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Chirlaque MD, Peris-Bonet R, Sánchez A, Cruz O, Marcos-Gragera R, Gutiérrez-Ávila G, Quirós-García JR, Almela-Vich F, López de Munain A, Sánchez MJ, Franch-Sureda P, Ardanaz E, Galceran J, Martos C, Salmerón D, Gatta G, Botta L, Cañete A. Childhood and Adolescent Central Nervous System Tumours in Spain: Incidence and Survival over 20 Years: A Historical Baseline for Current Assessment. Cancers (Basel) 2023; 15:5889. [PMID: 38136432 PMCID: PMC10742240 DOI: 10.3390/cancers15245889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Central nervous system (CNS) neoplasms are highly frequent solid tumours in children and adolescents. While some studies have shown a rise in their incidence in Europe, others have not. Survival remains limited. We addressed two questions about these tumours in Spain: (1) Is incidence increasing? and (2) Has survival improved? METHODS This population-based study included 1635 children and 328 adolescents from 11 population-based cancer registries with International Classification of Childhood Cancer Group III tumours, incident in 1983-2007. Age-specific and age-standardised (world population) incidence rates (ASRws) were calculated. Incidence time trends were characterised using annual percent change (APC) obtained with Joinpoint. Cases from 1991 to 2005 (1171) were included in Kaplan-Meier survival analyses, and the results were evaluated with log-rank and log-rank for trend tests. Children's survival was age-standardised using: (1) the age distribution of cases and the corresponding trends assessed with Joinpoint; and (2) European weights for comparison with Europe. RESULTS ASRw 1983-2007: children: 32.7 cases/106; adolescents: 23.5 cases/106. The overall incidence of all tumours increased across 1983-2007 in children and adolescents. Considering change points, the APCs were: (1) children: 1983-1993, 4.3%^ (1.1; 7.7); 1993-2007, -0.2% (-1.9; 1.6); (2) adolescents: 1983-2004: 2.9%^ (0.9; 4.9); 2004-2007: -7.7% (-40; 41.9). For malignant tumours, the trends were not significant. 5-year survival was 65% (1991-2005), with no significant trends (except for non-malignant tumours). CONCLUSIONS CNS tumour incidence in Spain was found to be similar to that in Europe. Rises in incidence may be mostly attributable to changes in the registration of non-malignant tumours. The overall malignant CNS tumour trend was compatible with reports for Southern Europe. Survival was lower than in Europe, without improvement over time. We provide a baseline for assessing current paediatric oncology achievements and incidence in respect of childhood and adolescent CNS tumours.
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Affiliation(s)
- Maria D. Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.D.C.); (R.M.-G.); (M.J.S.); (E.A.); (D.S.)
- Department of Epidemiology, Murcia Regional Health Authority, 30071 Murcia, Spain;
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, El Palmar, 30120 Murcia, Spain
| | - Rafael Peris-Bonet
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Faculty of Medicine, 46010 Valencia, Spain
| | - Antonia Sánchez
- Department of Epidemiology, Murcia Regional Health Authority, 30071 Murcia, Spain;
| | - Ofelia Cruz
- Neuro-Oncology Unit, Paediatric Cancer Centre, Sant Joan de Déu Hospital, Esplugues de Llobregat, 08950 Barcelona, Spain;
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.D.C.); (R.M.-G.); (M.J.S.); (E.A.); (D.S.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Co-Ordination Plan, Catalonian Oncology Institute, 17004 Girona, Spain
- Josep Trueta Girona Biomedical Research Institute (IDIBGI), Salt, 17190 Girona, Spain
- Statistics, Econometrics and Health Research Group (GRECS), University of Girona, 17004 Girona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | | | | | - Fernando Almela-Vich
- Valencian Regional Childhood Cancer Registry, Non-Communicable Disease Epidemiology and Surveillance Department, General Subdirectorate of Epidemiology and Health Surveillance, General Directorate of Public Health and Addictions, Regional Public Health Authority, Valencian Regional Authority, 46010 Valencia, Spain;
| | - Arantza López de Munain
- Basque Country Cancer Registry, Health Department, Basque Country Regional Authority, 01010 Vitoria-Gasteiz, Spain;
| | - Maria J. Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.D.C.); (R.M.-G.); (M.J.S.); (E.A.); (D.S.)
- Andalusian School of Public Health (EASP), 18011 Granada, Spain
- Granada Bio-Health Research Institute, 18012 Granada, Spain
| | - Paula Franch-Sureda
- Mallorca Cancer Registry, General Directorate of Public Health and Participation, Balearic Isles Health Research Institute (IdISBa), 07010 Palma de Mallorca, Spain;
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.D.C.); (R.M.-G.); (M.J.S.); (E.A.); (D.S.)
- Navarre Public Health Institute, 31003 Pamplona, Spain
- IdiSNA, Navarre Health Research Institute, 31008 Pamplona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Teaching Hospital, 43204 Reus, Spain;
- Pere Virgili Health Research Institute (IISPV), 43204 Reus, Spain
- Faculty of Medicine and Health Sciences, Rovira i Virgili University (URV), 43003 Reus, Spain
| | - Carmen Martos
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain;
| | - Diego Salmerón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.D.C.); (R.M.-G.); (M.J.S.); (E.A.); (D.S.)
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, El Palmar, 30120 Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, 30100 Murcia, Spain
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (G.G.); (L.B.)
