The Rising Tide of Brain Tumours in Nigeria: A Call to Action

Recently cell phones have become the target of much controversy because they are increasingly being viewed as potential carcinogenic agents with a causal role in brain tumor development. The overall incidence of malignant brain tumors in the United States from 1992 to 2007 declined slightly from 6.8 to 6.2 per 100,000, while the incidence in children has risen slightly over the past three decades [1, 2]. According to the Central Brain Tumor Registry (CBTRUS) [3] in 1995 the incidence of both benign and malignant brain tumors was 13.4 per 100,000 and in 2004 it was 18.2 per 100,000. The cause of the clear increase in benign tumor incidence is unknown, but there is concern that cell phones can trigger biological effects and that several decades of cell phone use in an individual may significantly increase the risk of a malignant brain tumor. The potential public health problem is sizeable as the most common malignant brain tumors are highly lethal and cell phone use in the U.S. alone has escalated dramatically, with approximately 70 million new cell phone subscriptions between 2006 and 2010, and 250 million subscriptions overall in 2007 [4, 5]. The concern relating to cell phone use and brain cancer is underscored by the fact that teens and children are beginning to use cell phones at younger ages [6]. Moreover, greater than 4 of 5 children/teens 12 years and older sleep with a cell phone next to them, often under the pillow [7]. Children and young adults are more susceptible to the harmful effects of carcinogenic agents such as radiation [8]. Therefore, a shift in incidence of brain tumors in younger age groups may emerge as their exposure to cell phones reaches long-term status and attains the 10-year or greater mark. A recent study revealed that children exposed to 1,800 MHz cell phone electromagnetic fields (EMF) can experience significantly higher exposures to cortical regions, hippocampus, hypothalamus and the eye than adults, and that this difference can be greater than one order of magnitude [6]. The most feared brain tumors in adults and children are the gliomas, which include the astrocytomas and oligodendrogliomas. These tumors are graded on a progressive scale of malignancy, and astrocytomas that have progressed to the Grade IV World Health Organization (WHO) classification level are also known as glioblastomas [9]. Glioblastomas are common brain tumors and most frequently arise de novo as primary cancers. The gliomas as a whole comprise approximately 33% of all brain tumors and 79% of malignant brain tumors [3]. Cure is not typical and the therapy of even low grade gliomas can be challenging. The glioblastomas are highly lethal and despite aggressive treatment efforts patients are dead at a median of 14 months after diagnosis [10]. Five year survival is dismal, less than 10%. This review will focus specifically on glioma risk from cell phone use, and will begin with a brief overview of the state of the relevant cell phone—brain tumor risk literature. The two significant, comprehensive databases concerning cell phone use and brain cancer risk are the often cited Hardell (Sweden) and the multicenter European Interphone studies [11, 12]. These two groups each include multiple studies, and they comprise the major focus of the current review. Glioma risk data derived from Hardell and Interphone, as well as from some smaller studies, is partitioned Courtney Corle and Milan Makale are co-first authors.

