Incidence Rate Of Brain Tumors Research Articles

EPID-07. INCIDENCE OF PAEDIATRIC BRAIN TUMORS IN AN ITALIAN REGIONAL COHORT: AN EPIDEMIOLOGICAL STUDY FROM 2012 TO 2023

Abstract BACKGROUND Central nervous system (CNS) tumors are the most common solid cancer in children, second only to leukaemia. METHODS We conducted a retrospective epidemiological study of primary CNS tumors diagnosed in children up to 16 years of age between 2012 and 2023, in order to estimate the incidence in a regional cohort of 1,2 million inhabitants (Northeastern Italy). Only primitive lesions were enrolled, relapses were excluded. RESULTS Over a period of twelve years, 100 new diagnoses were made (44% Female, 56% Male) with a mean age of 8,92 years (range 0-16 years) at time of onset. In terms of location, we recorded an equal number of supratentorial and subtentorial diagnoses (50% vs 50%). A time-series analysis was performed to verify possible variations in the incidence rate of brain tumors over years, and no significant change was described (R2 0.301, p=0.06). However, after 2017 a significant increase was noted (R2 0.725, p=0.015), as the incidence of new diagnosis quite doubled, from 3.16 in 2018 (95%CI 3.15-3.17) to 5.59 in 2023 (95%CI 5.57-5,61). Data were therefore divided in two groups: 2012-2017 (group 1), and 2018-2023 (group 2). There were no differences in terms of gender or age. The number of low-grade (LG) and high-grade (HG) diagnosis were compared: HG tumors, including high grade glioma, ependymoma and medulloblastoma, were significantly higher in the group 2 than group 1 (27/50, 54% vs 6/43, 14%, p<0.001). CONCLUSIONS In childhood, CNS tumors incidence has been fairly stable in the last twelve years in our regional cohort, but a recent concern of an increased rate of high-grade diseases emerged according to our data. In case of a confirmation of this trend, further analysis will be required in order to understand the reason.

Brain and other central nervous system tumor statistics, 2021.

Brain and other central nervous system (CNS) tumors are among the most fatal cancers and account for substantial morbidity and mortality in the United States. Population-based data from the Central Brain Tumor Registry of the United States (a combined data set of the National Program of Cancer Registries [NPCR] and Surveillance, Epidemiology, and End Results [SEER] registries), NPCR, National Vital Statistics System and SEER program were analyzed to assess the contemporary burden of malignant and nonmalignant brain and other CNS tumors (hereafter brain) by histology, anatomic site, age, sex, and race/ethnicity. Malignant brain tumor incidence rates declined by 0.8% annually from 2008 to 2017 for all ages combined but increased 0.5% to 0.7% per year among children and adolescents. Malignant brain tumor incidence is highest in males and non-Hispanic White individuals, whereas the rates for nonmalignant tumors are highest in females and non-Hispanic Black individuals. Five-year relative survival for all malignant brain tumors combined increased between 1975 to 1977 and 2009 to 2015 from 23% to 36%, with larger gains among younger age groups. Less improvement among older age groups largely reflects a higher burden of glioblastoma, for which there have been few major advances in prevention, early detection, and treatment the past 4 decades. Specifically, 5-year glioblastoma survival only increased from 4% to 7% during the same time period. In addition, important survival disparities by race/ethnicity remain for childhood tumors, with the largest Black-White disparities for diffuse astrocytomas (75% vs 86% for patients diagnosed during 2009-2015) and embryonal tumors (59% vs 67%). Increased resources for the collection and reporting of timely consistent data are critical for advancing research to elucidate the causes of sex, age, and racial/ethnic differences in brain tumor occurrence, especially for rarer subtypes and among understudied populations.

Three Cases of Levodopa-Resistant Parkinsonism After Radiation Therapy.

