Introduction: There has been very little attention to the impact of geography and race on the practice of neurosurgery, study of the epidemiology of the various types of intracranial tumors and their prevention or cure. Yet intracranial tumor management remains one of the most challenging frontiers of modern medicine which the emerging stem cell and molecular research are trying to address.

Methods: This was a follow-up to an earlier study by the author published in 2002 on geographical neurosurgery. The study consisted of a comprehensive literature review of the epidemiology of intracranial tumors including their global prevalence and incidence rates between races, countries and within countries. The study period included all relevant literature published up to 2015.

Results: The study found strong geographical variations in the prevalence and incidence rates of intracranial tumours per 100,000 that ranged from 12.5 in Europe and USA to 3.2 in Columbia and 1.0 in Trinidad. The annual global age standardized incidence of primary malignant brain tumor was higher in more developed countries(m:5.8; f:4.1 per 100,000) than in less developed countries (m:3.0; f:2.1 per 100,000). Europe had the highest incidence of primary intracranial tumors while Africa had the lowest rate. Glioma was more prvalent in the West, teratomas in Japan and Far East. Meningiomas were more frequent in Africa. Vestibular schwannomas appeared to be uncommon in blacks. Geographical and or racial differences in incidences were also found for craniopharyngeomas, medulloblastomas, meningiomas and pituitary tumors.

Conclusions: There was evidence to suggest that race and geography significantly influenced the prevalence and incidence rates of intracranial tumors.

Patient Care: The results point to genetic and environmental factors as possible risk factors in tumorigenesis. These would positively influence the direction of research to tackle the reported rising incidence of brain cancer.

Learning Objectives: By the conclusion of this session, participants should be able to 1.Describe the importance of geography in intracranial tumor incidence 2. Describe the importance of race in ICT incidence 3.Discuss in small groups target populations for tumor research 4.Identify populations to be targeted for molecular research on ICT

References: .Geographical Neurosurgery: Ohaegbulam SC, Ablin G, Ohaegbulam CO (editors) CNS Online Book Publication. http://book.neurosurgeon.org. 2002 .Ohaegbulam SC;Geographical neurosurgery. Neurosurgical Research 21:161-170, 1999. .Bondy ML,Schourer ME,Buffler PA. Brain Tumor Epidemiology: Consensus from the brain tumor Epidemiology Consortium (BTEC). Cancer 113(7):1953-1968, 2008.