Thursday, July 1, 2021

Brain Tumor Rates Are Rising in the US: The Role of Cell Phone & Cordless Phone Use

For additional evidence that cellphone and cordless phone use increase
brain tumor risk and that brain tumor incidence has been increasing in the U.S.

Hardell and Carlberg (2015) reported that brain tumor rates have been increasing in Sweden based upon the Swedish National Inpatient Registry data.  Hardell and Carlberg (2017) reported that brain tumors of unknown type increased from 2007-2015, especially in the age group 20-39 years of age. According to the authors, "This may be explained by higher risk for brain tumor in subjects with first use of a wireless phone before the age of 20 years taking a reasonable latency period." 

What about brain tumor rates in the United States?

The incidence of glioma, the most common malignant brain tumor, has increased in the United States, although not across-the-board. The National Cancer Institute reported that glioma incidence in the frontal lobe increased among young adults 20-29 years of age (Inskip et al., 2010). 

The incidence of glioblastoma multiforme (GBM), which accounts for about half of all gliomas, increased in the frontal and temporal lobes, and in the cerebellum among adults in the U.S. from 1992-2006 (Zada et al., 2012).

The Cancer Prevention Institute of California (2016) in their annual report about cancer incidence in the greater San Francisco Bay Area noted that the incidence of GBM increased from 1988-2013 among non-Hispanic white male (0.7% per year) and female adults (1.1% per year) and remained stable among other race/ethnic groups.

Using national tumor registry data, a recent study found that the overall incidence of meningioma, the most common non-malignant brain tumor, has increased in the United States in recent years (Dolecek et al., 2015). The age-adjusted incidence rate for meningioma increased from about 6.3 per 100,000 in 2004 to about 7.8 per 100,000 in 2009. Brain tumor incidence increased for all age groups except youth (0-19 years of age).

Risk of glioma from cell phone and cordless phone use

Three independent, case-control studies have found that long-term use of cell phones increases risk for glioma (Interphone Study Group, 2010Hardell et al, 2013Coureau et al, 2014). The only research to examine cordless phone use also found increased glioma risk with long-term use (Hardell et al, 2013). These studies include data from 13 nations: Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden and the UK. After ten years of wireless phone use (i.e., cell phone plus cordless phone use), the risk of glioma doubles and after 25 years, the risk triples (Hardell et al, 2013).

Although the U.S. does not conduct research on wireless phone use and tumor risk in humans and does not participate in the international studies, there is no reason to believe that Americans are immune to these potential effects of wireless phone use.


In sum, the peer-reviewed research on brain tumor risk and wireless phone use strongly suggests that we should exercise precaution and keep cell phones and cordless phones away from our heads. Moreover, the research calls into question the adequacy of national  and international guidelines that limit the amount of microwave radiation emitted by cell phones and cordless phones.

Risk of meningioma from cell phone and cordless phone use

A study by Carlberg and Hardell (2015) adds to the growing body of evidence that heavy use of wireless phones (i.e., cell phones and cordless phones) is associated with increased risk of meningioma in Sweden. Heavy cordless phone users (defined as more than 1,436 hours of lifetime use) had a 1.7-fold greater risk of meningioma (OR = 1.7; 95% CI = 1.3-2.2). The heaviest cordless phone users (defined as more than 3,358 hours of lifetime use) had a two-fold greater risk of meningioma (OR = 2.0; 95% CI = 1.4 - 2.8). The heaviest cell phone users had a 1.5-fold greater risk of meningioma (OR = 1.5, 95% CI = 0.99 - 2.1). 

Two earlier case-control studies conducted in other nations have found significant evidence of increased risk for meningioma among heavy cell phone users:

(1) In France, Coureau et al. (2014) found a two and a half-fold greater risk of meningioma for heavy cell phone users (defined as 896 or more hours of lifetime use) (OR = 2.57; 95% CI = 1.02 to 6.44). 

(2) In Australia, Canada, France, Israel and New Zealand, Cardis et al. (2011) found a two-fold greater risk of meningioma for heavy cell phone users (defined as 3,124 or more hours of lifetime use) (OR = 2.01; 95% CI = 1.03 to 2.93). 

The two prior studies did not assess cordless phone use so it's likely they underestimate the meningioma risk from wireless phone use.

Thus, three independent, case-control studies have found that wireless phone use is a risk factor for meningioma.

Related Posts:


Recent Research Studies & Reports 
(updated August 1, 2021)

Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics

Islami F, Ward EM, Sung H, Cronin KA, Tangka FKL, Sherman RL, Zhao J, Anderson RN, Henley SJ, Yabroff KR, Jemal A, Benard VB. Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics. J Natl Cancer Inst. 2021 Jul 8:djab131. doi: 10.1093/jnci/djab131. Epub ahead of print. PMID: 34240195.

