Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.
Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA.
Neuro Oncol. 2024 May 6;26(Supplement_3):iii1-iii53. doi: 10.1093/neuonc/noae047.
Recent analyses have shown that, whereas cancer survival overall has been improving, it has not improved for adolescents and young adults ages 15-39 years (AYA). The clinical care of AYA with primary brain and other central nervous system (CNS) tumors (BT) is complicated by the fact that the histopathologies of such tumors in AYA differ from their histopathologies in either children (ages 0-14 years) or older adults (ages 40+ years). The present report, as an update to a 2016 publication from the Central Brain Tumor Registry of the United States and the American Brain Tumor Association, provides in-depth analyses of the epidemiology of primary BT in AYA in the United States and is the first to provide biomolecular marker-specific statistics and prevalence by histopathology for both primary malignant and non-malignant BT in AYA. Between 2016 and 2020, the annual average age-specific incidence rate (AASIR) of primary malignant and non-malignant BT in AYA was 12.00 per 100,000 population, an average of 12,848 newly diagnosed cases per year. During the same period, an average of 1,018 AYA deaths per year were caused by primary malignant BT, representing an annual average age-specific mortality rate of 0.96 per 100,000 population. When primary BT were categorized by histopathology, pituitary tumors were the most common (36.6%), with an AASIR of 4.34 per 100,000 population. Total incidence increased with age overall; when stratified by sex, the incidence was higher in females than males at all ages. Incidence rates for all primary BT combined and for non-malignant tumors only were highest for non-Hispanic American Indian/Alaska Native individuals, whereas malignant tumors were more frequent in non-Hispanic White individuals, compared with other racial/ethnic groups. On the basis of histopathology, the most common molecularly defined tumor was diffuse glioma (an AASIR of 1.51 per 100,000). Primary malignant BT are the second most common cause of cancer death in the AYA population. Incidence rates of primary BT overall, as well as specific histopathologies, vary significantly by age. Accordingly, an accurate statistical assessment of primary BT in the AYA population is vital for better understanding the impact of these tumors on the US population and to serve as a reference for afflicted individuals, for researchers investigating new therapies, and for clinicians treating these patients.
最近的分析表明，尽管整体癌症存活率有所提高，但 15-39 岁的青少年和年轻成年人（AYA）的存活率并未提高。由于 AYA 原发性脑和其他中枢神经系统（CNS）肿瘤（BT）的组织病理学与儿童（0-14 岁）或老年人（40 岁以上）的组织病理学不同，因此对 AYA 患者进行临床治疗较为复杂。本报告是对美国中央脑肿瘤登记处和美国脑肿瘤协会 2016 年出版物的更新，深入分析了美国 AYA 原发性 BT 的流行病学，并首次提供了基于组织病理学的原发性恶性和非恶性 BT 的生物标志物特异性统计数据和患病率。在 2016 年至 2020 年期间，AYA 中原发性恶性和非恶性 BT 的年龄标准化发病率（AASIR）平均为每 10 万人 12.00，每年平均有 12848 例新诊断病例。在此期间，每年有 1018 例 AYA 死于原发性恶性 BT，这代表每 10 万人的年平均年龄特异性死亡率为 0.96。当根据组织病理学对原发性 BT 进行分类时，垂体肿瘤最为常见（36.6%），AASIR 为每 10 万人 4.34。总体而言，发病率随年龄增长而增加；按性别分层时，所有年龄段女性的发病率均高于男性。非西班牙裔美国印第安人/阿拉斯加原住民的所有原发性 BT 合并和非恶性肿瘤的发病率最高，而非西班牙裔白人的恶性肿瘤发病率高于其他种族/族裔群体。根据组织病理学，最常见的分子定义肿瘤是弥漫性神经胶质瘤（AASIR 为每 10 万人 1.51）。原发性恶性 BT 是 AYA 人群中癌症死亡的第二大主要原因。总体原发性 BT 的发病率以及特定的组织病理学，随年龄有显著差异。因此，对 AYA 人群中原发性 BT 进行准确的统计评估对于更好地了解这些肿瘤对美国人群的影响至关重要，也为受影响的个人、研究新疗法的研究人员以及治疗这些患者的临床医生提供了参考。
