Adenocarcinoma of unknown primary site (AUP) is a histologic subtype making up approximately 50% to 80% of all cancers of unknown primary site (CUP).[3]Lee MS, Sanoff HK. Cancer of unknown primary. BMJ. 2020 Dec 7;371:m4050.
http://www.ncbi.nlm.nih.gov/pubmed/33288500?tool=bestpractice.com
[4]Pavlidis N, Pentheroudakis G. Cancer of unknown primary site. Lancet. 2012 Apr 14;379(9824):1428-35.
http://www.ncbi.nlm.nih.gov/pubmed/22414598?tool=bestpractice.com
[5]Hemminki K, Bevier M, Hemminki A, et al. Survival in cancer of unknown primary site: population-based analysis by site and histology. Ann Oncol. 2012 Jul;23(7):1854-63.
https://www.annalsofoncology.org/article/S0923-7534(19)37996-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22115926?tool=bestpractice.com
[6]Varadhachary GR, Raber MN. Cancer of unknown primary site. N Engl J Med. 2014 Aug 21;371(8):757-65.
http://www.ncbi.nlm.nih.gov/pubmed/25140961?tool=bestpractice.com
According to the American Cancer Society, approximately 32,950 new cases of CUP will be diagnosed in the US in 2023, representing about 2% of all new cancer cases.[7]American Cancer Society. Key statistics for cancers of unknown primary. 2023 [internet publication].
https://www.cancer.org/cancer/cancer-unknown-primary/about/key-statistics.html
Incidence increases with age.[8]Ganesh B, Buragamadagu B, Baralo B, et al. Cancer of unknown primary site: a population-based analysis of demographics and all-cause mortality. Paper presented at: 2022 American Society of Clinical Oncology annual meeting. Jun 3-7, 2022. Chicago, IL. Health services research and quality improvement: abstract e18518. J Clin Oncol. 2022 Jun;40(16_suppl):e18518.
https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.e18518
[9]Cancer Research UK. Cancer of unknown primary incidence statistics: cancer of unknown primary incidence by age. 2021 [internet publication].
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cancer-of-unknown-primary/incidence#heading-One
In the UK, between 2016 and 2018, approximately 60% of new cases were diagnosed in people ages 75 years or more.[9]Cancer Research UK. Cancer of unknown primary incidence statistics: cancer of unknown primary incidence by age. 2021 [internet publication].
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cancer-of-unknown-primary/incidence#heading-One
In a US population-based cohort of patients with CUP diagnosed between 2010 and 2014, median age at diagnosis was 71 years.[8]Ganesh B, Buragamadagu B, Baralo B, et al. Cancer of unknown primary site: a population-based analysis of demographics and all-cause mortality. Paper presented at: 2022 American Society of Clinical Oncology annual meeting. Jun 3-7, 2022. Chicago, IL. Health services research and quality improvement: abstract e18518. J Clin Oncol. 2022 Jun;40(16_suppl):e18518.
https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.e18518
Among the US cohort of 13,441 patients (9683 of whom had adenocarcinoma), most were white (81.6%). The remainder comprised black patients (10.8%); American Indian, Alaska native, Asian/Pacific Islander (6.7%); and unknown race (0.9%).[8]Ganesh B, Buragamadagu B, Baralo B, et al. Cancer of unknown primary site: a population-based analysis of demographics and all-cause mortality. Paper presented at: 2022 American Society of Clinical Oncology annual meeting. Jun 3-7, 2022. Chicago, IL. Health services research and quality improvement: abstract e18518. J Clin Oncol. 2022 Jun;40(16_suppl):e18518.
https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.e18518
Earlier US analyses reported a higher proportion of CUP among patients who were female or black, or who were living in poverty.[10]Urban D, Rao A, Bressel M, et al. Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities. Br J Cancer. 2013 Sep 3;109(5):1318-24.
https://www.nature.com/articles/bjc2013386
http://www.ncbi.nlm.nih.gov/pubmed/23860528?tool=bestpractice.com
UK data indicate that CUP incidence rates are lower in women than in men.[9]Cancer Research UK. Cancer of unknown primary incidence statistics: cancer of unknown primary incidence by age. 2021 [internet publication].
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cancer-of-unknown-primary/incidence#heading-One
An age-standardized annual CUP incidence rate of 14 per 100,000 population (2016-2018) has been reported in the UK.[11]Cancer Research UK. Cancer of unknown primary incidence statistics: cancer of unknown primary incidence by sex and UK country. 2021 [internet publication].
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cancer-of-unknown-primary/incidence#heading-Zero
Overall, the epidemiologic data relating to CUP are consistent worldwide, likely reflecting the lack of defined risk factors, either genetic or environmental, thus far observed in this entity.