Teng Haibo, Yan Ouying, Xiao Chaoxin, Wang Xin, Liu Zhiyong, Xu Jianguo
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Division of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China.
Int J Surg. 2025 Feb 1;111(2):1760-1772. doi: 10.1097/JS9.0000000000002207.
Central nervous system (CNS) cancers are highly lethal and increasingly affect younger populations aged 20-49, posing significant challenges to global healthcare systems. Current research on early-onset CNS cancer trends is limited and outdated, with uncertain impacts from the COVID-19 pandemic. This study explores the epidemiology of early-onset CNS cancer and the pandemic's effects.
We analyzed incidence, mortality, and disability-adjusted life years (DALYs) rates for early-onset CNS cancer (age 20-49) from 2019 to 2021 using GBD 2021 data. The global data were categorized into five regions based on the Socio-Demographic Index (SDI), reflecting income, education, and fertility rates. Trends over the past 30 years were examined using estimated annual percentage change (EAPC), average annual percentage change (AAPC), and joinpoint analysis, with a focus on 2019-2021. The Bayesian age-period-cohort (BAPC) model predicted post-pandemic impacts on CNS cancer metrics.
In 2021, global cases of early-onset CNS cancer rose to 50 201.7 (95% UI, 42 864.1-58 187.5), with deaths increasing to 25 023.1 (95% UI, 20 973.8-29 670.8) and DALYs reaching 1 483 019.4 (95% UI, 1 240 923.4-1 756 043.3). The incidence rate increased to 2.1 (95% UI, 1.8-2.5), while mortality rates remained stable at 1.1 (95% UI, 0.9-1.2), and DALY rates decreased to 62.6 (95% UI, 52.4-74.1). Over the past two decades, the incidence of early-onset CNS cancer has steadily increased, particularly in regions with a high SDI and in emerging economies. Although there was a decline in early-onset CNS cancer-related metrics during the pandemic, it is anticipated that global incidence rates will peak between 2035 and 2040.
This study provides a comprehensive overview of early-onset CNS cancer trends. Despite stable mortality rates, the increasing incidence suggests a growing global burden, with a delayed peak expected due to the pandemic. These findings highlight the need for preventive and control policies targeting early-onset CNS cancer.
中枢神经系统(CNS)癌症具有高度致死性,且越来越多地影响20至49岁的年轻人群,给全球医疗系统带来了重大挑战。目前关于早发性中枢神经系统癌症趋势的研究有限且过时,新冠疫情的影响尚不确定。本研究探讨早发性中枢神经系统癌症的流行病学以及疫情的影响。
我们使用全球疾病负担研究(GBD)2021数据,分析了2019年至2021年早发性中枢神经系统癌症(20至49岁)的发病率、死亡率和伤残调整生命年(DALY)率。全球数据根据社会人口指数(SDI)分为五个区域,该指数反映了收入、教育和生育率。使用估计年百分比变化(EAPC)、平均年百分比变化(AAPC)和连接点分析来研究过去30年的趋势,重点关注2019 - 2021年。贝叶斯年龄 - 时期 - 队列(BAPC)模型预测了疫情对中枢神经系统癌症指标的影响。
2021年,全球早发性中枢神经系统癌症病例增至50201.7例(95%不确定区间,42864.1 - 58187.5),死亡人数增至25023.1例(95%不确定区间,20973.8 - 29670.8),伤残调整生命年达到1483019.4(95%不确定区间,1240923.4 - 1756043.3)。发病率增至2.1(95%不确定区间,1.8 - 2.5),而死亡率保持稳定,为1.1(95%不确定区间,0.9 - 1.2),伤残调整生命年率降至62.6(95%不确定区间,52.4 - 74.1)。在过去二十年中,早发性中枢神经系统癌症的发病率稳步上升,特别是在社会人口指数高的地区和新兴经济体。尽管在疫情期间早发性中枢神经系统癌症相关指标有所下降,但预计全球发病率将在2035年至2040年之间达到峰值。
本研究全面概述了早发性中枢神经系统癌症的趋势。尽管死亡率稳定,但发病率上升表明全球负担在增加,由于疫情,峰值预计会延迟出现。这些发现凸显了针对早发性中枢神经系统癌症制定预防和控制政策的必要性。