Although much have been learned about the biology and natural history of neuroendocrine neoplasms over the past two decades, our understanding of these topics is still evolving due to continuing improvements in molecular diagnostics and therapeutics. Our recent analyses using Surveillance, Epidemiology, and End Results (SEER) registry data showed the incidence and prevalence of neuroendocrine tumors are continuing to rise (Dasari et al, JAMA Oncology 2017). The age-adjusted incidence rate increased 6.4-fold from 1973 (1.09 per 100 000) to 2012 (6.98 per 100 000). The estimated 20-year limited-duration prevalence of NETs in the United States on January 1, 2014, was 171,321. The overall survival for all NETs improved from the 2000-2004 period to the 2009-2012 period (hazard ratio [HR], 0.79; 95%CI, 0.73-0.85). Even larger increases in OS between these periods were noted in distant-stage gastrointestinal NETs (HR, 0.71; 95%CI, 0.62-0.81) and distant-stage pancreatic NETs (HR, 0.56; 95%CI, 0.44-0.70). Using SEER data linked to Medicare claims database, we showed that carcinoid syndrome is significantly associated with tumor grade, stage, and primary tumor site, and leads to shorter survival compared with those patients without carcinoid syndrome (Halperin et al, Lancet Oncol 2017). We also leveraged data from these sources to examine the recurrence rates after surgery and demonstrated likelihood of recurrence varied by grade, stage, primary tumor size and primary site (Shen et al, Annals of Oncology 2017). Our study suggests that surveillance recommendations should be tailored according to patient and tumor characteristics after resection. Surveillance past 5 years may be avoided in elderly patients with competing morbidities or low risk of recurrence.