Central Brain Tumor Registry of the United States, Hinsdale, Illinois.
Section of Epidemiology and Population Sciences, Department of Medicine, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas.
JAMA Oncol. 2018 Sep 1;4(9):1254-1262. doi: 10.1001/jamaoncol.2018.1789.
IMPORTANCE: Glioma is the most commonly occurring malignant brain tumor in the United States, and its incidence varies by age, sex, and race or ethnicity. Survival after brain tumor diagnosis has been shown to vary by these factors. OBJECTIVE: To quantify the differences in incidence and survival rates of glioma in adults by race or ethnicity. DESIGN, SETTING, AND PARTICIPANTS: This population-based study obtained incidence data from the Central Brain Tumor Registry of the United States and survival data from Surveillance, Epidemiology, and End Results registries, covering the period January 1, 2000, to December 31, 2014. Average annual age-adjusted incidence rates with 95% CIs were generated by glioma histologic groups, race, Hispanic ethnicity, sex, and age groups. One-year and 5-year relative survival rates were generated by glioma histologic groups, race, Hispanic ethnicity, and insurance status. The analysis included 244 808 patients with glioma diagnosed in adults aged 18 years or older. Data were collected from January 1, 2000, to December 31, 2014. Data analysis took place from December 11, 2017, to January 31, 2018. RESULTS: Overall, 244 808 patients with glioma were analyzed. Of these, 150 631 (61.5%) were glioblastomas, 46 002 (18.8%) were non-glioblastoma astrocytomas, 26 068 (10.7%) were oligodendroglial tumors, 8816 (3.6%) were ependymomas, and 13 291 (5.4%) were other glioma diagnoses in adults. The data set included 137 733 males (56.3%) and 107 075 (43.7%) females. There were 204 580 non-Hispanic whites (83.6%), 17 321 Hispanic whites (7.08%), 14 566 blacks (6.0%), 1070 American Indians or Alaska Natives (0.4%), and 5947 Asians or Pacific Islanders (2.4%). Incidences of glioblastoma, non-glioblastoma astrocytoma, and oligodendroglial tumors were higher among non-Hispanic whites than among Hispanic whites (30% lower overall), blacks (52% lower overall), American Indians or Alaska Natives (58% lower overall), or Asians or Pacific Islanders (52% lower overall). Most tumors were more common in males than in females across all race or ethnicity groups, with the great difference in glioblastoma where the incidence was 60% higher overall in males. Most tumors (193 329 [79.9%]) occurred in those aged 45 years or older, with differences in incidence by race or ethnicity appearing in all age groups. Survival after diagnosis of glioma of different subtypes was generally comparable among Hispanic whites, blacks, and Asians or Pacific Islanders but was lower among non-Hispanic whites for many tumor types, including glioblastoma, irrespective of treatment type. CONCLUSIONS AND RELEVANCE: Incidence of glioma and 1-year and 5-year survival rates after diagnosis vary significantly by race or ethnicity, with non-Hispanic whites having higher incidence and lower survival rates compared with individuals of other racial or ethnic groups. These findings can inform future discovery of risk factors and reveal unaddressed health disparities.
重要性:脑肿瘤在美国是最常见的恶性脑肿瘤,其发病率因年龄、性别和种族或族裔而异。脑肿瘤诊断后的生存率已被证明因这些因素而异。 目的:量化成人脑肿瘤发病率和生存率的种族或族裔差异。 设计、地点和参与者:本基于人群的研究从美国中央脑肿瘤登记处获得发病率数据,从监测、流行病学和最终结果登记处获得生存率数据,涵盖 2000 年 1 月 1 日至 2014 年 12 月 31 日。根据脑肿瘤组织学类型、种族、西班牙裔、性别和年龄组生成平均年龄调整发病率的年率及其 95%置信区间。根据脑肿瘤组织学类型、种族、西班牙裔和保险状况生成 1 年和 5 年相对生存率。该分析包括 244808 名成年患者患有脑肿瘤。数据收集于 2000 年 1 月 1 日至 2014 年 12 月 31 日。数据分析于 2017 年 12 月 11 日至 2018 年 1 月 31 日进行。 结果:总体而言,分析了 244808 名患有脑肿瘤的患者。其中,150631 名(61.5%)为胶质母细胞瘤,46002 名(18.8%)为非胶质母细胞瘤星形细胞瘤,26068 名(10.7%)为少突胶质细胞瘤,8816 名(3.6%)为室管膜瘤,13291 名(5.4%)为其他成人脑肿瘤诊断。数据集包括 137733 名男性(56.3%)和 107075 名女性(43.7%)。204580 名非西班牙裔白人(83.6%),17321 名西班牙裔白人(7.08%),14566 名黑人(6.0%),1070 名美国印第安人或阿拉斯加原住民(0.4%),5947 名亚洲人或太平洋岛民(2.4%)。非西班牙裔白人的胶质母细胞瘤、非胶质母细胞瘤星形细胞瘤和少突胶质细胞瘤的发病率高于西班牙裔白人(总体低 30%)、黑人(总体低 52%)、美国印第安人或阿拉斯加原住民(总体低 58%)或亚洲人或太平洋岛民(总体低 52%)。在所有种族或族裔群体中,大多数肿瘤在男性中比在女性中更为常见,其中胶质母细胞瘤的差异最大,男性总体发病率高出 60%。大多数肿瘤(193329 例[79.9%])发生在 45 岁或以上的人群中,种族或族裔差异在所有年龄组中均有出现。不同脑肿瘤亚型的诊断后生存情况总体上在西班牙裔白人、黑人和亚洲人或太平洋岛民之间相似,但在许多肿瘤类型中,包括胶质母细胞瘤,非西班牙裔白人的生存率低于其他种族或族裔群体,无论治疗类型如何。 结论和相关性:脑肿瘤的发病率和诊断后 1 年和 5 年生存率因种族或族裔而异,与其他种族或族裔群体相比,非西班牙裔白人的发病率更高,生存率更低。这些发现可以为未来风险因素的发现提供信息,并揭示未得到解决的健康差异。
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