Case seriesPatients: Male, 77 • Female, 44 • Male, 9Final Diagnosis: Radiation induced parkinsonismSymptoms: SlownessMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Unusual or unexpected effect of treatmentBackground:Unequivocal brain radiation-induced parkinsonism has so far been reported in only in two pediatric patients. However, with the rising incidence rates for brain tumors in industrialized countries and the consequential increased exposure to cranial radiotherapy, clinicians might become more exposed to this entity.Case Report:Three patients were treated for intraparenchymal brain tumor with resection, chemotherapy, and whole brain radiation. One patient developed leukoencephalopathy and parkinsonism within one year of treatment, one developed it seven years after treatment completion, and one developed dementia, parkinsonism and cerebral infracts 40 years after whole brain radiation. Brain MRIs and a DaTscan were obtained. All patients failed a trial of carbidopa/levodopa. We suggest that the brain radiation exposure was responsible for levodopa resistant parkinsonism, cognitive decline, and diffuse leukoencephalopathy.Conclusions:Although rare, radiation therapy-induced parkinsonism might be responsible for levodopa-resistant parkinsonism.

Clinicopathological findings and five year survival rates for patients with central nervous system tumors in Yazd, Iran.

The incidence rate of brain tumors has increased more than 40% in the past 20 years, especially in adults. We aimed to study the clinical and pathological findings of central nervous system (CNS) tumor patients and to evaluate their 5 year survival rates. The archives of all patients with CNS tumors in 6 health care centers in Yazd, Iran, from 2006 to 2013, were studied. Patients data were extracted using a checklist which included age, sex, date of reference and diagnosis, date of death, clinical signs, radiography findings, pathology report, size and location of tumor, patient treatment and grade of tumor. A total of 306 patient records were studied in the 8 year period. The most prevalent type of tumor was astrocytoma (n=113, 36.9%). The frequency of almost all tumor types was statistically higher in male patients (p=0.025). In most cases surgery with radiotherapy was the treatment of choice (49.3%). The most frequent symptom reported was headache (in 60.8% of patients) followed by convulsions (15.7%). Most of the tumors were located in the right hemisphere (46.1%) and the frontal and parietal lobe (26% and 12%, respectively). Radiography findings displayed edema with a nonhomogeneous lesion in majority of the patients (87%). The survival fraction of the patients with malignant tumors decreased over time (0.807 in the first year and 0.358 at the end of the 5th year). Astrocytoma was the more common CNS tumor with male predominance. Overall survival rates of malignant tumors decreased over time and this was in relation with tumor grade.

Effects of cerebral magnetic resonance imaging in outpatients on observed incidence of intracranial tumors and patient survival: a national observational study

It is assumed that the observed increase in brain tumor incidence may at least partially be explained by increased use of MRI. However, to date no direct estimate of this effect is available. The authors undertook this registry-based study to examine whether regional frequencies of cerebral MRI use correlate to regional incidence rates of intracranial tumors and survival of patients with these lesions. The authors used Norwegian national population registries from January 2002 through December 2007 to conduct this observational study. They obtained information on outpatient MRI scans in Norwegian counties and examined whether the annual regional rates of cerebral MRI scans correlated to regional age- and sex-adjusted brain tumor incidence rates. They also explored whether differences in cerebral MRI use were associated with survival and examined time trends in the study period. Approximately 50,000 cerebral MRI scans are carried out annually in outpatient settings in Norway, and 6363 primary intracranial tumors were diagnosed in Norway during the study period. There was an overall positive correlation between the annual number of cerebral MRI scans per 100,000 capita and age- and sex-adjusted incidence rates of intracranial tumors in the various Norwegian counties (Spearman's rho = 0.35, p < 0.001). In a linear model, an increase in 1 MRI per 100,000 capita per year results in a 0.004 (95% CI 0.002-0.006) increase in diagnosed intracranial tumors per 100,000 capita per year (p < 0.001). Subgroup analysis showed a correlation between MRI use and the annual age- and sex-adjusted incidence rates of extraaxial tumors (p = 0.04, Spearman's rho = 0.28) but not intraaxial tumors (p = 0.394). Overall survival for unselected patients with intracranial tumors is longer with increasing number of cerebral MRI scans per capita in the county of residence at the time of the diagnosis (log rank, p = 0.029). However, after adjustment for year of diagnosis and catchment region of the Norwegian neurosurgical centers, the association between MRI scans per capita and overall survival was no longer statistically significant (p = 0.076). Presumably due to the incidental discovery of benign extraaxial tumors, regional differences in the use of cerebral MRI in outpatients affect observed incidence rates of intracranial tumors.

