Abstract
In the mid-1980s, there was a rise in incidence rates of childhood brain tumors (CBT) in the United States that appeared to stabilize at a higher rate in the early 1990s. An updated analysis of the pattern of CBT over the past 2 decades, with commentary on whether the elevated incidence rate has continued, is past due. We used Surveillance, Epidemiology and End Results (SEER) data to examine trends in incidence of CBT from 1973 through 2009. We examined age-adjusted incidence rates (AAIRs) and secular trends for all malignant brain tumors combined (SEER classification) by histologic tumor type and anatomic site. The incidence of CBT remained stable from 1987 to 2009 [annual percent change (APC) = 0.10; 95 % confidence intervals (CI) −0.39 to 0.61] with an AAIR for all CBT of 3.32 (95 % CI 3.22–3.42). The stability of rates in these two decades contrast the change that occurred in the mid-1980s (1983–1986), when the incidence of CBT increased by 53 % (APC = 14.06; 95 % CI 4.05–25.0). From 1983 to 1986, statistically significant rate increases were observed for pilocytic astrocytoma, PNET/medulloblastoma, and mixed glioma. Further, the rate of increase in pilocytic astrocytoma was similar to the rate of decrease for astrocytomas NOS from 1981 to 2009, suggesting a change from a more general to more specific classification. After the increase in rates in the mid-1980s, rates of CBT over the past two decades have stabilized. Changes in incidence rates of subtypes of tumors over this time period reflect changes both in classification of CBT and in diagnostic techniques.
References
Baldwin RT, Preston-Martin S (2004) Epidemiology of brain tumors in childhood—a review. Toxicol Appl Pharmacol 199:118–131. doi:10.1016/j.taap.2003.12.029
Dolecek TA, Propp JM, Stroup NE, Kruchko C (2012) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro Oncol 14(Suppl 5):v1–v49. doi:10.1093/neuonc/nos218
Wrensch M, Minn Y, Chew T, Bondy M, Berger MS (2002) Epidemiology of primary brain tumors: current concepts and review of the literature. Neuro Oncol 4:278–299
Preston-Martin S (1996) Epidemiology of primary CNS neoplasms. Neurol Clin 14:273–290
Smith MA, Freidlin B, Ries LA, Simon R (1998) Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90:1269–1277
Steinberg EP (1986) The status of MRI in 1986: rates of adoption in the United States and worldwide. AJR Am J Roentgenol 147:453–455
Mack TM (1977) Cancer surveillance program in Los Angeles County. Natl Cancer Inst Monogr 47:99–101
Fritz AG (2000) International classification of diseases for oncology: ICD-O. World Health Organization, Geneva
Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351
Yu B, Barrett MJ, Kim H-J, Feuer EJ (2007) Estimating joinpoints in continuous time scale for multiple change-point models. Comput Stat Data Anal 51:2420–2427
Liu L, Deapen D, Bernstein L (1998) Socioeconomic status and cancers of the female breast and reproductive organs: a comparison across racial/ethnic populations in Los Angeles County, California (United States). Cancer Causes Control 9:369–380
Gurney JG, Davis S, Severson RK, Fang JY, Ross JA, Robison LL (1996) Trends in cancer incidence among children in the U.S. Cancer 78:532–541
Legler JM, Ries LA, Smith MA, Warren JL, Heineman EF, Kaplan RS, Linet MS (1999) Cancer surveillance series [corrected]: brain and other central nervous system cancers: recent trends in incidence and mortality. J Natl Cancer Inst 91:1382–1390
Kohler BA, Ward E, McCarthy BJ, Schymura MJ, Ries LA, Eheman C, Jemal A, Anderson RN, Ajani UA, Edwards BK (2011) Annual report to the nation on the status of cancer, 1975–2007, featuring tumors of the brain and other nervous system. J Natl Cancer Inst 103:714–736. doi:10.1093/jnci/djr077
Poussaint TY (2001) Magnetic resonance imaging of pediatric brain tumors: state of the art. Top Magn Reson Imaging 12:411–433
Zulch K (1979) Histological typing of tumors of the central nervous system. World Health Organization, Geneva
McNeil DE, Cote TR, Clegg L, Mauer A (2002) SEER update of incidence and trends in pediatric malignancies: acute lymphoblastic leukemia. Med Pediatr Oncol 39:554–557; discussion 552–553
Kool M, Koster J, Bunt J, Hasselt NE, Lakeman A, van Sluis P, Troost D, Meeteren NS, Caron HN, Cloos J, Mrsić A, Ylstra B, Grajkowska W, Hartmann W, Pietsch T, Ellison D, Clifford SC, Versteeg R (2008) Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features. PLoS One 3:e3088. doi:10.1371/journal.pone.0003088