Abstract

Background: The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries collaborate to provide annual updates on cancer incidence and mortality and trends by cancer type, sex, age group, and racial/ethnic group in the United States. In this report, we also examine trends in stage-specific survival for melanoma of the skin (melanoma).

Methods: Incidence data for all cancers from 2001 through 2017 and survival data for melanoma cases diagnosed during 2001-2014 and followed up through 2016 were obtained from the Centers for Disease Control and Prevention- and National Cancer Institute-funded population-based cancer registry programs compiled by the North American Association of Central Cancer Registries. Data on cancer deaths from 2001 through 2018 were obtained from the National Center for Health Statistics' National Vital Statistics System. Trends in age-standardized incidence and death rates and 2-year relative survival were estimated by joinpoint analysis, and trends in incidence and mortality were expressed as average annual percent change (AAPC) during the most recent 5 years (2013-2017 for incidence and 2014-2018 for mortality).

Results: Overall cancer incidence rates (per 100,000 population) for all ages during 2013-2017 were 487.4 among males and 422.4 among females. During this period, incidence rates remained stable among males but slightly increased in females (AAPC = 0.2%; 95% confidence interval [CI] = 0.1% to 0.2%). Overall cancer death rates (per 100,000 population) during 2014-2018 were 185.5 among males and 133.5 among females. During this period, overall death rates decreased in both males (AAPC = -2.2%; 95% CI = -2.5% to - 1.9%) and females (AAPC = -1.7%; 95% CI = -2.1% to - 1.4%); death rates decreased for 11 of the 19 most common cancers among males and for 14 of the 20 most common cancers among females, but increased for 5 cancers in each sex. During 2014-2018, the declines in death rates accelerated for lung cancer and melanoma, slowed down for colorectal and female breast cancers, and leveled off for prostate cancer. Among children younger than age 15 years and adolescents and young adults aged 15-39 years, cancer death rates continued to decrease in contrast to the increasing incidence rates. Two-year relative survival for distant-stage skin melanoma was stable for those diagnosed during 2001-2009 but increased by 3.1% (95% CI = 2.8% to 3.5%) per year for those diagnosed during 2009-2014, with comparable trends among males and females.

Conclusions: Cancer death rates in the United States continue to decline overall and for many cancer types, with the decline accelerated for lung cancer and melanoma. For several other major cancers, however, death rates continue to increase or previous declines in rates have slowed or ceased. Moreover, overall incidence rates continue to increase among females, children, and adolescents and young adults. These findings inform efforts related to prevention, early detection, and treatment and for broad and equitable implementation of effective interventions, especially among under-resourced populations.


Excerpts

"Moreover, overall incidence rates continue to increase among females, children, and  adolescents and young adults."

Overall:

"During 2013-2017, incidence rates among males increased for 5 of the 18 most common cancers: melanoma, kidney and renal pelvis (kidney), pancreas, oral cavity and pharynx, and testis; were stable for 7 cancers: liver and intrahepatic bile duct (liver), myeloma, prostate, esophagus, leukemia, non-Hodgkin lymphoma (NHL), and thyroid; and decreased for 6 cancers: lung and bronchus (lung), larynx, urinary bladder (bladder), stomach, colon and rectum (colorectum); and brain and other nervous systems (ONS) (Figure 3, Table 1)."

"Among females, incidence rates increased during 2013-2017 for 8 of the 18 most common cancers: liver, melanoma, kidney, myeloma, corpus and uterus, not otherwise specified (uterus), pancreas, breast, and oral cavity and pharynx; were stable for 4 cancers: cervix, leukemia, stomach, and NHL; and decreased for 6 cancers: thyroid, ovary, lung, colorectum, bladder, and brain and ONS (Figure 3, Table 1). However, liver cancer incidence rates among females stabilized during 2014-2017 (Table 2)."

Children aged 0-14 years:

"Among children aged 0-14 years, the incidence rate for all cancers combined was 16.8 cases per 100,000 standard population, ranging from 12.6 among AI/AN children to 17.8 among White children (Table 1). Overall cancer incidence rates increased during 2013-2017 (AAPC = 0.7%; 95% CI = 0.5% to 0.9%). The increase occurred in all racial/ethnic groups except among AI/AN children, in whom rates were stable (Table 1). The most common cancer types included leukemia (5.2 cases per 100,000 standard population), brain and ONS (3.8), and lymphoma (1.6), 15 with increasing trends of 0.7%-0.8% per year on average for each of these cancers during 2001-2017 (Table 2). Leukemia rates showed the most variability among racial/ethnic groups, ranging from 3.2 cases per 100,000 standard population among Black children to 6.2 among Hispanic children (Table 1). Leukemia incidence rates increased during the most recent 5 years (2013-2017) among White, Black, AI/AN, and Hispanic children but were stable among API children."

