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Brain and other central nervous system tumor statistics, 2021.

Literature Information

DOI	10.3322/caac.21693
PMID	34427324
Journal	CA: a cancer journal for clinicians
Impact Factor	232.4
JCR Quartile	Q1
Publication Year	2021
Times Cited	433
Keywords	Central Brain Tumor Registry of the United States (CBTRUS), brain tumors, central nervous system tumors, epidemiology
Literature Type	Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.
ISSN	0007-9235
Pages	381-406
Issue	71(5)
Authors	Kimberly D Miller, Quinn T Ostrom, Carol Kruchko, Nirav Patil, Tarik Tihan, Gino Cioffi, Hannah E Fuchs, Kristin A Waite, Ahmedin Jemal, Rebecca L Siegel, Jill S Barnholtz-Sloan

TL;DR

This study analyzes population-based data to assess the burden of brain and CNS tumors in the U.S., revealing a decline in malignant tumor incidence rates overall, yet an increase among children and adolescents, while survival rates have improved since the late 1970s, particularly for younger patients. Notably, significant survival disparities by race and ethnicity persist, highlighting the need for enhanced data collection to better understand the causes of these differences and improve outcomes for underrepresented groups.

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Central Brain Tumor Registry of the United States (CBTRUS) · brain tumors · central nervous system tumors · epidemiology

Abstract

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.

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Primary Questions Addressed

1. What factors contribute to the declining incidence rates of malignant brain tumors in the general population, while they are increasing among children and adolescents?
2. How do survival rates for brain tumors differ across various demographic groups, and what implications does this have for healthcare policies?
3. What advancements in treatment and early detection have been made for glioblastoma, and why have they been limited compared to other brain tumors?
4. In what ways can the collection and reporting of brain tumor data be improved to better understand the disparities in incidence and survival rates among different racial and ethnic groups?
5. What role does socioeconomic status play in the outcomes of patients diagnosed with brain and CNS tumors, particularly among underrepresented populations?

Key Findings

1. Research Background and Objectives

Brain tumors, including both malignant and nonmalignant types, represent a significant public health challenge due to their high fatality rates and substantial morbidity. The objective of this study was to analyze contemporary data on the incidence, survival rates, and demographic disparities associated with brain tumors in the United States. By utilizing population-based data from various national cancer registries, the research aimed to provide insights into the burden of brain tumors, dissect trends by histology, anatomic site, age, sex, and race/ethnicity, and identify areas needing further attention for research and policy development.

2. Main Methods and Findings

The study conducted a comprehensive analysis using data from the Central Brain Tumor Registry of the United States, which includes information from the National Program of Cancer Registries (NPCR), Surveillance, Epidemiology, and End Results (SEER) registries, and the National Vital Statistics System. The findings revealed a slight annual decline of 0.8% in malignant brain tumor incidence rates from 2008 to 2017 across all ages, though a concerning increase of 0.5% to 0.7% per year was observed among children and adolescents. The incidence of malignant tumors was predominantly higher in males and non-Hispanic Whites, while nonmalignant tumors showed higher rates in females and non-Hispanic Blacks.

Survival rates for malignant brain tumors improved from 23% to 36% between 1975-1977 and 2009-2015, with younger patients experiencing more significant gains. Notably, glioblastoma survival rates increased minimally from 4% to 7%, indicating stagnation in advancements for this aggressive tumor type. Racial and ethnic disparities were particularly pronounced in childhood tumors, with Black patients having significantly lower survival rates compared to White patients for certain tumor types.

3. Core Conclusions

The study underscores the complex landscape of brain tumor epidemiology, highlighting a mixed trend in incidence and survival rates across different demographics. While some improvements in survival have been observed over the decades, significant disparities persist, especially for certain populations and tumor types. The stagnation in glioblastoma survival rates calls for urgent attention to enhance research and treatment strategies.

4. Research Significance and Impact

The insights generated by this research are critical for shaping future cancer research and public health policies. The identification of demographic disparities necessitates targeted efforts to improve outcomes for underrepresented groups, particularly Black patients and children facing brain tumors. Furthermore, the call for enhanced data collection and reporting mechanisms is vital for understanding the underlying causes of disparities and advancing research on rare tumor subtypes. This comprehensive analysis not only informs clinical practice but also emphasizes the need for equitable healthcare interventions and resource allocation to address the ongoing challenges in brain tumor management.

Literatures Citing This Work

1. In Vivo Study of the Efficacy and Safety of 5-Aminolevulinic Radiodynamic Therapy for Glioblastoma Fractionated Radiotherapy. - Junko Takahashi;Shinsuke Nagasawa;Motomichi Doi;Masamichi Takahashi;Yoshitaka Narita;Junkoh Yamamoto;Mitsushi J Ikemoto;Hitoshi Iwahashi - International journal of molecular sciences (2021)
2. Glioblastoma gene network reconstruction and ontology analysis by online bioinformatics tools. - Natalya V Gubanova;Nina G Orlova;Arthur I Dergilev;Nina Y Oparina;Yuriy L Orlov - Journal of integrative bioinformatics (2021)
3. The integrated multiomic diagnosis of sporadic meningiomas: a review of its clinical implications. - Stephanie M Robert;Shaurey Vetsa;Arushii Nadar;Sagar Vasandani;Mark W Youngblood;Evan Gorelick;Lan Jin;Neelan Marianayagam;E Zeynep Erson-Omay;Murat Günel;Jennifer Moliterno - Journal of neuro-oncology (2022)
4. Circulating tumor DNA profiling for childhood brain tumors: Technical challenges and evidence for utility. - Anthony Pak-Yin Liu;Paul A Northcott;Giles W Robinson;Amar Gajjar - Laboratory investigation; a journal of technical methods and pathology (2022)
5. Clinical strategies to manage adult glioblastoma patients without MGMT hypermethylation. - Delin Liu;Tianrui Yang;Wenbin Ma;Yu Wang - Journal of Cancer (2022)
6. Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis. - Oliver Y Tang;Ross A Clarke;Krissia M Rivera Perla;Kiara M Corcoran Ruiz;Steven A Toms;Robert J Weil - Journal of neuro-oncology (2022)
7. Local Delivery and Glioblastoma: Why Not Combining Sustained Release and Targeting? - Claire Gazaille;Marion Sicot;Patrick Saulnier;Joël Eyer;Guillaume Bastiat - Frontiers in medical technology (2021)
8. Somatostatin Receptor Splicing Variant sst5TMD4 Overexpression in Glioblastoma Is Associated with Poor Survival, Increased Aggressiveness Features, and Somatostatin Analogs Resistance. - Antonio C Fuentes-Fayos;Miguel E G-García;Jesús M Pérez-Gómez;Annabel Peel;Cristóbal Blanco-Acevedo;Juan Solivera;Alejandro Ibáñez-Costa;Manuel D Gahete;Justo P Castaño;Raúl M Luque - International journal of molecular sciences (2022)
9. Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics. - Massimo E Maffei - International journal of molecular sciences (2022)
10. Preoperative Stereotactic Radiosurgery for Glioblastoma. - Eric J Lehrer;Henry Ruiz-Garcia;Anthony D Nehlsen;Kunal K Sindhu;Rachel Sarabia Estrada;Gerben R Borst;Jason P Sheehan;Alfredo Quinones-Hinojosa;Daniel M Trifiletti - Biology (2022)

... (423 more literatures)

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