a rare, aggressive malignancy that arises from neuroendocrine cells found throughout the body, most commonly in the lungs, gastrointestinal tract, and pancreas. It is characterized by rapid growth, a high propensity for early metastasis, and poor differentiation in most cases. Symptoms vary depending on the primary tumor site but may include abdominal pain, weight loss, fatigue, cough, or bowel disturbances, while advanced disease can lead to organ dysfunction. NEC is driven by complex genetic and molecular alterations, although the exact causes remain unclear. Diagnosis is based on clinical presentation, imaging studies, histopathological examination, immune-histochemical markers, and assessment of tumor proliferation using the Ki-67 index.

Pulmonary NEC / Small Cell Lung Cancer (SCLC)

Pulmonary NEC primarily includes SCLC and large-cell neuroendocrine carcinoma (LCNEC), with SCLC representing the most common subtype. SCLC is a highly aggressive neuroendocrine malignancy of the lung that is strongly associated with cigarette smoking. It is characterized by rapid growth, early metastatic dissemination, high proliferative activity, and frequent recurrence. SCLC accounts for approximately 15% of all lung cancers and is associated with a poorer prognosis than most other lung cancer subtypes.

Pulmonary NEC/SCLC is diagnosed through clinical evaluation, imaging studies, histopathological examination, and immunohistochemical analysis to confirm neuroendocrine differentiation and determine disease stage. Diagnostic evaluation includes contrast-enhanced CT of the chest and abdomen, PET-CT, and brain MRI for staging, followed by tissue biopsy with immunohistochemical markers such as synaptophysin, chromogranin A, CD56, and INSM1. Additional molecular biomarker testing, including DLL3, SLFN11, and B7-H3, may be performed to identify patients eligible for targeted therapies and clinical trials while supporting treatment decisions.

Extrapulmonary NEC (excluding NEPC)

EP-NEC refers to high-grade NECs that arise outside the lungs, excluding neuroendocrine prostate cancer (NEPC). These tumors most commonly originate in the gastrointestinal tract, pancreas, hepatobiliary system, genitourinary tract, head and neck, and gynecological organs. EP-NECs are rare, biologically aggressive malignancies characterized by poor differentiation, rapid progression, and early distant metastasis. Similar to pulmonary NEC, they are classified into small-cell and large-cell subtypes based on histopathological features and generally have an unfavorable prognosis due to their aggressive clinical behavior.

EP-NEC (excluding NEPC) is diagnosed through clinical evaluation, histopathological examination, and imaging studies. Diagnosis is confirmed using tumor biopsy with neuroendocrine markers such as synaptophysin, chromogranin A, and INSM1, along with assessment of the Ki-67 proliferation index. Additional investigations, including CT, MRI, PET imaging, and molecular profiling when appropriate, help determine the primary tumor site, disease extent, prognosis, and treatment strategy.

Note: Further details are provided in the report.

Neuroendocrine Carcinoma (NEC) Epidemiology

Key Findings from Neuroendocrine Carcinoma (NEC) Epidemiological Analysis and Forecast

Pulmonary NEC/SCLC

The incidence of SCLC across the 7MM is expected to increase throughout the study period (2022–2036), driven by the aging population, continued tobacco exposure in high-risk groups, and improved diagnostic and disease reporting practices.

• Among the 7MM, in 2025 the United States accounts for the highest incident cases of NEC compared with the EU4 & UK and Japan, and this burden is expected to increase over the forecast period.
• In 2025, the incident cases of NEC were substantially higher among males than females in the United States.
• In United States, the majority of incident NEC cases occurred in individuals aged =65 years, while a smaller proportion was observed in those aged <65 years, in 2025.
• In 2025, DLL3-positive NEC represented the largest share of biomarker-specific cases, accounting for 14,935 cases in 2025, followed by B7-H3-positive NEC (~13,000 cases) and SLFN11-positive NEC (~9,000 cases) in Japan.

Extrapulmonary NEC (excluding NEPC)

• The incidence of EP-NEC across the 7MM is expected to increase throughout the study period (2022–2036), driven by improved diagnostic capabilities, increasing disease awareness, greater use of advanced imaging and immunohistochemical testing, and an aging population with a higher cancer burden.
• Among the 7MM, in 2025 the United States accounts for the highest incident cases of NEC compared with the EU4 & UK and Japan, and this burden is expected to increase over the forecast period.
• In 2025, the incident cases of EP-NEC were substantially higher among males than females in the United States.
• In United States, gastroenteropancreatic neuroendocrine carcinoma (GEP-NEC) accounted for the largest proportion of site-specific EP-NEC cases, followed by other extrapulmonary sites, while genitourinary neuroendocrine carcinoma represented the smallest share in 2025.
• In 2025, the majority of treated EP-NEC cases receive first-line therapy, while substantially fewer patients progress to second-line and third-line or later treatments, reflecting the aggressive nature of the disease, rapid progression, and limited effective treatment options after frontline therapy in Japan.

Scope of the Report

• The report covers a segment of an executive summary, a descriptive overview of NEC, explaining its causes, signs and symptoms, and pathogenesis.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of the diagnosis rate, and disease progression.

Report Insights

• Neuroendocrine Carcinoma (NEC) Patient Population Forecast

Report Key Strengths

• Epidemiology-based (epi-based) Bottom-up Forecasting
• 11-year Forecast
• Patient Burden Trends (by geography)

FAQs

• What are the disease risks, burdens, and unmet needs of NEC? What will be the growth opportunities across the 7MM concerning the patient population with NEC?
• What is the historical and forecasted NECpatient pool in the US, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?

Reasons to Buy

• Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand key opinion leaders’ perspectives around the diagnostic challenges to overcome barriers in the future.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges.