Mortality trends in primary malignant brain and central nervous system tumors vary by histopathology, age, race, and sex

Abstract

Purpose: Primary malignant brain and other central nervous system tumors are rare cancers that have shown rising mortality rates in recent years. To elucidate potential factors involved in this rising death rate, we examined mortality trends for primary malignant BT in the United States stratified by histopathology groupings, age, race, and sex.

Methods: Mortality rates for demographic factors within primary malignant BT were generated using the National Center for Health Statistics' National Vital Statistics Systems data from 2004 to 2018. Additionally, histopathology-specific incidence-based mortality rates were calculated using the National Cancer Institute's Surveillance, Epidemiology, and End-Results (SEER) 18 data from 2004 to 2018. Joinpoint modeling was used to estimate mortality trends and annual percent changes with corresponding 95% confidence intervals.

Results: Overall, there was a very small increase in mortality from 2004 to 2018. Individuals > 65 years saw a small increase in mortality, while changes in individuals of other ages were non-significant. Asian/Pacific Islander or American Indian/Alaskan Native had the largest increase in mortality. Among histopathology groupings, there was a small mortality increase in adults ages > 65 years with glioblastoma, while the mortality rate of other malignant gliomas declined in the same age group. CNS lymphoma mortality rates in patients ages 15-39 and 40-64 years declined significantly while rising significantly in the > 65 age group. In pediatric patients, embryonal tumor mortality had a non-significant increase between 2004 and 2007 but declined significantly between 2007 and 2018.

Conclusion: Examining age, race, sex, and histopathology-specific mortality trends at the population level can provide important information for clinicians, researchers, and aid in public health planning.

Keywords: Brain tumors; Central nervous system; Mortality trends; SEER.

Fig. 1

A Overall age-adjusted mortality rates and annual percent changes in primary malignant brain tumors from 2004 and 2018 in NVSS and SEER. B Mortality to incidence ratios and annual percent changes (APCs with 95% CI) in primary malignant brain tumors among children (0–14 years), adolescent young adults (15–39 years), adults (40–64 years), and older adults (65 + years) from 2004 and 2018 in SEER (APC: annual percent change; 95% CI 95% confidence interval)

Fig. 2

Age-adjusted mortality rates and annual percent changes in primary malignant brain tumors among A children (0–14 years), B adolescent young adults (15–39 years), C adults (40–64 years), and D older adults (65 + years) from 2004 and 2018 in NVSS and SEER (APC: annual percent change; 95% CI 95% confidence interval)

Fig. 3

Age-adjusted mortality rates and annual percent changes in primary malignant brain tumors among A males, and B females from 2004 and 2018 in NVSS and SEER (APC: annual percent change; 95% CI 95% confidence interval)

Fig. 4

Age-adjusted mortality rates and annual percent changes in primary malignant brain tumors among A individuals who are White, B individuals who are Black, and C individuals of “other” race (Asian or Pacific Islander, and American Indian or Alaskan Native from 2004 and 2018 in NVSS and SEER (APC: annual percent change; 95% CI 95% confidence interval)

Fig. 5

Histopathology specific age-adjusted mortality rates and annual percent changes among A children (0–14 years), B adolescent young adults (15–39 years), C adults (40–64 years), and D older adults (65 + years) from 2004 and 2018 (SEER) for the most common histopathologies by age group (APC: annual percent change; 95% CI 95% confidence interval)