Thursday, November 05, 2015

Incidence of some brain & central nervous system tumors increased in children & adults in US from 2000-2010

Incidence of some brain & central nervous system tumors increased in children & adults in US from 2000-2010

My comments: According to this study, there has been a significant increase in the incidence of primary malignant brain and central nervous system tumors (MCNST) in American children (0-14 years of age) between 2000 and 2010, with an annual percentage change (APC) of 0.6%.
In adolescents (15-19 years old), there was a significant increase in the incidence of primary MCNST between 2000 and 2008, with an APC of 1.0%. Adolescents also experienced an increase in 
non-malignant brain and central nervous system tumors (NMCNST) from 2004 to 2010, with an APC of 3.9%.
In adults, there was a significant increase in NMCNST from 2004 to 2010, with an APC of 2.7%.
Funding for research on the causes of these tumors is practically non-existent in the U.S. 

Gittleman HR, Ostrom QT, Rouse CD, Dowling JA, de Blank PM, Kruchko CA, Elder JB, Rosenfeld SS, Selman WR, Sloan AE, Barnholtz-Sloan JS. 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. 2015 Jan 1;121(1):102-12. doi: 10.1002/cncr.29015. Epub 2014 Aug 25.


BACKGROUND: Time trends in cancer incidence rates (IR) are important to measure the changing burden of cancer on a population over time. The overall IR of cancer in the United States is declining. Although central nervous system tumors (CNST) are rare, they contribute disproportionately to mortality and morbidity. In this analysis, the authors examined trends in the incidence of the most common cancers and CNST between 2000 and 2010.

METHODS: The current analysis used data from the United States Cancer Statistics publication and the Central Brain Tumor Registry of the United States. Age-adjusted IR per 100,000 population with 95% confidence intervals and the annual percent change (APC) with 95% confidence intervals were calculated for selected common cancers and CNST overall and by age, sex, race/ethnicity, selected histologies, and malignancy status.

RESULTS: In adults, there were significant decreases in colon (2000-2010: APC, -3.1), breast (2000-2010: APC, -0.8), lung (2000-2010: APC, -1.1), and prostate (2000-2010: APC, -2.4) cancer as well as malignant CNST (2008-2010: APC, -3.1), but a significant increase was noted in nonmalignant CNST (2004-2010: APC, 2.7). In adolescents, there were significant increases in malignant CNST (2000-2008: APC, 1.0) and nonmalignant CNST (2004-2010: APC, 3.9). In children, there were significant increases in acute lymphocytic leukemia (2000-2010: APC, 1.0), non-Hodgkin lymphoma (2000-2010: APC, 0.6), and malignant CNST (2000-2010: APC, 0.6).

CONCLUSIONS: Surveillance of IR trends is an important way to measure the changing public health and economic burden of cancer. In the current study, there were significant decreases noted in the incidence of adult cancer, whereas adolescent and childhood cancer IR were either stable or increasing.
Open Access Paper:

Incidence Trends in Childhood Cancers

US cancer incidence for individuals aged <20 0.6="" 1975="" has="" increased="" since="" slightly="" span="" style="line-height: 1.6363em; vertical-align: baseline;" years="">2
 Analyses of childhood cancer incidence in other countries have demonstrated similar increases in Australia and Europe.15,16 We found a significant increase in the incidence of ALL, NHL, and MCNST in children from 2000 through 2010, but no significant change in incidence was noted for AML, HL, or NMCNST. A recent analysis of the SEER 9 registries from 1973 to 200917 found a much larger increase in childhood brain tumor IR overall between 1983 and 1986 for children aged birth to 14 years, and a nonsignificant increase between 1987 and 2009. This analysis also found an increase in the incidence of gliomas across the entire period examined.
Because the incidence of CNST peaks among young children (those aged <5 again="" and="" decades="" fifth="" in="" life="" of="" seventh="" span="" style="line-height: 1.6363em; vertical-align: baseline;" the="" then="" to="" years="">3
 CNST among adolescents and young adults is rarely examined. The incidence of MCNST and NMCNST increased in adolescents, but there were no significant changes in the incidence of lymphoma or leukemia noted from 2000 through 2010. The rarity of cancer in this age group may make it difficult to detect statistically significant differences over time. An analysis of data collected using the Automated Childhood Cancer Information System (ACCIS) found significant increases in CNST among adolescents aged 15 to 19 years (APC, 1.4; P<0 .0001="" 1970="" 1999="" and="" assess="" been="" between="" but="" by="" difficult="" during="" have="" imaging="" increases="" influenced="" is="" it="" may="" new="" of="" popularization="" span="" style="line-height: 1.6363em; vertical-align: baseline;" technology="" the="" these="" this="" time.="" to="" whether="">18

Incidence Trends in NMCNST

Reporting of NMCNST became mandatory in 2004 with the passage of the Benign Brain Tumor Cancer Registries Amendment Act, although several state registries had collected these data both actively and passively before the mandate.5 Due to the short period that NMCNST reporting has been mandated, it is difficult to determine whether apparent increases in these tumor types are due to improvements in case ascertainment over time. A previous CBTRUS analysis examined NMCNST cases collected from 1997 through 2008 from 11 population-based cancer registries5 and found a significant increase in incidence from 1997 through 2002 (APC, 7.0) and from 2002 through 2004 (APC, 12.2), but no significant change in IR was noted from 2005 through 2008. In addition, a recent study of Nordic cancer registry data also found a significant increase in the incidence of meningioma in women from 1990 through 2003 and in men from 1974 through 2003.11
Previous reports documented a dramatic increase in CNST incidence in the 1970s and 1980s,22,23 which has been attributed to improvements in diagnostic imaging techniques such as magnetic resonance imaging and computed tomography. The majority of analyses that examined diagnoses made since the early 1980s (when computed tomography became widely available) and the early 1990s (when magnetic resonance imaging became widely available) have found no significant increases in CNST incidence over time.14,22


The incidence of the most common cancers in adults decreased between 2000 and 2010, as did the incidence of MCNST. However, the incidence of NMCNST increased significantly. In comparison, adolescents had increasing rates of MCNST and NMCNST, and children had increasing rates of AML, NHL, and MCNST. Cancer in adolescents, especially CNST, is an understudied topic and deserves further individual examination to characterize the burden of CNST on adolescents and young adults in the United States. Surveillance of cancer incidence trends is an important measure of the changing public health and economic burden of cancer in the United States, as well as a tool with which to assess the success of cancer prevention programs. It is important to assess rare cancer types separately and compare their incidence with that of other common cancers.
Also see "Brain Tumor Rates Are Rising in the US: The Role of Cell Phone & Cordless Phone Use"
Joel M. Moskowitz, Ph.D., Director
Center for Family and Community Health
School of Public Health
University of California, Berkeley

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