Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9012
Revised: July 17, 2013
Accepted: September 16, 2013
Published online: December 21, 2013
Core tip: Modern endoscopic and radiological tumor imaging have been implicated in the rise of the incidence of detected neuroendocrine tumors (NET) in Western countries. The particularities of German history, which resulted in two German states with two different health care systems from 1949-1989, allowed to study the epidemiological changes of NET in Germany on the background of two health care systems in 1949-1989. The number of detected gastroenteropancreatic-NET increased about 5-fold between 1976 and 2006. Most likely, the general availability of endoscopy after German reunification contributed to the major rise in frequency of detected rectal, gastric and duodenal NET in the new federal states of reunified Germany.