Background The incidence of brain tumors or cerebral aneurysms remains unknown on repeated brain check-up.Purpose We studied the incidence of brain tumors or cerebral aneurysms in large number of individuals who reccceived brain checkup more than twice in PL Tokyo Health Care Center, Japan.Method In our center, 9, 538 participants received brain check-up between August 1995 and July 2002. We analyzed 2, 175 participants (1, 598 men and 577 women) who had brain and physical check-ups more than 2 times. Mean age of subjects was 53.4 (SD 10.4) years in all, 53.1 (SD 10.3) years in men and 54.2 (SD 10.6) years in women. Subjects who were diagnosed as brain tumors or cerebral aneurysms on the first brain check-up were excluded. Brain check-up was produced by 1.5-tesla superconducting system (Stratis II, Hitachi Medical, Japan) . Conventional magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) using three-dimension time-of-flight sequence were undertaken in all subjects. The incidence and the clinical features of brain tumors or cerebral aneurysms were studied.Results The frequency of repeated brain check-up was 22.8%. The intervals between brain check-ups were 277 to 728 days. The times of brain check-up were two to sex. The analysis of brain tumor was diagnosed as meningioma in one woman. The incidence of brain tumors was 0.05% in total subjects and 0.17% in women. The duration between the first and the 2nd brain check-up was one year in this case. Cerebral aneurysms were seen in 6 subjects (2 men and 4 women) . All subjects had no clinical symptoms without a family history of subarachnoid hemorrhage. The total number of aneurysms was 8. Aneurysms were located in the internal carotid artery (n=2), the anterior cerebral arteries (n=3), the middle cerebral artery (n=3) and the basilar artery (n=1) . Two women had two aneurysms. The incidence of aneurysms was 0.28% in total subjects, 0.13% in men and 0.69% in women. The mean age of subjects with aneurysms was 57.7 (SD 6.7) years in all, 64.0 (SD 6.7) years in men, and 54.5 (SD 5.4) years in women. The interval between the first and the 2nd brain check-up was one to five years and the mean duration was 3.0 years (SD 1.7) in 6 subjects with aneurysms. The prognosis was excellent in those five subjects. Subarachnoid hemorrhage occurred in one woman with multiple aneurysms although we strongly recommended neurosurgical procedures for enlarging aneurysms.Conclusion The underdiagnosis of brain tumors and cerebral aneurysms on the first brain check-up contributed to sizes and portions of lesions, radiological technique and reviewers of neuroim-ages. To make the early and correct diagnosis of both fatal diseases, we should compare between the initial and repeated data, including resource imaging of MRA. Radiological technicians always investigate the monitor of MRI and MRA. Cooperation with neurological reviewers and radiological technicians is important to make the early diagnosis of brain tumors and cerebral aneurysms. Our stud-ies indicate that brain check-up should be repeated within a few years, in order to discover asymptomatic brain tumors and unrup-tured aneurysms.

Using the vital statistics issued annually by the Japanese Government from 1960 to 1994, the mortality of brain tumors during childhood (0-14 years of age) in Japan was estimated. Since there are few nationwide registries of childhood cancers with a sufficiently high registration rate, the incidence of brain tumors was calculated using the Registry of Childhood Malignancies in Hokkaido Prefecture from 1969 to 1996. Though the mortality due to malignant diseases as a whole during childhood has been decreasing, and though there should be progress in therapeutic methods, the mortality due to brain tumors in children has been increasing. The incidence of brain tumors in Hokkaido Prefecture has been increasing as well. There was no tendency for the incidence of medulloblastoma to decrease. The incidence of childhood brain tumors has been increasing in Japan, though the cause is unknown. The period of the present study corresponded to a period of high economic growth. Thus, a study on environmental factors would be interesting.

OBJECTIVETo define the incidence of brain tumours in Devon and Cornwall and to discover which case finding methods are the most fruitful. To examine what happens to patients after the...

Introduction: Experimental studies suggest that exposure to air pollution can lead to neurotoxicity and development of brain tumours in animals, but epidemiological evidence in humans is sparse. We examined the association between long-term exposure to air pollution and incidence of brain tumor in European population. Methods: We utilized 12 cohorts from Sweden, Denmark, Norway, Netherlands, Austria, and Italy for which individual estimates of air pollution levels at residence were predicted by standardized land-use regression models developed within the ESCAPE study. We had data for particulate matter (PM) ≤ 2.5 μm in diameter (PM2.5), PM ≤ 10 μm in diameter (PM10), PM with diameter 2.5-10 μm (PM2.5-10), PM2.5 absorbance, nitrogen oxides (NO2 and NOx), and traffic indicator. We estimated cohort-specific associations between brain tumor (benign and malignant) incidence and air pollutants by Cox proportional hazards model, adjusting for age, gender, calendar time, occupation, education, and socio-economic status, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282,194 included subjects, 643 developed incident brain tumors during 4,176,933 person-years of follow-up. We found weak inverse association between brain tumor incidence and PM2.5 (Hazard Ratio and 95% Confidence Interval: 0.90; 0.56-1.44 per 5 µg/m3), PM10 (0.95: 0.54-1.65 per 10 µg/m3), and PM2.5-10 (0.86: 0.62-1.21 per 5 µg/m3), and strong positive, but statistically insignificant association with PM2.5 absorbance (1.40; 0.79-2.49 per 10-5/m). We found no association between brain tumor incidence and NO2 (1.01; 0.84-1.20 per 10 µg/m3) or NOx (1.01; 0.86-1.19 per 20 µg/m3), but detected statistically significant positive association with traffic density on the nearest road (1.07; 1.01-1.14 per 5,000 vehicles per day). Conclusion: We found weak association between development of brain tumor and long-term exposure to traffic and soot in European population.

