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. 2018 Jun 24:2018:7910754.
doi: 10.1155/2018/7910754. eCollection 2018.

Brain Tumours: Rise in Glioblastoma Multiforme Incidence in England 1995-2015 Suggests an Adverse Environmental or Lifestyle Factor

Alasdair Philips  1   2 , Denis L Henshaw  1   3 , Graham Lamburn  2 , Michael J O'Carroll  4
Affiliations

Brain Tumours: Rise in Glioblastoma Multiforme Incidence in England 1995-2015 Suggests an Adverse Environmental or Lifestyle Factor

Alasdair Philips et al. J Environ Public Health. .

Abstract

Objective: To investigate detailed trends in malignant brain tumour incidence over a recent time period.

Methods: UK Office of National Statistics (ONS) data covering 81,135 ICD10 C71 brain tumours diagnosed in England (1995-2015) were used to calculate incidence rates (ASR) per 100k person-years, age-standardised to the European Standard Population (ESP-2013).

Results: We report a sustained and highly statistically significant ASR rise in glioblastoma multiforme (GBM) across all ages. The ASR for GBM more than doubled from 2.4 to 5.0, with annual case numbers rising from 983 to 2531. Overall, this rise is mostly hidden in the overall data by a reduced incidence of lower-grade tumours.

Conclusions: The rise is of importance for clinical resources and brain tumour aetiology. The rise cannot be fully accounted for by promotion of lower-grade tumours, random chance or improvement in diagnostic techniques as it affects specific areas of the brain and only one type of brain tumour. Despite the large variation in case numbers by age, the percentage rise is similar across the age groups, which suggests widespread environmental or lifestyle factors may be responsible. This article reports incidence data trends and does not provide additional evidence for the role of any particular risk factor.

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Figures

Figure 1
Figure 1
Age–standardised overall trends from 1971 to 2015 using data in ONS MB1 series, including a smaller number of supratentorial neoplasms without histology or morphology data coded D43.0 & D43.2. The data table for this figure is in the SI file as [S4].
Figure 2
Figure 2
Age–standardised incidence rates for all C71 glioma cases diagnosed between 1995 and 2015 analysed by type and year (Data in Table 3). Grouping details: (1) = 94403–94433 (2) = 93843, 94003–94303 (3) = 93803 (4) = 93813, 93823, 93903–93943, 94503–94733.
Figure 3
Figure 3
Age–standardised rates for two age groups. The possible split between de novo and secondary promoted GBMs is based on incidence change of Grades II and III diffuse and anaplastic astrocytoma.
Figure 4
Figure 4
Relative change in GBM age–specific incidence rates (ASpR) averaged over two five-year periods 1995-1999 and 2011-2015 in 5-year age bands and gender.
Figure 5
Figure 5
Frontal and temporal lobe GBM age–standardised incidence rates by tumour site and year (data table in the SI as [S6]).
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