Huang Bin, Luo Alice, Durbin Eric B, Lycan Ellen, Tucker Thomas, Chen Quan, Horbinski Craig, Villano John L
Markey Cancer Center, University of Kentucky, Lexington, KY, 40536, USA.
Kentucky Cancer Registry, Lexington, KY, 40504, USA.
J Neurooncol. 2017 May;132(3):507-512. doi: 10.1007/s11060-017-2403-2. Epub 2017 Mar 11.
Determine whether the risk of astrocytomas in Appalachian children is higher than the national average. We compared the incidence of pediatric brain tumors in Appalachia versus non-Appalachia regions, covering years 2000-2011. The North American Association of Central Cancer Registries (NAACCR) collects population-based data from 55 cancer registries throughout U.S. and Canada. All invasive primary (i.e. non-metastatic tumors), with age at diagnosis 0-19 years old, were included. Nearly 27,000 and 2200 central nervous system (CNS) tumors from non-Appalachia and Appalachia, respectively comprise the cohorts. Age-adjusted incidence rates of each main brain tumor subtype were compared. The incidence rate of pediatric CNS tumors was 8% higher in Appalachia, 3.31 [95% CI 3.17-3.45] versus non-Appalachia, 3.06, [95% CI 3.02-3.09] for the years 2001-2011, all rates are per 100,000 population. Astrocytomas accounted for the majority of this difference, with the rate being 16% higher in Appalachian children, 1.77, [95% CI 1.67-1.87] versus non-Appalachian children, 1.52, [95% CI 1.50-1.55]. Among astrocytomas, World Health Organization (WHO) grade I astrocytomas were 41% higher in Appalachia, 0.63 [95% CI 0.56-0.70] versus non-Appalachia 0.44 [95% CI 0.43-0.46] for the years 2004-2011. This is the first study to demonstrate that Appalachian children are at greater risk of CNS neoplasms, and that much of this difference is in WHO grade I astrocytomas, 41% more common. The cause of this increased incidence is unknown and we discuss the importance of this in relation to genetic and environmental findings in Appalachia.
确定阿巴拉契亚地区儿童患星形细胞瘤的风险是否高于全国平均水平。我们比较了2000年至2011年阿巴拉契亚地区与非阿巴拉契亚地区儿童脑肿瘤的发病率。北美中央癌症登记协会（NAACCR）收集了来自美国和加拿大55个癌症登记处基于人群的数据。纳入所有诊断年龄在0至19岁的侵袭性原发性（即非转移性肿瘤）。非阿巴拉契亚地区和阿巴拉契亚地区分别有近27000例和2200例中枢神经系统（CNS）肿瘤构成了队列。比较了每种主要脑肿瘤亚型的年龄调整发病率。2001年至2011年期间，阿巴拉契亚地区儿童中枢神经系统肿瘤的发病率比非阿巴拉契亚地区高8%，分别为3.31[95%可信区间3.17 - 3.45]和3.06[95%可信区间3.02 - 3.09]，所有发病率均为每10万人口。星形细胞瘤占了这一差异的大部分，阿巴拉契亚地区儿童的发病率比非阿巴拉契亚地区儿童高16%，分别为1.77[95%可信区间1.67 - 1.87]和1.52[95%可信区间1.50 - 1.55]。在星形细胞瘤中，2004年至2011年期间，世界卫生组织（WHO）I级星形细胞瘤在阿巴拉契亚地区比非阿巴拉契亚地区高41%，分别为0.63[95%可信区间0.56 - 0.70]和0.44[95%可信区间0.43 - 0.46]。这是第一项表明阿巴拉契亚地区儿童患中枢神经系统肿瘤风险更高的研究，而且这种差异很大一部分在于WHO I级星形细胞瘤，其发病率高出41%。这种发病率增加的原因尚不清楚，我们讨论了这与阿巴拉契亚地区的遗传和环境研究结果相关的重要性。
