Cancer Research UK Paediatric and Familial Cancer Research Group, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Eur J Cancer. 2010 Jun;46(9):1607-16. doi: 10.1016/j.ejca.2010.02.007. Epub 2010 Mar 1.
Reported increases in the incidence of CNS tumours in the developed world in the 1970s to 1990s have been a cause for concern and debate. It still remains to be adequately answered whether these increases are true or an artefact of changes in diagnostic and registration practices. Using high-quality national cancer registration data, we have analysed incidence trends for each major histological subgroup of CNS tumour (2000 World Health Organisation (WHO) classification) registered in those aged 0-84 years for the whole of England during the period 1979 through 2003. 134,509 primary CNS tumours of malignant, benign and uncertain behaviour located in the brain, meninges, spinal cord, cranial nerves, other parts of the central nervous system and in the pituitary and pineal glands were registered. In summary, we present the single largest nationwide study on the longitudinal incidence trends of CNS tumours. The increase in incidence observed in the 1970s and 1980s was mainly in the young and the elderly and has now plateaued and may even be decreasing. There is however variation in trends by histology. The incidence of some histological sub-groups has continued to increase until the most recent period of analysis. Much of the initial increase can be attributed to the emergence of much more widely available neuroimaging, while the most recent incidence changes for specific sub-groups of CNS tumours appear to be due to greater diagnostic specificity leading to a shift in registered categories. However, the trends for high-grade astrocytomas and other gliomas need further observation and investigation.
在 20 世纪 70 年代至 90 年代，发达国家中枢神经系统肿瘤发病率的上升引起了人们的关注和争议。这些增加是否真实存在，或者只是诊断和登记实践变化的一种假象，仍然需要充分回答。我们利用高质量的全国癌症登记数据，分析了英格兰在 1979 年至 2003 年期间，年龄在 0 至 84 岁的所有人群中，每一种主要的中枢神经系统肿瘤组织学亚组（2000 年世界卫生组织[WHO]分类）的发病趋势。共登记了 134509 例原发于脑、脑膜、脊髓、颅神经、中枢神经系统其他部位以及垂体和松果体的恶性、良性和性质不明的中枢神经系统肿瘤。总之，我们呈现了关于中枢神经系统肿瘤纵向发病趋势的最大的全国性研究。在 20 世纪 70 年代和 80 年代观察到的发病率上升主要发生在年轻人和老年人中，现在已经趋于平稳，甚至可能在下降。但是，不同组织学的发病趋势存在差异。某些组织学亚组的发病率一直持续上升，直到最近的分析期。最初的大部分上升可以归因于更广泛应用的神经影像学的出现，而最近特定中枢神经系统肿瘤亚组的发病率变化似乎是由于诊断的特异性更高，导致登记类别发生了变化。然而，高级别星形细胞瘤和其他神经胶质瘤的趋势需要进一步观察和研究。