Re: Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974–2003

Re: time trends in brain tumor incidence rates in Denmark, Finland, Norway, and Sweden, 1974-2003

Response: Re: Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974–2003

Response: Re: Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974–2003

Re: Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974–2003

Re: Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974–2003

Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974-2003

In Denmark, Finland, Norway, and Sweden, the use of mobile phones increased sharply in the mid-1990s; thus, time trends in brain tumor incidence after 1998 may provide information about possible tumor risks associated with mobile phone use. We investigated time trends in the incidence of glioma and meningioma in Denmark, Finland, Norway, and Sweden from 1974 to 2003, using data from national cancer registries. We used joinpoint regression models to analyze the annual incidence rates of glioma and meningioma. During this period, 59,984 men and women aged 20-79 years were diagnosed with brain tumors in a population of 16 million adults. All statistical tests were two-sided. From 1974 to 2003, the incidence rate of glioma increased by 0.5% per year (95% confidence interval [CI] = 0.2% to 0.8%) among men and by 0.2% per year (95% CI = -0.1% to 0.5%) among women and that of meningioma increased by 0.8% per year (95% CI = 0.4% to 1.3%) among men, and after the early 1990s, by 3.8% per year (95% CI = 3.2% to 4.4%) among women. No change in incidence trends were observed from 1998 to 2003, the time when possible associations between mobile phone use and cancer risk would be informative about an induction period of 5-10 years.

A population‐based description of glioblastoma multiforme in Los Angeles County, 1974–1999

There have been reports that the incidence rates of brain tumors have increased over the past few decades, but most have considered all brain tumors together. The authors analyzed the pattern of glioblastoma multiforme (GBM) occurrence in Los Angeles County, California to shed light on the incidence and descriptive epidemiology of this type of brain tumor. Data were obtained from the Los Angeles County Cancer Surveillance Program. Incidence rates were analyzed by gender, race, age at diagnosis, period of diagnosis (1974-1981, 1982-1988, or 1989-1999), and socioeconomic status (SES). In addition, data were stratified according to anatomic subsite. A multivariate model describing changes in rates by each of these variables was constructed. Age-specific incidence rates (ASIR) rose sharply after age 30 years. The peak ASIR was at age 70-74 years in males and at age 75-79 years in females. The age-adjusted incidence rate (AAIR) of GBM increased from 1974 to 1999 by an estimated 2.4% per year among males and 2.8% per year among females. Overall, males had a 60% increased risk of brain tumors compared with females. Males had a higher incidence of GBM compared with females at each anatomic subsite except the posterior fossa. The largest male:female ratio occurred in the occipital lobes. Non-Latino whites had the highest incidence rates (2.5 per 100,000) followed by Latino whites (1.8 per 100,000), and blacks (1.5 per 100,000). After 1989, compared with the period before magnetic resonance imaging (MRI) was available, there was an increase in GBM incidence rates among those with of higher SES that was most pronounced in females. The incidence of GBM was highest for frontal lobe tumors and for tumors that involved two or more lobes (overlapping tumors), followed by tumors in the temporal and parietal lobes. In the multivariate analysis, year of diagnosis, SES, gender, race (Latino but not black), site, and age at diagnosis all were important predictors of incidence rate. GBM incidence increased in Los Angeles County over the last 30 years and especially after 1989, suggesting that the introduction of MRI may have contributed to the increase. Individuals older than age 65 years experienced the greatest increase in incidence over time. Older age, male gender, higher SES, and non-Latino white race increased the risk of GBM. Previously unreported incidence rates for GBM among Latino whites were significantly lower than among non-Latino whites but were intermediate between non-Latino whites and blacks.

