Case Western Reserve University, Cleveland, OH, USA.
Division of Cancer Epidemiology and Genetics, Trans Divisional Research Program, National Cancer Institute, Bethesda, MD, USA.
J Neurooncol. 2023 Mar;162(1):167-177. doi: 10.1007/s11060-023-04279-6. Epub 2023 Mar 16.
Primary malignant brain and other central nervous system tumors are rare cancers that have shown rising mortality rates in recent years. To elucidate potential factors involved in this rising death rate, we examined mortality trends for primary malignant BT in the United States stratified by histopathology groupings, age, race, and sex.
Mortality rates for demographic factors within primary malignant BT were generated using the National Center for Health Statistics' National Vital Statistics Systems data from 2004 to 2018. Additionally, histopathology-specific incidence-based mortality rates were calculated using the National Cancer Institute's Surveillance, Epidemiology, and End-Results (SEER) 18 data from 2004 to 2018. Joinpoint modeling was used to estimate mortality trends and annual percent changes with corresponding 95% confidence intervals.
Overall, there was a very small increase in mortality from 2004 to 2018. Individuals > 65 years saw a small increase in mortality, while changes in individuals of other ages were non-significant. Asian/Pacific Islander or American Indian/Alaskan Native had the largest increase in mortality. Among histopathology groupings, there was a small mortality increase in adults ages > 65 years with glioblastoma, while the mortality rate of other malignant gliomas declined in the same age group. CNS lymphoma mortality rates in patients ages 15-39 and 40-64 years declined significantly while rising significantly in the > 65 age group. In pediatric patients, embryonal tumor mortality had a non-significant increase between 2004 and 2007 but declined significantly between 2007 and 2018.
Examining age, race, sex, and histopathology-specific mortality trends at the population level can provide important information for clinicians, researchers, and aid in public health planning.
原发性脑和其他中枢神经系统恶性肿瘤是罕见的癌症,近年来死亡率呈上升趋势。为了阐明导致这一死亡率上升的潜在因素,我们按组织病理学分组、年龄、种族和性别检查了美国原发性脑恶性肿瘤(BT)的死亡率趋势。
使用国家卫生统计中心国家生命统计系统的数据,从 2004 年到 2018 年,生成了原发性脑 BT 中人口统计学因素的死亡率。此外,使用国家癌症研究所的监测、流行病学和最终结果(SEER)18 数据,从 2004 年到 2018 年计算了基于组织病理学的特定发病率死亡率。使用 Joinpoint 模型估计死亡率趋势和年度百分比变化,以及相应的 95%置信区间。
总体而言,2004 年至 2018 年死亡率略有上升。>65 岁的个体死亡率略有上升,而其他年龄段的变化不显著。亚洲/太平洋岛民或美国印第安人/阿拉斯加原住民的死亡率增幅最大。在组织病理学分组中,>65 岁的成年人胶质母细胞瘤的死亡率略有上升,而同一年龄组的其他恶性神经胶质瘤的死亡率则下降。15-39 岁和 40-64 岁的中枢神经系统淋巴瘤患者的死亡率显著下降,而>65 岁年龄组的死亡率显著上升。在儿科患者中,胚胎瘤的死亡率在 2004 年至 2007 年之间略有上升,但在 2007 年至 2018 年之间显著下降。
在人群水平上检查年龄、种族、性别和组织病理学特异性死亡率趋势,可以为临床医生、研究人员提供重要信息,并有助于公共卫生规划。