Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3)

Abstract

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.

Methods: We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.

Results: The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults.

Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.

Keywords: brain tumor; international comparisons; net survival; population-based cancer registries.

Fig. 1

Age-standardized 5-year net survival (%) with 95% confidence interval, by country: adults (15–99 years) diagnosed with diffuse and anaplastic astrocytoma, glioblastoma, or oligodendroglioma during 2010–2014. *Countries with 100% coverage of the national population. §Survival estimates are not age standardized. Continents are identified by different colors. In each panel, countries are ranked from highest to lowest, based on survival during 2010–2014.

Fig. 2

Fifteen-year trends in age-standardized 5-year net survival (%) for adults (15–99 years) diagnosed with diffuse and anaplastic astrocytoma during 2000–2014, by continent (or continental region), and country. Countries are only included if age-standardized survival estimates were available for patients diagnosed during 2000–2004, 2005–2009, and 2010–2014. Continents (or continental regions) are identified by different colors. In each panel, countries are ranked from highest to lowest, based on survival during 2000–2004. X-axis: period of diagnosis; Y-axis: age-standardized 5-year net survival (%). International Organization for Standardization abbreviations for country names: Australia, AUS; Austria, AUT; Belgium, BEL; Canada, CAN; Czech Republic, CZE; Denmark, DNK; Finland, FIN; Israel, ISR; Italy, ITA; Netherlands, NLD; New Zealand, NZL; Norway, NOR; Poland, POL; Portugal, PRT; South Korea, KOR; Spain, ESP; Sweden, SWE; Switzerland, CHE; Taiwan, TWN; UK, GBR; USA, USA.

Fig. 3

Fifteen-year trends in age-standardized 5-year net survival (%) for adults (15–99 years) diagnosed with glioblastoma during 2000–2014, by continent (or continental region), and country. Countries are only included if age-standardized survival estimates were available for patients diagnosed during 2000–2004, 2005–2009, and 2010–2014. Continents (or continental regions) are identified by different colors. In each panel, countries are ranked from highest to lowest, based on survival during 2000–2004. X-axis: period of diagnosis; Y-axis: age-standardized 5-year net survival (%). International Organization for Standardization abbreviations for country names: Australia, AUS; Austria, AUT; Belgium, BEL; Canada, CAN; Croatia, HRV; Czech Republic, CZE; Denmark, DNK; Finland, FIN; France, FRA; Germany, DEU; Ireland, IRL; Israel, ISR; Italy, ITA; Latvia, LVA; Netherlands, NLD; New Zealand, NZL; Norway, NOR; Poland, POL; Portugal, PRT; Singapore, SGP; Slovenia, SVN; South Korea, KOR; Spain, ESP; Sweden, SWE; Switzerland, CHE; Taiwan, TWN; UK, GBR; USA, USA.

Fig. 4

Fifteen-year trends in age-standardized 5-year net survival (%) for adults (15–99 years) diagnosed with oligodendroglioma during 2000–2014, by continent (or continental region), and country. Countries are only included if age-standardized survival estimates were available for patients diagnosed during 2000–2004, 2005–2009, and 2010–2014. Continents (or continental regions) are identified by different colors. In each panel, countries are ranked from highest to lowest, based on survival during 2000–2004. X-axis: period of diagnosis; Y-axis: age-standardized 5-year net survival (%). International Organization for Standardization abbreviations for country names: Australia, AUS; Austria, AUT; Belgium, BEL; Canada, CAN; Croatia, HRV; Czech Republic, CZE; Denmark, DNK; Finland, FIN; France, FRA; Ireland, IRL; Israel, ISR; Italy, ITA; Netherlands, NLD; New Zealand, NZL; Norway, NOR; Poland, POL; Portugal, PRT; South Korea, KOR; Spain, ESP; Sweden, SWE; Switzerland, CHE; Taiwan, TWN; UK, GBR; USA, USA.