Chirlaque Maria D, Peris-Bonet Rafael, Sánchez Antonia, Cruz Ofelia, Marcos-Gragera Rafael, Gutiérrez-Ávila Gonzalo, Quirós-García José R, Almela-Vich Fernando, López de Munain Arantza, Sánchez Maria J, Franch-Sureda Paula, Ardanaz Eva, Galceran Jaume, Martos Carmen, Salmerón Diego, Gatta Gemma, Botta Laura, Cañete Adela
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
Department of Epidemiology, Murcia Regional Health Authority, 30071 Murcia, Spain.
Cancers (Basel). 2023 Dec 18;15(24):5889. doi: 10.3390/cancers15245889.
Central nervous system (CNS) neoplasms are highly frequent solid tumours in children and adolescents. While some studies have shown a rise in their incidence in Europe, others have not. Survival remains limited. We addressed two questions about these tumours in Spain: (1) Is incidence increasing? and (2) Has survival improved?
This population-based study included 1635 children and 328 adolescents from 11 population-based cancer registries with International Classification of Childhood Cancer Group III tumours, incident in 1983-2007. Age-specific and age-standardised (world population) incidence rates (ASRws) were calculated. Incidence time trends were characterised using annual percent change (APC) obtained with Joinpoint. Cases from 1991 to 2005 (1171) were included in Kaplan-Meier survival analyses, and the results were evaluated with log-rank and log-rank for trend tests. Children's survival was age-standardised using: (1) the age distribution of cases and the corresponding trends assessed with Joinpoint; and (2) European weights for comparison with Europe.
ASRw 1983-2007: children: 32.7 cases/10; adolescents: 23.5 cases/10. The overall incidence of all tumours increased across 1983-2007 in children and adolescents. Considering change points, the APCs were: (1) children: 1983-1993, 4.3%^ (1.1; 7.7); 1993-2007, -0.2% (-1.9; 1.6); (2) adolescents: 1983-2004: 2.9%^ (0.9; 4.9); 2004-2007: -7.7% (-40; 41.9). For malignant tumours, the trends were not significant. 5-year survival was 65% (1991-2005), with no significant trends (except for non-malignant tumours).
CNS tumour incidence in Spain was found to be similar to that in Europe. Rises in incidence may be mostly attributable to changes in the registration of non-malignant tumours. The overall malignant CNS tumour trend was compatible with reports for Southern Europe. Survival was lower than in Europe, without improvement over time. We provide a baseline for assessing current paediatric oncology achievements and incidence in respect of childhood and adolescent CNS tumours.
中枢神经系统（CNS）肿瘤是儿童和青少年中常见的实体瘤。虽然一些研究表明欧洲其发病率有所上升，但其他研究并非如此。生存率仍然有限。我们针对西班牙的这些肿瘤研究了两个问题：（1）发病率是否在上升？（2）生存率是否有所提高？
这项基于人群的研究纳入了来自11个基于人群的癌症登记处的1635名儿童和328名青少年，他们患有国际儿童癌症分类第三组肿瘤，发病时间为1983年至2007年。计算了年龄特异性和年龄标准化（世界人口）发病率（ASRws）。使用Joinpoint获得的年度百分比变化（APC）来描述发病率的时间趋势。1991年至2005年的病例（1171例）纳入Kaplan-Meier生存分析，并使用对数秩和对数秩趋势检验评估结果。儿童生存率的年龄标准化使用：（1）病例的年龄分布以及用Joinpoint评估的相应趋势；（2）欧洲权重以与欧洲进行比较。
1983 - 2007年的ASRws：儿童：32.7例/10万；青少年：23.5例/10万。1983年至2007年期间，儿童和青少年中所有肿瘤的总体发病率均有所上升。考虑变化点，APC分别为：（1）儿童：1983 - 1993年，4.3%（1.1；7.7）；1993 - 2007年， - 0.2%（ - 1.9；1.6）；（2）青少年：1983 - 2004年：2.9%（0.9；4.9）；2004 - 2007年： - 7.7%（ - 40；41.9）。对于恶性肿瘤，趋势不显著。5年生存率为65%（1991 - 2005年），无显著趋势（非恶性肿瘤除外）。
西班牙中枢神经系统肿瘤的发病率与欧洲相似。发病率上升可能主要归因于非恶性肿瘤登记的变化。总体恶性中枢神经系统肿瘤趋势与南欧的报告一致。生存率低于欧洲，且未随时间改善。我们为评估当前儿童肿瘤学在儿童和青少年中枢神经系统肿瘤方面的成就和发病率提供了一个基线。
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