High incidence of secondary brain tumours after radiotherapy and antimetabolites

According to World Health Organization's GLOBOCAN 2012 database, brain tumors account for about 2% of all cancers in Malaysia. It was ranked 11th and 13th most common cancer among males and females, respectively. This debilitating disease can cause a tremendous burden to patients and their families and healthcare services. The main objective of this study is to provide demographic data on the type of brain tumors and their distribution of age and gender from the cases presented to the neurosurgical department of a rural hospital in Sibu from 2018 to 2021. This is a retrospective study of the incidence and pattern of brain tumors admitted to the Neurosurgery Department in Sibu Hospital. Data were emanated from the brain tumor registry census from 2018 to 2021. Of all cases, only cases with confirmed histopathological results were included. Inoperable brain tumors that were diagnosed through radiological investigations were excluded. There were 230 patients with brain tumors included in this study. Males constituted 42.6% (n = 98) of the cases, whereas 57.4% (n = 132) of them were female. The brain tumor was the least common in the pediatric group (0 to 10 years old) with only 3.5% (n = 8). The incidence of brain tumors increased with age and reached its peak in the age group of 51 to 60 years (34.8%). The commonest type of brain tumor was meningioma (38.7%), followed by a metastatic brain tumor (25.2%) and glioma (15.6%). Meningothelial WHO grade I was the most common variant that accounted for 67% (n = 46) of all meningioma. Lung carcinoma was found to be the most common primary, accounting for more than half (69.0%) of the metastatic brain tumors, followed by breast cancer (10.3%), thyroid cancer (8.6%), female genital tract (8.6%), and malignant melanoma (3.5%). The crude incidence of the brain tumor in Sibu was 4.98 per 100,000 population/year. This study showed that the commonest brain tumor in central rural of Sarawak was meningioma, followed by metastatic brain tumor and glioma. Meningothelial is the most frequent subtype of meningioma, whereas lung carcinoma was the commonest primary in brain metastases. The peak age group was 51 to 60 years old, and females showed a higher incidence than males. This study provides a baseline profile of the brain tumor spectrum in rural Sarawak. More data should be collected to aid in future research and healthcare planning.

There has been a paucity of information on the epidemiology of primary brain tumors (BTs) in Canada. This study documents epidemiology of primary BTs in Saskatchewan over three decades to define their current state, changing pattern over years and relative distribution in two geographically defined areas of the province. Data on all primary BTs from 1970 to 2001 from the Brain Tumor Registry in Saskatchewan was collected. The aggregate data on primary BTs including the time-series for incidence, age, geographic location and sex were statistically analyzed using SPSS 13. Poisson regression was used to model the incidence as a function of decade of diagnosis and age at the time of diagnosis. The average annual incidence of primary BTs was 11.1 per 100,000 person-years (male 12.5 per 100.000 and female 9.8 per 100.000). Males constituted 54.5% of all these tumors. The age distribution of tumors was bimodal with peaks at 5 years and 65 years. During this time, the incidence of primary BTs has increase predominantly in non-malignant types. No difference was found in the rate of all the diagnosed primary BTs combined, meningioma and lymphoma between the northern part (Regina) and southern part (Saskatoon) of the province. The incidence of BTs in Saskatchewan is more than previously reported in Canada. There is a temporal trend in increasing incidence of some of the BTs predominantly in the non-malignant types. No spatial difference in the incidence of primary BTs was shown in this province. These data will provide useful information to guide the future studies on BTs changing patterns, possible etiologies and efficient resource allocation for management of these diseases.

Magnetite nanoparticles are small, strongly magnetic iron oxide particles which are produced during high-temperature combustion and friction processes and form part of the outdoor air pollution mixture. These particles can translocate to the brain and have been found in human brain tissue. In this study, we estimated associations between within-city spatial variations in concentrations of magnetite nanoparticles in outdoor fine particulate matter (PM2.5) and brain cancer incidence. We performed a cohort study of 1.29 million participants in four cycles of the Canadian Census Health and Environment Cohort in Montreal and Toronto, Canada who were followed for malignant brain tumour (glioma) incidence. As a proxy for magnetite nanoparticle content, we measured the susceptibility of anhysteretic remanent magnetization (χARM) in PM2.5 samples (N = 124 in Montreal, N = 110 in Toronto), and values were assigned to residential locations. Stratified Cox proportional hazards models were used to estimate hazard ratios (per IQR change in volume-normalized χARM). ARM was not associated with brain tumour incidence (HR = 0.998, 95% CI 0.988, 1.009) after adjusting for relevant potential confounders. Although we found no evidence of an important relationship between within-city spatial variations in airborne magnetite nanoparticles and brain tumour incidence, further research is needed to evaluate this understudied exposure, and other measures of exposure to magnetite nanoparticles should be considered.

