Fabio Girardi1,2, Brian Rous3, Charles A Stiller3, Gemma Gatta4, Naomi Fersht2, Hans H Storm5, Jessica R Rodrigues6, Christian Herrmann7, Rafael Marcos-Gragera8, Rafael Peris-Bonet9, Mikhail Valkov10, Hannah K Weir11, Ryan R Woods12, Hui You13, Patricia A Cueva14, Prithwish De15, Veronica Di Carlo1, Tom Børge Johannesen16, Carlos A Lima17, Charles F Lynch18, Michel P Coleman1,2, Claudia Allemani1. 1. Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK. 2. Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK. 3. National Cancer Registration and Analysis Service, Public Health England, London, UK. 4. Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5. Danish Cancer Society, Copenhagen, Denmark. 6. Registo Oncológico Regional do Norte, Porto, Portugal. 7. Cancer Registry of St Gallen-Appenzell, St Gallen, Switzerland. 8. Epidemiology Unit and Girona Cancer Registry, Girona, Spain. 9. Registro Español de Tumores Infantiles, Valencia, Spain. 10. Arkhangelsk Regional Cancer Registry, Arkhangelsk, Russian Federation. 11. Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 12. British Columbia Cancer Registry, Vancouver, British Columbia, Canada. 13. New South Wales Cancer Registry, Alexandria, Australia. 14. Quito Cancer Registry, Quito, Ecuador. 15. Ontario Cancer Registry, Toronto, Ontario, Canada. 16. The Cancer Registry of Norway, Oslo, Norway. 17. Registro de Câncer de Base Populacional de Aracaju, Aracaju, Brazil. 18. State Health Registry of Iowa, Iowa City, Iowa, USA.
Abstract
BACKGROUND: Global variations in survival for brain tumors are very wide when all histological types are considered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America. METHODS: The source for the analysis was the CONCORD database, a program of global surveillance of cancer survival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for patients diagnosed during 2000-2004, 2005-2009, and 2010-2014. RESULTS: Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in countries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glioblastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in the proportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults. CONCLUSIONS: To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.
BACKGROUND: Global variations in survival for brain tumors are very wide when all histological types are considered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America. METHODS: The source for the analysis was the CONCORD database, a program of global surveillance of cancer survival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for patients diagnosed during 2000-2004, 2005-2009, and 2010-2014. RESULTS: Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in countries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glioblastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in the proportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults. CONCLUSIONS: To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.
Keywords:
International Classification of Diseases; epidemiological study; health care disparities; histology; population-based cancer registries; primary brain tumor
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