Chakrabarti Indro, Cockburn Myles, Cozen Wendy, Wang Ya-Ping, Preston-Martin Susan
Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, 90032, USA.
Cancer. 2005 Dec 15;104(12):2798-806. doi: 10.1002/cncr.21539.
There have been reports that the incidence rates of brain tumors have increased over the past few decades, but most have considered all brain tumors together. The authors analyzed the pattern of glioblastoma multiforme (GBM) occurrence in Los Angeles County, California to shed light on the incidence and descriptive epidemiology of this type of brain tumor.
Data were obtained from the Los Angeles County Cancer Surveillance Program. Incidence rates were analyzed by gender, race, age at diagnosis, period of diagnosis (1974-1981, 1982-1988, or 1989-1999), and socioeconomic status (SES). In addition, data were stratified according to anatomic subsite. A multivariate model describing changes in rates by each of these variables was constructed.
Age-specific incidence rates (ASIR) rose sharply after age 30 years. The peak ASIR was at age 70-74 years in males and at age 75-79 years in females. The age-adjusted incidence rate (AAIR) of GBM increased from 1974 to 1999 by an estimated 2.4% per year among males and 2.8% per year among females. Overall, males had a 60% increased risk of brain tumors compared with females. Males had a higher incidence of GBM compared with females at each anatomic subsite except the posterior fossa. The largest male:female ratio occurred in the occipital lobes. Non-Latino whites had the highest incidence rates (2.5 per 100,000) followed by Latino whites (1.8 per 100,000), and blacks (1.5 per 100,000). After 1989, compared with the period before magnetic resonance imaging (MRI) was available, there was an increase in GBM incidence rates among those with of higher SES that was most pronounced in females. The incidence of GBM was highest for frontal lobe tumors and for tumors that involved two or more lobes (overlapping tumors), followed by tumors in the temporal and parietal lobes. In the multivariate analysis, year of diagnosis, SES, gender, race (Latino but not black), site, and age at diagnosis all were important predictors of incidence rate.
GBM incidence increased in Los Angeles County over the last 30 years and especially after 1989, suggesting that the introduction of MRI may have contributed to the increase. Individuals older than age 65 years experienced the greatest increase in incidence over time. Older age, male gender, higher SES, and non-Latino white race increased the risk of GBM. Previously unreported incidence rates for GBM among Latino whites were significantly lower than among non-Latino whites but were intermediate between non-Latino whites and blacks.
有报道称在过去几十年里脑肿瘤的发病率有所上升，但大多数报道是将所有脑肿瘤综合考虑的。作者分析了加利福尼亚州洛杉矶县多形性胶质母细胞瘤（GBM）的发病模式，以阐明这类脑肿瘤的发病率及描述性流行病学特征。
数据来自洛杉矶县癌症监测项目。发病率按性别、种族、诊断时年龄、诊断时期（1974 - 1981年、1982 - 1988年或1989 - 1999年）以及社会经济地位（SES）进行分析。此外，数据按解剖亚部位进行分层。构建了一个多变量模型来描述这些变量各自导致的发病率变化。
30岁以后年龄别发病率（ASIR）急剧上升。男性ASIR峰值出现在70 - 74岁，女性出现在75 - 79岁。1974年至1999年，GBM的年龄调整发病率（AAIR）在男性中每年估计增加2.4%，在女性中每年增加2.8%。总体而言，男性患脑肿瘤的风险比女性高60%。除后颅窝外，在每个解剖亚部位男性的GBM发病率均高于女性。男女比例最大的是枕叶。非西班牙裔白人发病率最高（每10万人中有2.5例），其次是西班牙裔白人（每10万人中有1.8例）和黑人（每10万人中有1.5例）。1989年以后，与磁共振成像（MRI）应用之前的时期相比，SES较高者中GBM发病率有所上升，在女性中最为明显。额叶肿瘤以及累及两个或更多脑叶的肿瘤（重叠肿瘤）的GBM发病率最高，其次是颞叶和顶叶肿瘤。在多变量分析中，诊断年份、SES、性别、种族（西班牙裔但非黑人）、部位以及诊断时年龄都是发病率的重要预测因素。
在过去30年里，洛杉矶县GBM发病率上升，尤其是1989年以后，这表明MRI的应用可能促使了发病率上升。65岁以上人群的发病率随时间增长上升幅度最大。年龄较大、男性、SES较高以及非西班牙裔白人种族增加了患GBM的风险。之前未报道的西班牙裔白人中GBM发病率显著低于非西班牙裔白人，但介于非西班牙裔白人和黑人之间。
