Davis F G, Malinski N, Haenszel W, Chang J, Flannery J, Gershman S, Dibble R, Bigner D D
School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Ill 60680, USA.
Neuroepidemiology. 1996;15(2):103-12. doi: 10.1159/000109895.
There has been controversy in the last decade over whether the reported increase in brain tumors reflects a real increase in incidence rates. Incidence data on the full spectrum of brain tumors is lacking in the discussion since current cancer reports in the United States are restricted to malignant tumors. Data on tumors from four population-based cancer registries in the United States were compiled to provide incidence rates of benign and malignant brain tumors and to assess the feasibility of providing these data on a larger scale. A total of 8,070 primary tumors diagnosed from 1985 to 1989 in Connecticut, Massachusetts, Missouri and Utah were obtained. Brain tumors were defined using the International Classification of Diseases for Oncology codes 191.0-191.9, 192.0-192.3, 192.8-192.9 and 194.3-194.4. Stratum-specific incidence rates by location and histology were estimated by sex, age and region. Age-adjusted rates were standardized to the 1970 United States population. An age-adjusted incidence rate of 9.4/10(5) was observed, which reflects a 36% increase in males and a 68% increase in females over the rate based on malignant tumors alone from the Surveillance, Epidemiology and End Results cancer reporting system. Incorporating benign tumors into cancer registry data would increase the reported incidence rates primarily in females and for meningiomas and nerve sheath tumors. This expanded incidence rate represents a substantial improvement in the ability to describe the occurrence of these complex tumors by subtype with a modest increase in overall case registrations for cancer registries. Centralization of data on all brain tumors appears feasible. Variations in histology-specific rates across regions raises questions that need to be addressed about the ascertainment and accuracy of tumor classification. Use of the cancer registration system to improve the reporting of brain tumors in the United States is important to our understanding of the occurrence of these complex tumors and to our ability to conduct large-scale epidemiologic investigations.
在过去十年中，关于报告的脑肿瘤发病率上升是否反映了实际发病率的增加一直存在争议。由于美国目前的癌症报告仅限于恶性肿瘤，因此在讨论中缺乏关于全谱脑肿瘤的发病率数据。汇编了来自美国四个基于人群的癌症登记处的肿瘤数据，以提供良性和恶性脑肿瘤的发病率，并评估大规模提供这些数据的可行性。共获得了1985年至1989年在康涅狄格州、马萨诸塞州、密苏里州和犹他州诊断出的8070例原发性肿瘤。脑肿瘤是使用国际肿瘤疾病分类代码191.0 - 191.9、192.0 - 192.3、192.8 - 192.9和194.3 - 194.4来定义的。按位置和组织学分层的发病率按性别、年龄和地区进行了估计。年龄调整率根据1970年美国人口进行了标准化。观察到年龄调整后的发病率为9.4/10(5)，这反映出男性发病率比仅基于监测、流行病学和最终结果癌症报告系统的恶性肿瘤发病率增加了36%，女性增加了68%。将良性肿瘤纳入癌症登记数据将主要增加女性以及脑膜瘤和神经鞘瘤的报告发病率。这种扩大后的发病率代表了在通过亚型描述这些复杂肿瘤的发生情况方面能力的显著提高，同时癌症登记处的总体病例登记略有增加。集中所有脑肿瘤的数据似乎是可行的。不同地区组织学特异性发病率的差异提出了一些问题，这些问题需要在肿瘤分类的确定和准确性方面加以解决。利用癌症登记系统改善美国脑肿瘤的报告对于我们了解这些复杂肿瘤的发生情况以及进行大规模流行病学调查的能力非常重要。
