Review article: the investigation and management of rectal neuroendocrine tumours

Summary Background Rectal neuroendocrine tumours (NETs) are increasingly identified at endoscopy possibly as a result of bowel cancer screening programmes. Aim To present a review of the literature to aid clinicians in the diagnosis and management of rectal neuroendocrine tumours. Methods A literature search was conducted through MEDLINE using search terms: rectal, rectum, carcinoid, NET, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review with reference lists reviewed for additional articles. Results The incidence of rectal neuroendocrine tumours is approximately 1 per 100 000 population per year with the majority (80–90%) being 2 cm or with invasion and regional disease. The treatment of advanced disease is multimodal. Conclusions The long‐term tumour biology of small rectal neuroendocrine tumours remains unclear. There is uncertain impact from bowel cancer screening programmes on rectal neuroendocrine tumour incidence, morbidity and mortality. Referral to neuroendocrine tumour centres for patients with locally advanced disease or metastatic disease is recommended.