Northcott PA, Korshunov A, Witt H, Hielscher T, Eberhart CG, Mack S, Bouffet E, Clifford SC, Hawkins CE, French P, Rutka JT, Pfister S, Taylor MD (2011) Medulloblastoma comprises four distinct molecular variants. J Clin Oncol 29:1408–1414. doi:10.1200/JCO.2009.27.4324
Thompson MC, Fuller C, Hogg TL, Dalton J, Finkelstein D, Lau CC, Chintagumpala M, Adesina A, Ashley DM, Kellie SJ, Taylor MD, Curran T, Gajjar A, Gilbertson RJ (2006) Genomics identifies medulloblastoma subgroups that are enriched for specific genetic alterations. J Clin Oncol 24:1924–1931. doi:10.1200/JCO.2005.04.4974
Parsons DW, Li M, Zhang X, Jones S, Leary RJ, Lin JC, Boca SM, Carter H, Samayoa J, Bettegowda C, Gallia GL, Jallo GI, Binder ZA, Nikolsky Y, Hartigan J, Smith DR, Gerhard DS, Fults DW, VandenBerg S, Berger MS, Marie SK, Shinjo SM, Clara C, Phillips PC, Minturn JE, Biegel JA, Judkins AR, Resnick AC, Storm PB, Curran T, He Y, Rasheed BA, Friedman HS, Keir ST, McLendon R, Northcott PA, Taylor MD, Burger PC, Riggins GJ, Karchin R, Parmigiani G, Bigner DD, Yan H, Papadopoulos N, Vogelstein B, Kinzler KW, Velculescu VE (2011) The genetic landscape of the childhood cancer medulloblastoma. Science 331:435–439. doi:10.1126/science.1198056
Kleihues P, Cavenee WK (eds) (2000) World Health Organisation classification of tumours: pathology and genetics of tumours of the nervous system. IARC Press, Lyon
Partap S, Curran EK, Propp JM, Le GM, Sainani KL, Fisher PG (2009) Medulloblastoma incidence has not changed over time: a CBTRUS study. J Pediatr Hematol Oncol 31:970–971. doi:10.1097/MPH.0b013e3181bbc502
Pomeroy SL, Tamayo P, Gaasenbeek M, Sturla LM, Angelo M, McLaughlin ME, Kim JY, Goumnerova LC, Black PM, Lau C, Allen JC, Zagzag D, Olson JM, Curran T, Wetmore C, Biegel JA, Poggio T, Mukherjee S, Rifkin R, Califano A, Stolovitzky G, Louis DN, Mesirov JP, Lander ES, Golub TR (2002) Prediction of central nervous system embryonal tumour outcome based on gene expression. Nature 415:436–442. doi:10.1038/415436a415436a
McNeil DE, Cote TR, Clegg L, Rorke LB (2002) Incidence and trends in pediatric malignancies medulloblastoma/primitive neuroectodermal tumor: a SEER update. Surveillance Epidemiology and End Results. Med Pediatr Oncol 39:190–194
Louis DNOH, Wiestler OD, Cavenee WK (eds) (2007) WHO classification of tumours of the central nervous system. IARC, Lyon
Steinberg EP, Sisk JE, Locke KE (1985) X-ray CT and magnetic resonance imagers. Diffusion patterns and policy issues. N Engl J Med 313:859–864
U.S. Government Accountability Office (2008) Medicare part B imaging services: rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices (GAO-08-452). Government Printing Office, Washington, DC, pp 5–13
Davis FG, Malmer BS, Aldape K, Barnholtz-Sloan JS, Bondy ML, Brannstrom T, Bruner JM, Burger PC, Collins VP, Inskip PD, Kruchko C, McCarthy BJ, McLendon RE, Sadetzki S, Tihan T, Wrensch MR, Buffler PA (2008) Issues of diagnostic review in brain tumor studies: from the Brain Tumor Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 17:484–489
Pollack IF (1999) Pediatric brain tumors. Semin Surg Oncol 16:73–90. doi:10.1002/(SICI)1098-2388(199903)16:2<73
Kazner E, Wende S, Grumme T, Stochdorph FR, Claussen C (eds) (1989) Computed tomography and magnetic resonance tomography of intracranial tumors—a clinical perspective. Springer, Berlin
Guendelman S, Angulo V, Oman D (2005) Access to health care for children and adolescents in working poor families: recent findings from California. Med Care 43:68–78
Gurney JG, Kadan-Lottick N (2001) Brain and other central nervous system tumors: rates, trends, and epidemiology. Curr Opin Oncol 13:160–166
Acknowledgments
Funding for this research was provided by the National Cancer Institute (NCI) [R01 CA116724]; the American Cancer Society [PTAPM-02-074-01]; the National Institute of Environmental Health Sciences (NIEHS) [2 T32 ES 013678-06]; the National Institute of Environmental Health Sciences Center, Grant #5P30ES07048; and the Ronald Ross, MD, Cancer Research Fund at the University of Southern California Norris Comprehensive Cancer Center.
Conflict of interest
The authors have no conflict of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
McKean-Cowdin, R., Razavi, P., Barrington-Trimis, J. et al. Trends in childhood brain tumor incidence, 1973–2009. J Neurooncol 115, 153–160 (2013). https://doi.org/10.1007/s11060-013-1212-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-013-1212-5