Trends in childhood brain tumor incidence, 1973-2009

Abstract

In the mid-1980s, there was a rise in incidence rates of childhood brain tumors (CBT) in the United States that appeared to stabilize at a higher rate in the early 1990 s. An updated analysis of the pattern of CBT over the past 2 decades, with commentary on whether the elevated incidence rate has continued, is past due. We used Surveillance, Epidemiology and End Results (SEER) data to examine trends in incidence of CBT from 1973 through 2009. We examined age-adjusted incidence rates (AAIRs) and secular trends for all malignant brain tumors combined (SEER classification) by histologic tumor type and anatomic site. The incidence of CBT remained stable from 1987 to 2009 [annual percent change (APC) = 0.10; 95 % confidence intervals (CI) -0.39 to 0.61] with an AAIR for all CBT of 3.32 (95 % CI 3.22-3.42). The stability of rates in these two decades contrast the change that occurred in the mid-1980s (1983-1986), when the incidence of CBT increased by 53 % (APC = 14.06; 95 % CI 4.05-25.0). From 1983 to 1986, statistically significant rate increases were observed for pilocytic astrocytoma, PNET/medulloblastoma, and mixed glioma. Further, the rate of increase in pilocytic astrocytoma was similar to the rate of decrease for astrocytomas NOS from 1981 to 2009, suggesting a change from a more general to more specific classification. After the increase in rates in the mid-1980s, rates of CBT over the past two decades have stabilized. Changes in incidence rates of subtypes of tumors over this time period reflect changes both in classification of CBT and in diagnostic techniques.

Fig. 1

Age-adjusted incidence rate (AAIR) per 100,000 children and best fit Joinpoint line for primary brain cancer by year of diagnosis for children 0-14 years of age, SEER 9, 1973-2009

Fig. 2

Age-adjusted incidence rates (AAIRs) per 100,000 persons by major histologic types of brain tumors in children 0-14 years of age at diagnosis, SEER 9, 1973-2009

Fig. 3

Secular trends in age-adjusted incidence rates (AAIRs) for astrocytoma, NOS and pilocytic astrocytomas, SEER 9, 1981-2009

Fig. 4

Age-specific incidence rate of childhood brain tumors diagnosed at 0-14 years of age by histology, SEER 18, 2000-2009