Introduction: Brain and spinal tumors represent biologically and epidemiologically heterogeneous neoplasms.Technical challenges in identifying, imaging, sampling, and histologically characterizing these tumors have made studying their epidemiology difficult, particularly in resource-limited settings [1-6]. Understanding global disease burden is a critical prerequisite to planning to meet health needs, and the global incidence of brain and spinal tumors has not been reported. Our study aims to determine the global incidence of brain and spinal tumors by geographic region and income level.
Methods: We analyzed data from 207 tumor registries on five continents, and calculated age-standardized rates to compare tumor incidence between World Health Organization regions and World Bank income groups.
Results: The global incidence of malignant brain tumors was 4.25 cases per 100,000 person-years (95% CI [4.21 – 4.29]), and varied by region from 6.76 [6.71 – 6.80] in Europe to 2.81 [2.64 – 2.99] in Africa. Incidence also varied by World Bank income group, ranging from 6.29 [6.26 – 6.32] cases per 100,000 in high income countries (HIC), to 4.81 [4.77 – 4.86] in low and middle income countries (LMIC). Malignant spinal tumors were much less frequent (0.098 [0.093 – 0.104]) and varied similarly by region and income group.
Conclusions: The apparent incidence of brain and spinal tumors varies by region and income group, although case ascertainment bias driven by limited resources in low income regions likely plays a large role. The burden of neurosurgical disease in low to middle income countries is large, and similar in scale to high income countries.
Patient Care: Understanding burden of tumor globally will allow better allocation of resources to meet neurosurgical need around the word.
Learning Objectives: Understand disease burden of brain and spinal tumors in different regions around the world and ascertain a relationship between disease burden, income levels, and clinical need.
References: References:
1. Bondy ML, Scheurer ME, Malmer B, Barnholtz-Sloan JS, Davis FG, Il’yasova D, et al: Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium. Cancer 113:1953–1968, 2008
2. Counsell CE, Collie DA, Grant R: Limitations of using a cancer registry to identify incident primary intracranial tumours. J Neurol Neurosurg Psychiatry 63:94–97, 1997
3. Curry WT Jr, Barker FG 2nd: Racial, ethnic and socioeconomic disparities in the treatment of brain tumors. J Neurooncol 93:25–39, 2009
4. Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, et al: Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004-2007. Cancer 118:4220–4227, 2012
5. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al: Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–86, 2015
6. Forman D, Bray F, Brewster DH, Gombe Mbalawa C, Kohler B, Piñeros M, et al: Cancer Incidence in Five Continents, Vol. X (electronic version) Lyon, IARC. 2013