Abstract
In this national population-based study of glioma, we present epidemiologic data on incidence, demographics, survival, clinical characteristics and symptoms, and evaluate the association of specific indicators with the grade of glioma. We included 1930 patients registered in the Danish Neuro-Oncology Registry (DNOR) from 2009 to 2014. DNOR is a large-scale national population-based database including all adult glioma patients in Denmark. The age-adjusted annual incidence of histologic verified glioma was 7.3 cases pr. 100,000 person-years. High-grade gliomas were present in 85% and low-grade glioma in 15%. The overall male:female ratio was 3:2 and the mean age at onset was 60 years. Data for WHO grade I, II, III and IV glioma showed several important differences regarding age and sex distribution and symptomatology at presentation. The mean age increased with the grade of glioma and males predominated in all grades. Focal deficits were the most frequent presenting symptom, but among patients with glioma, grade II epileptic seizures were the most frequent symptom. Headache was a rare mono-symptomatic onset symptom. At presentation, higher age, focal deficits and cognitive change for <3 months duration, and headache <1 month were significant independent indicators of high-grade gliomas. Younger age and epileptic seizures for more than 3 months were indicative for low-grade gliomas. Survival rates for glioma grade I–IV showed decreasing survival with increasing grade. Glioma grade I–IV showed high diversity regarding several demographic and clinical characteristics emphasizing the importance of individually tailored disease treatments and support.
Similar content being viewed by others
References
Ohgaki H, Kleihues P (2005) Epidemiology and etiology of gliomas. Acta Neuropathol 109(1):93–108
Ostrom QT, Bauchet L, Davis FG et al (2014) The epidemiology of glioma in adults: a “state of the science” review. Neuro-Oncology 16(7):896–913
Ohgaki H, Kleihues P (2005) Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 64(6):479–489
NORDCAN (2016) http://www-dep.iarc.fr/NORDCAN/English/frame.asp. Accessed 17 August 2016
The International Classification of Diseases—Oncology, version 3 (ICD-O-3) (2016) http://codes.iarc.fr/. Accessed 17 August 2016
Louis DN, Ohgaki H, Wiestler OD et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 14(2):97–109
Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131: 803–820
Salminen E, Nuutinen JM, Huhtala S (1996) Multivariate analysis of prognostic factors in 106 patients with malignant glioma. Eur J Cancer 32A(11):1918–1923
Stewart LA (2002) Glioma Metaanalysis Trialists (GMT) Group. Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 359:1011–1018
Ostrom QT, Gittleman H, Stetson L et al (2015) Epidemiology of gliomas. Cancer Treat Res 163:1–14
Hansen S, Nielsen J, Laursen RJ et al (2016) The Danish Neuro-Oncology Registry: establishment, completeness and validity. BMC Res Notes 9:425
Hansen S (2016) The Danish Neuro-Oncology Registry. Clin Epidemiol 8:629–632
Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655
Statistics Denmark (2016) http://www.statistikbanken.dk/. Accessed 17 August 2016
Hill AB (1965) The environment and disease: association or causation? Proc R Soc Med 58:295–300
Posti JP, Bori M, Kauko T et al (2015) Presenting symptoms of glioma in adults. Acta Neurol Scand 131:88–93
Baldi I, Gruber A, Alioum A et al (2011) Descriptive epidemiology of CNS tumors in France: results from the Gironde Registry for the period 2000–2007. Neuro-Oncology 13(12):1370–1378
Ho VKY, Reijneveld JC, Roelien HE et al (2014) Changing incidence and improved survival of gliomas. Eur J Cancer 50:2309–2318
Christensen HC, Kosteljanetz M, Johansen C (2003) Incidence of gliomas and meningiomas in Denmark, 1943 to 1997. Neurosurgery 52:1327–1334
Deltour I, Auvinen A, Feychting M et al (2012) Mobile phone use and incidence of glioma in the Nordic countries 1979–2008: consistency check. Epidemiology 23(2):301–307
Deltour I, Johansen C, Auvinen A et al (2009) Time trends in brain tumor incidence rates in Denmark, Finland, Norway and Sweden, 1974–2003. J Natl Cancer Inst 101:1721–1724
Dahlrot RH, Kristensen BW, Hjelmborg J et al (2013) A population-based study of high-grade gliomas and mutated isocitrate dehydrogenase 1. Int J Clin Exp Pathol 6:31–40
Dahlrot RH, Kristensen BW, Hjelmborg J et al (2013) A population-based study of low-grade gliomas and mutated isocitrate dehydrogenase 1 (IDH1). J Neurooncol 114:309–317
Gittleman HR, Ostrom QT, Rouse CD et al (2015) Trends in Central Nervous System tumor incidence relative to other common cancer in adults, adolescents, and children in the United States, 2000 to 2010. Cancer 121:102–112
Hamilton W, Kernick D (2007) Clinical features of primary brain tumours: a case-control study using primary care records. Br J Gen Pract 57:695–699
Wöhrer A, Waldhör T, Heinzl M et al (2009) The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registry. J Neurooncol 95:401–411
Probst HB, Hussain ZB, Andersen O (2012) Cancer patient pathways in Denmark as a joint effort between bureaucrats, health professionals and politicians—a national Danish project. Health Policy 105:65–70
Schmidt-Hansen M, Berendse S, Hamilton W (2015) Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review. Fam Pract 32(6):618–623
Lipton RB, Bigal ME, Diamond M et al (2007) Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 68:343–349
Rasmussen BK (1995) Epidemiology of headache. Cephalalgia 15:45–68
Laursen EL, Rasmussen BK (2012) A brain cancer pathway in clinical practice. Danish Med J 59(5):A4437
Valentinis L, Tuniz F, Valent et al (2010) Headache attributed to intracranial tumors: a prospective cohort study. Cephalalgia 30(4):389–398
Schankin CJ, Ferrari U, Reinish VM et al (2007) Characteristics of brain tumor-associated headache. Cephalalgia 27:904–911
Kahn K, Finkel A (2014) It IS a tumor—current review of headache and brain tumor. Curr Pain Headache Rep 18:421
Goffaux P (2010) Brain tumor headaches: from bedside to bench. Neurosurgery 67:459–466
Kirby S, Purdy A (2014) Headaches and brain tumors. Neurol Clin 32:423–432
De Luca GC, Bartleson JD (2010) When and how to investigate the patient with headache. Semin Neurol 30(2):131–144
Schwartzbaum J, Jonsson F, Ahlbom A et al (2005) Prior hospitalization for epilepsy, diabetes, and stroke and subsequent glioma and meningioma risk. Cancer Epidemiol Biomarkers Prev 14:643–650
Tucha O, Smely C, Preier M et al (2000) Cognitive deficits before treatment among patients with brain tumors. Neurosurgery 47:324–334
Acknowledgements
The authors thank all the contributing departments for reporting data to DNOR, and we thank Susanne Møllerstrøm for language editing.
Funding
The Danish Cancer Society (R94-A5827).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any competing interests.
Rights and permissions
About this article
Cite this article
Rasmussen, B.K., Hansen, S., Laursen, R.J. et al. Epidemiology of glioma: clinical characteristics, symptoms, and predictors of glioma patients grade I–IV in the the Danish Neuro-Oncology Registry. J Neurooncol 135, 571–579 (2017). https://doi.org/10.1007/s11060-017-2607-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-017-2607-5