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (G.G.); (L.B.)
| | - Adela Cañete
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Faculty of Medicine, 46010 Valencia, Spain
- Paediatric Oncology Department, La Fe Hospital, 46026 Valencia, Spain
- Paediatrics, Obstetrics and Gynaecology Department, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
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Lu VM, Elarjani T, Niazi TN. Global, Regional, and National Incidence and Mortality Trends in Pediatric Central Nervous System Tumors over the Past 2 Decades. World Neurosurg 2023; 179:e568-e574. [PMID: 37683927 DOI: 10.1016/j.wneu.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Pediatric tumors of the brain and central nervous system (CNS) are a worldwide issue with variances in epidemiology. How exactly incidence and mortality rates have changed over time has not been summarized. Correspondingly, the aim of this study was to quantitively define the global, regional, and national epidemiological trends of these tumors. METHODS A retrospective review of data from the Global Burden of Disease Study 2019 Database was performed incorporating data from 1999 to 2019. Global, regional, and national outcomes for pediatric CNS tumors were collected for incidence and mortality at a worldwide level, as well as across 7 continental regions, and then 204 countries and territories. RESULTS Globally, the latest incidence of pediatric CNS tumors was 47,600 (uncertainty interval, 36,500-55,200) at a rate of 1.8 (1.4-2.2) per 100,000, with 23,500 (18,000-27,500) deaths due to these tumors at a rate of 0.9 (0.7-1.1) per 100,000 population. Both rates per 100,000 have decreased over the past 2 decades. With respect to regions, East Asia and Pacific had the highest incidence and mortality cases overall, but in terms of rate per 100,000, North America and Latin America and Caribbean had the highest values, respectively. There were 3/7 (43%) and 6/7 (86%) regions with decreasing incidence and mortality rates per 100,000 over the past 2 decades. China, India, and Pakistan were the 3 countries with both the highest incidence and mortality cases overall; however, San Marino, Denmark, and Norway had the highest incidence rates per 100,000, and Albania, Armenia, and Haiti had the highest mortality rates per 100,000. In the past 2 decades, 79/204 (39%) and 120/204 (59%) countries observed decreasing incidence and mortality rates per 100,000, respectively. CONCLUSIONS Pediatric CNS tumors remains a worldwide issue, with there being multiple regions and countries worldwide that continue to experience uptrending incidence and mortality rates per 100,000. For both incidence and mortality, there is a clear discordance between regions and countries that report the highest number of cases versus the highest rate of cases per 100,000. Future research efforts are needed to identify positive intervention measures that respect the epidemiology of these tumors at global, regional, and national levels.
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Affiliation(s)
- Victor M Lu
- Department of Neurological Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA; Department of Neurological Surgery, Nicklaus Children's Hospital, Miami, Florida, USA.
| | - Turki Elarjani
- Department of Neurological Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA
| | - Toba N Niazi
- Department of Neurological Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA; Department of Neurological Surgery, Nicklaus Children's Hospital, Miami, Florida, USA
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Endersby R, Wainwright BJ, Gottardo NG. Editorial: Bench to bedside: translating pre-clinical research into clinical trials for childhood brain tumors. Front Oncol 2023; 13:1274465. [PMID: 37664044 PMCID: PMC10470617 DOI: 10.3389/fonc.2023.1274465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Raelene Endersby
- Brain Tumour Research Program, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
| | - Brandon J. Wainwright
- The University of Queensland Frazer Institute, Translational Research Institute, Woolloongabba, QLD, Australia
| | - Nicholas G. Gottardo
- Brain Tumour Research Program, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
- Department of Paediatric and Adolescent Oncology/Haematology, Perth Children’s Hospital, Nedlands, WA, Australia
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Lindsay HB, Cheng S, Fisher PG, Peters KB, Walsh KM, Ashley DM, Huang A. Physician, patient, and caregiver support for a formal certification in pediatric neuro-oncology: A survey-based report from the SNO pediatrics working group. Neurooncol Adv 2023; 5:vdad130. [PMID: 37964897 PMCID: PMC10642732 DOI: 10.1093/noajnl/vdad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Background Although CNS tumors are the most common pediatric cancer in the United States, most physicians caring for these patients are not formally certified in the subspecialty. To determine support for developing a formal certification process in pediatric neuro-oncology, the Society for Neuro-Oncology's Pediatrics Special Interest Track Training and Credentialing working group performed a cross-sectional survey-based study of physicians and patients/caregivers of children with a CNS tumor history. Methods Surveys were built in Survey Monkey and were available for 3 months. The physician survey had 34 questions and was open to doctors currently caring for pediatric neuro-oncology patients. The patient/caregiver survey had 13 questions. Both surveys were completed anonymously. Results The physician survey was completed by 193 participants, the majority of whom self-identified as oncologists. Only 5.6% of survey participants had ever been board-certified in neuro-oncology; the majority of participating physicians were either unaware that this certification existed or thought they were not eligible due to training in pediatrics rather than neurology or internal medicine. Almost half of the self-identified pediatric neuro-oncologists had not completed any specific clinical neuro-oncology training. Over 75% of physicians were supportive of the implementation of a formal certification process in pediatric neuro-oncology. A total of 30 participants completed the patient/caregiver survey. Although the majority of survey participants were highly satisfied with their oncologist, 70% would have been more comfortable if their oncologist had been specifically certified in pediatric neuro-oncology. Conclusions There is support from physicians, patients, and caregivers to establish a formal certification process in pediatric neuro-oncology.
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Affiliation(s)
- Holly B Lindsay
- Children’s Hospital Colorado Center for Cancer and Blood Disorders, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sylvia Cheng
- B.C. Children’s Hospital, Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul Graham Fisher
- Departments of Neurology and Pediatrics, Stanford University, Palo Alto, California, USA
| | - Katherine B Peters
- Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kyle M Walsh
- Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - David M Ashley
- Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Annie Huang
- Division of Hematology Oncology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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