Brain cancer – news gets worse

 

The objective of the CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012 is to provide a comprehensive summary of the current descriptive epidemiology of primary brain and central nervous system (CNS) tumors in the United States (US) population. CBTRUS obtained the latest available data on all newly diagnosed primary brain and CNS tumors from the Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR), and the National Cancer Institute (NCI), Surveillance, Epidemiology and End Results (SEER) program for diagnosis years 2008-2012. Incidence counts and rates of primary malignant and non-malignant brain and CNS tumors are documented by histology, gender, age, race and Hispanic ethnicity. Mortality and relative survival rates for selected malignant histologies calculated using SEER data for the period 1995-2012 are also presented.

… data for CBTRUS analyses come from the NPCR and SEER programs. By law, all primary malignant and non-malignant brain tumors are reportable diseases. Hence, tumor registrars in treatment centers collect these data and send this information to CCR in their states where they are collated and de-identified and sent to NPCR and SEER.

The broad category glioma represents approximately 27% of all tumors (Figure 9a) and 80% of malignant tumors (Figure 9b). The distribution of gliomas by site and histology are shown in Figures 10 and 11, respectively.

• The majority of gliomas occur in the frontal, temporal, parietal, and occipital lobes combined (60.8%). Only a very small proportion of gliomas occur outside the brain.
• Glioblastoma accounts for the majority of gliomas (55.1%).
• Other astrocytomas and glioblastoma combined account for about 75% of all gliomas.

Brain and CNS tumor incidence rates by behavior (malignant and non-malignant) and by major histologies are presented in Table 7.

• For malignant tumors, the incidence rate was highest for glioblastoma (3.20 per 100,000 population), followed by diffuse astrocytoma (0.53 per 100,000 population) and lymphoma (0.44 per 100,000 population).
• For non-malignant tumors, the incidence rate was highest for meningioma (7.75 per 100,000 population), followed by tumors of the pituitary (3.49 per 100,000 population), and nerve sheath (1.75 per 100,000 population).

Incidence rates for all primary brain and CNS tumors combined are lower for race groups AIAN (14.28 per 100,000 population) as compared to whites (22.09 per 100,000 population), blacks (22.04 per 100,000 population), and API (20.14 per 100,000 population).

The overall incidence rate for primary brain and CNS tumors is 20.45 per 100,000 population among Hispanics and 22.31 per 100,000 population among non-Hispanics.

Brain and CNS tumors are the most common form of solid tumors in children,32,33 accounting for the majority of cancer mortality in this age group.34

Gliomas account for approximately 47.0% of tumors in children and adolescents age 0-19 years … Gliomas account for approximately 53.0% of tumors in children age 0-14 years.

The incidence rate for all brain and CNS tumors is highest among the age 85+ years (83.14 per 100,000 population) and lowest among children and adolescents age 0-19 years (5.57 per 100,000 population).

There is less variation by region for malignant tumor incidence rates as compared to incidence rates for non-malignant tumors. CCR and regional variations likely reflect differences in reporting and case ascertainment practices.

Overall, the most common tumor site is the meninges (the outer covering of the brain), representing 36.4% of all tumors.

The total number of new cases of primary brain and CNS tumors for all 50 states and the District of Columbia in 2015 is estimated to be 76,520 with 24,560 malignant and 51,960 non-malignant.

• Meningioma has the highest number of all estimated new cases, with 25,110 cases in 2015 and 24,880 in 2016. Tumors of the pituitary have the second highest number of all estimated cases, with 11,610 cases in 2015 and 11,700 in 2016.
• Glioblastoma has the highest number of cases of all malignant tumors, with 11,890 cases predicted in 2015 and 12,120 in 2016.

Glioma accounts for approximately 29% of all brain and CNS tumors in AYA (15-39 years of age), and about 82% of malignant tumors. (Figure 21b).

Descriptive Summary of Time Trends in Primary Brain and CNS Tumors

Time trends in cancer incidence rates are an important measure of the changing burden of cancer in a population over time. Incidence rates of cancer overall, and many specific cancer histologies, have decreased over time. 36 Overall, there have been some changes in incidence rates of brain and CNS tumors between 2000 and 2010, but the scale of these changes has been small. 37

• In children (0-14 years old), there have been significant increases in incidence of primary malignant brain and CNS tumors between 2000-2010, with an annual percentage change (APC) of 0.6%. 37
• In adolescents (15-19 years old), there was a significant increase in incidence of primary malignant brain and CNS tumors between 2000-2008, with an APC of 1.0%. 37
• Adolescents also experienced an increase in non-malignant brain and CNS tumors from 2004-2010, with an APC of 3.9%. 37
• Between 2008 and 2010, adults (age 20+years) experienced a decrease in incidence of primary malignant brain and CNS tumors, with an APC of -3.1%. 37

Ref. 37. Gittleman HR, Ostrom QT, Rouse CD, et al. Trends in central nervous system tumor incidence relative to other common cancers in adults, adolescents, and children in the United States, 2000 to 2010. Cancer. Aug 25 2014. URL: http://onlinelibrary.wiley.com/doi/10.1002/cncr.29015/full