Brain tumor is one of the common diseases of the central nervous system, and the incidence and death of brain tumors are among the highest in the world. Although the incidence of brain tumors is lower than that of other systemic tumors, due to the wide range of types and pathological types, the same pathological type is divided into different sub-grades, and has complex imaging manifestations, which makes clinical diagnosis and treatment difficult. In this paper, a new CAD model named BraDect is proposed based on the inducible bias of convolution and the high capacity of Transformer, and the fully connected layer and attention mechanism are improved, which effectively solves the problem of large amount of parameters and low efficiency in the current model. The proposed method had performed SOTA as specificity=99.83%, precision=99.84%, Recall=99.83%, F1 score=99.84%, area under the ROC curve=99%, accuracy=99.28%.

The relationship between socioeconomic status and health care disparities in the incidence of brain tumors is unclear. To identify the associations between age, sex, and Medicaid enrollment and the incidence of primary malignant brain tumors in Michigan in 1996 and 1997. Records were obtained from the Michigan Cancer Surveillance Program on the 1,006 incident cases during this period and cross-checked with Medicaid enrollment files. Persons enrolled in Medicaid were more likely than non-enrolled persons to develop a malignant brain tumor of any type, a glioblastoma multiforme, and an astrocytoma for certain subgroups. In addition, incidence rates for malignant brain tumors in persons enrolled in Medicaid peaked at a younger age. Sociodemographic status may be associated with cerebral malignancy and should be considered when targeting treatment and educational interventions at persons at risk.

Routine reporting of descriptive population-based brain tumor epidemiological data is important for evaluating incidence trends, providing clues for putative risk factors, benchmarking outcomes, and stimulating research into the causes of this deadly disease. We propose to standardize reporting of cancer registry data for brain tumors in the United Kingdom through researcher-led collaborations. Interpretation of incidence trends needs to account for changing diagnostic practice. In the United Kingdom, reports from government agencies do not provide epidemiological data of brain tumor subtypes beyond the overall burden of these tumors. Using the Welsh cancer registry, we have demonstrated that separate reporting of histologically confirmed tumors enhances the interpretation of age- and sex-adjusted brain tumor incidence trends because only patients undergoing surgery would have a histological diagnosis of disease. Wanis et al1 reported on English brain tumor cancer registry data from 1995 to 2017 and observed similar patterns as we described for Wales.2 One exception was that Wanis et al did not report results by histological diagnosis, which we propose should become a standard analysis to document trends accounting for changing diagnostic practice. We have already been in touch with the authors to discuss collaborative analyses to standardize reporting of brain tumor incidence data from Wales, Scotland, and England, with the aim of providing a comprehensive and clinically informed UK-wide picture of brain and CNS tumor incidence trends, similar to the annual publication from the Central Brain Tumor Registry of the United States (CBTRUS).3

Impact of environmental pollutants on pediatric brain tumor incidence in New Jersey

Over 20 years have passed since the initial spread of mobile phones in Japan. Epidemiological studies of mobile phone use are currently being conducted around the world, but scientific evidence is inconclusive. The present study aimed to simulate the incidence of malignant brain tumors in cohorts that began using mobile phones when they first became popular in Japan. Mobile phone ownership data were collected through an Internet-based questionnaire survey of subjects born between 1960 and 1989. The proportion of mobile phone ownership between 1990 and 2012 was calculated by birth cohort (1960s, 1970s, and 1980s). Subsequently, using the ownership proportion, the incidence of malignant brain tumors was calculated under simulated risk conditions. When the relative risk was set to 1.4 for 1,640 h or more of cumulative mobile phone use and the mean daily call duration was 15 min, the incidence of malignant brain tumors in 2020 was 5.48 per 100,000 population for the 1960s birth cohort, 3.16 for the 1970s birth cohort, and 2.29 for the 1980s birth cohort. Under the modeled scenarios, an increase in the incidence of malignant brain tumors was shown to be observed around 2020. © 2019 Bioelectromagnetics Society.

Global incidence of brain and spinal tumors by geographic region and income level based on cancer registry data