Epidemiology and etiology of gliomas

Gliomas of astrocytic, oligodendroglial and ependymal origin account for more than 70% of all brain tumors. The most frequent (65%) and most malignant histological type is the glioblastoma. Since the introduction of computerized tomography and magnetic resonance imaging, the incidence rates of brain tumors have been rather stable, with a tendency of higher rates in highly developed, industrialized countries. Some reports indicate that Caucasians have higher incidence than black or Asian populations, but to some extent, this may reflect socio-economic differences and under-ascertainment in some regions, rather than a significant difference in genetic susceptibility. With the exception of pilocytic astrocytomas, the prognosis of glioma patients is still poor. Less than 3% of glioblastoma patients are still alive at 5 years after diagnosis, higher age being the most significant predictor of poor outcome. Brain tumors are a component of several inherited tumor syndromes, but the prevalence of these syndromes is very low. Several occupations, environmental carcinogens, and diet (N-nitroso compounds) have been reported to be associated with an elevated glioma risk, but the only environmental factor unequivocally associated with an increased risk of brain tumors, including gliomas, is therapeutic X-irradiation. In particular, children treated with X-irradiation for acute lymphoblastic leukemia show a significantly elevated risk of developing gliomas and primitive neuroectodermal tumor (PNET), often within 10 years after therapy. TP53 mutations are frequent in low-grade gliomas and secondary glioblastomas derived therefrom. Approximately 60% of mutations are located in the hot spot codons 248 and 273, and the majority of these are G:C-->A:T transitions at CpG sites. TP53 mutations are significantly more frequent in low-grade astrocytomas with promoter methylation of the O(6)-methylguanine-DNA methyltransferase repair gene, suggesting that, in addition to deamination of 5-methylcytosine, exogenous or endogenous alkylation in the O(6) position of guanine may contribute to the formation of these mutations.

Chromosome 10 and 17 deletions and p53 gene mutations in Thai patients with astrocytomas

The tumor suppressor gene locus is known to be partly responsible for the tumorigenesis of sporadic gliomas, but the genetic events that drive the neoplastic process of this tumor remain largely unknown. We correlated the results of loss of heterozygosity (LOH) analysis on chromosomes 10 and 17 and a point mutation analysis of a tumor suppressor gene, p53, in 21 patients with astrocytomas at different stages. LOH was determined in tumor and leukocyte DNAs of primary human central nervous system tumors. The incidence rate of brain tumors corresponded to every p53-coding exon for single-strand conformation polymorphisms (SSCP) and the mutations were confirmed by sequencing. p53 mutations were found in 2 of 10 glioblastomas (20%) and in 1 of 8 low-grade astrocytomas (12.5%). Similarly, LOH on chromosome 10 was also found in 2 of 10 glioblastomas (20%) and 1 of 8 low-grade astocytomas (12.5%). Neither of the p53 mutations nor LOH on chromosome 10 was observed together in the tumor types analyzed. Interestingly, the p53 mutations were found in 29% of patients with LOH on chromosome 17. The fact that p53 mutation and LOH on chromosome 17 were found together only in glioblastomas, suggested that these genetic changes may accumulate during astrocytoma progression.

Effects of a cell phone radiofrequency (860 MHz) on the latency of brain tumors in rats

The purpose of this study was to determine if an 860-MHz pulsed radiofrequency (PRF) shortened the latency of ethylnitrosourea (ENU)-induced brain tumors in rats. A total of 1080 Sprague–Dawley rats born of mothers given 6.3 or 10.0 mg/kg ENU intravenously on day 15 of gestation was randomized by ENU dose group into 18 groups of 60 rats (30 males and 30 females). Six groups were exposed to the PRF, 6 groups were sham exposed and 6 were cage controls. The PRF was delivered 6 h per day, 5 days per week beginning at 52±3 days of age. The specific absorption rate was 1±0.2 W/kg average to the brain. An equal number of rats from each exposure group was randomly selected for euthanasia and necropsy every 30 days from 828 rats between 172 and 322 days of age. A total of 252 rats were sacrificed because of the development of nervous disorders or they died spontaneously. There was no statistically significant difference between the incidence rates of brain tumors among PRF, sham or cage control groups in either the serial sacrifice or morbid groups. These results revealed no evidence that the PRF affects the incidence rate (or latency) of ENU-induced brain tumors in rats.

