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. 2023 Jun 2;25(6):1177-1192.
doi: 10.1093/neuonc/noad001.

Temporal trends in the incidence of malignant and nonmalignant primary brain and central nervous system tumors by the method of diagnosis in England, 1993-2017

Usama M Ali  1 , Diana R Withrow  2 , Andrew D Judge  3   4 , Puneet Plaha  5   6 , Sarah C Darby  1
Affiliations

Temporal trends in the incidence of malignant and nonmalignant primary brain and central nervous system tumors by the method of diagnosis in England, 1993-2017

Usama M Ali et al. Neuro Oncol. .

Abstract

Background: Several studies report increases in the incidences of primary central nervous system (CNS) tumors. The reasons for this are unclear.

Methods: Data on all 188 340 individuals diagnosed with a primary CNS tumor in England (1993-2017) were obtained from the National Cancer Registration and Analysis Service. Data on all computerized tomography (CT) head and magnetic resonance imaging (MRI) brain scans in England (2013-2017) were obtained from the National Health Service Digital. Age-sex-standardized annual incidence rates per 100 000 population (ASR) were calculated by calendar year, tumor behavior, tumor location, and method of diagnosis. Temporal trends were quantified using average annual percent change (AAPC).

Results: The ASR for all CNS tumors increased from 13.0 in 1993 to 18.6 in 2017 (AAPC: +1.5%, 95% CI: 1.3, 1.7). The ASR for malignant tumors (52% overall) remained stable (AAPC: +0.5%, 95% CI: -0.2, 1.3), while benign tumors (37% overall) increased (AAPC: +2.6%, 95% CI: 1.2, 4.0). Among the 66% of benign tumors that were microscopically confirmed, the ASR increased modestly (AAPC: +1.3%, 95% CI: 0.5, 2.1). However, among the 25% of benign tumors that were radiographically confirmed, the ASR increased substantially (AAPC: 10.2%, 95% CI: 7.9, 12.5), principally driven by large increases in those who are aged 65+ years. The rate of CT head scans in Accident & Emergency (A&E) increased during 2013-2017, with especially large increases in 65-84 and 85+-year-olds (AAPCs: +18.4% and +22.5%).

Conclusions: Increases in CNS tumor incidence in England are largely attributable to the greater detection of benign tumors. This could be the result of the increasing use of neuroimaging, particularly CT head scans in A&E in people who are aged 65+ years.

Keywords: brain tumor; cancer registry; diagnosis; epidemiology; incidence.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Incidence of primary central nervous system (CNS) tumors by (A) tumor behavior, (B) method of diagnosis, and (C) age group—England, 1993–2017.
Figure 2.
Figure 2.
Incidence of primary central nervous system (CNS) tumors by tumor behavior, method of diagnosis and age group—England, 1993–2017.
Figure 3.
Figure 3.
Incidence of primary central nervous system (CNS) tumors by anatomical location, method of diagnosis and age group—England, 1993–2017.
Figure 4.
Figure 4.
Age-specific rates of computerized tomography (CT) head and magnetic resonance imaging (MRI) brain scans by patient setting—England, 2013–2017.
See this image and copyright information in PMC

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