Navy review of nasopharyngeal radium treatments of submarine candidates.

From approximately 1945 through 1960 nasopharyngeal radium treatments were used to treat barotrauma incurred during submarine escape training by submarine candidates. Concern has been expressed that the treatments placed submarine candidates at significantly increased risk of having brain cancer develop. The concern is based on brain cancer incidence rates reported in a study of Washington County children. Using comparable populations' risk coefficients and secondary brain tumor incidence rates, the excess number of brain cancers per 10,000 subjects during the 42.5 years after treatment was calculated to be 0.5 to 2.8 cases and 1 case, respectively. Personnel records of a sample of those treated and others whose treatment status was unknown were reviewed to determine the feasibility of an epidemiologic study to confirm the cancer risk. The records indicated treatments were not consistently documented to confirm who was treated. In addition, social security numbers are not known to aid in determination of vital status. In conclusion, nasopharyngeal irradiation does not appear to pose a significant risk to submariners, and it is not feasible to use the submariner population to do a meaningful epidemiologic study to clarify the cancer risk.

Navy review of nasopharyngeal radium treatments of submarine candidates

From approximately 1945 through 1960 nasopharyngeal radium treatments were used to treat barotrauma incurred during submarine escape training by submarine candidates. Concern has been expressed that the treatments placed submarine candidates at significantly increased risk of having brain cancer develop. The concern is based on brain cancer incidence rates reported in a study of Washington County children. Using comparable populations' risk coefficients and secondary brain tumor incidence rates, the excess number of brain cancers per 10,000 subjects during the 42.5 years after treatment was calculated to be 0.5 to 2.8 cases and 1 case, respectively. Personnel records of a sample of those treated and others whose treatment status was unknown were reviewed to determine the feasibility of an epidemiologic study to confirm the cancer risk. The records indicated treatments were not consistently documented to confirm who was treated. In addition, social security numbers are not known to aid in determination of vital status. In conclusion, nasopharyngeal irradiation does not appear to pose a significant risk to submariners, and it is not feasible to use the submariner population to do a meaningful epidemiologic study to clarify the cancer risk. (Otolaryngol Head Neck Surg 1996;115:438-41.)

Primary brain tumor incidence rates in four United States regions, 1985-1989: a pilot study.

There has been controversy in the last decade over whether the reported increase in brain tumors reflects a real increase in incidence rates. Incidence data on the full spectrum of brain tumors is lacking in the discussion since current cancer reports in the United States are restricted to malignant tumors. Data on tumors from four population-based cancer registries in the United States were compiled to provide incidence rates of benign and malignant brain tumors and to assess the feasibility of providing these data on a larger scale. A total of 8,070 primary tumors diagnosed from 1985 to 1989 in Connecticut, Massachusetts, Missouri and Utah were obtained. Brain tumors were defined using the International Classification of Diseases for Oncology codes 191.0-191.9, 192.0-192.3, 192.8-192.9 and 194.3-194.4. Stratum-specific incidence rates by location and histology were estimated by sex, age and region. Age-adjusted rates were standardized to the 1970 United States population. An age-adjusted incidence rate of 9.4/10(5) was observed, which reflects a 36% increase in males and a 68% increase in females over the rate based on malignant tumors alone from the Surveillance, Epidemiology and End Results cancer reporting system. Incorporating benign tumors into cancer registry data would increase the reported incidence rates primarily in females and for meningiomas and nerve sheath tumors. This expanded incidence rate represents a substantial improvement in the ability to describe the occurrence of these complex tumors by subtype with a modest increase in overall case registrations for cancer registries. Centralization of data on all brain tumors appears feasible. Variations in histology-specific rates across regions raises questions that need to be addressed about the ascertainment and accuracy of tumor classification. Use of the cancer registration system to improve the reporting of brain tumors in the United States is important to our understanding of the occurrence of these complex tumors and to our ability to conduct large-scale epidemiologic investigations.