Adolescents and young adults [AYA] aged 15-39 years:

"Overall cancer incidence rates among AYA increased during 2001-2017 (APC = 0.9%; 95% CI = 0.8% to  1.0%), as did incidence rates of testicular cancer, whereas rates decreased for lymphoma and melanoma (Table 2). There were variations in trends during 2001-2017 for cancers of the colorectum, female breast, and thyroid. The annual percent increase in AYA colorectal cancer incidence rates almost tripled from 1.8% during 2001-2011 to 5.5% during 2011-2017. AYA female breast cancer incidence rates were stable during 2001-2010 then increased 1.1% per year during 2010-2017, whereas earlier increasing trends for AYA thyroid cancer stabilized during 2015-2017."

Thyroid cancer incidence trend:

"Last year’s report found that 5-year incidence trends for thyroid cancer had stabilized among both males and females after increasing for several decades. This year, for the first time, 5-year incidence rates are statistically significantly decreasing 2.0% per year among women of all racial/ethnic groups. Thyroid cancer incidence rates among AYA, which had been increasing, have now stabilized. However, incidence rates of advanced-stage thyroid cancer (81) and larger papillary thyroid cancers of classical variant (size ≥1 cm) have slightly increased in recent years (82), likely due to the obesity epidemic. As discussed in last year’s report, declines in overall thyroid cancer incidence are likely attributable to changes in diagnostic practices for low risk tumors (19). A small proportion of the decline during 2015-2017 has been attributed to diagnostic coding changes for follicular variant of papillary thyroid carcinoma (82)."

Limitation:

"...  although temporal trends for some cancer types may vary by histological or molecular subtype (50, 51, 99), we did not examine these patterns as they are beyond the scope of this report.

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CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013–2017


Abstract

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control (CDC) and National Cancer Institute (NCI), is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors (malignant and non-malignant) and supersedes all previous CBTRUS reports in terms of completeness and accuracy. All rates (incidence and mortality) are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.79 (Malignant AAAIR=7.08, non-Malignant AAAIR=16.71). This rate was higher in females compared to males (26.31 versus 21.09), Blacks compared to Whites (23.88 versus 23.83), and non-Hispanics compared to Hispanics (24.23 versus 21.48). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.5% of all tumors), and the most common non-malignant tumor was meningioma (38.3% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.14. An estimated 83,830 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2020 (24,970 malignant and 58,860 non-malignant). There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2017. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 36.0% and for a non-malignant brain and other CNS tumor was 91.7%.

Executive Summary

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control (CDC) and the National Cancer Institute (NCI), is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. The CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013-2017 contains the most up-to-date population-based data on primary brain tumors available through the surveillance system in the US and supersedes all previous CBTRUS reports in terms of completeness and accuracy, thereby providing a current comprehensive source for the descriptive epidemiology of these tumors. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population.

Incidence

  • The average annual age-adjusted incidence rate of all primary malignant and non-malignant brain and other CNS tumors for the years 2013-2017 was 23.79 per 100,000.

  • This rate was higher in females compared to males (26.31 versus 21.09 per 100,000), slightly higher Blacks compared to Whites (23.88 versus 23.83 per 100,000), and higher in non-Hispanics (of any race) compared to Hispanics (24.23 versus 21.48 per 100,000).

  • The average annual age-adjusted incidence rate of primary malignant brain and other CNS tumors was 7.08 per 100,000.

  • The average annual age-adjusted incidence rate of primary non-malignant brain and other CNS tumors was 16.71 per 100,000.

  • Approximately 29.7% of all primary brain and other CNS tumors were malignant and 70.3% were non-malignant, which makes non-malignant tumors more than twice as common as malignant tumors.

  • The most commonly occurring primary malignant brain and other CNS tumor was glioblastoma (14.5% of all tumors and 48.6% of malignant tumors), and the most common primary non-malignant tumor was meningioma (38.3% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females.

  • In children and adolescents (age 0-19 years), the incidence rate of primary malignant and non-malignant brain and other CNS tumors was 6.14 per 100,000 between 2013 and 2017. Incidence was higher in females compared to males (6.22 versus 6.07 per 100,000), Whites compared to Blacks (6.36 versus 4.83 per 100,000), and non-Hispanics compared to Hispanics (6.42 versus 5.26 per 100,000).

  • An estimated 83,830 new cases of primary malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2020. This includes an expected 24,970 primary malignant and 58,860 primary non-malignant tumors.

Mortality
  • There were 81,246 deaths attributed to primary malignant brain and other CNS tumors for the five-year period between 2013 and 2017. This represents an average annual mortality rate of 4.42 per 100,000, and an average of 16,249 deaths per year caused by primary malignant brain and other CNS tumors.

Survival
  • Median observed survival in primary malignant brain and other CNS tumors only was lowest for glioblastoma (8 months) and highest for malignant tumors of the pituitary (139 months, or approximately 11.5 years).

  • The five-year relative survival rate following diagnosis of a primary malignant brain and other CNS tumor was 36.0%. Survival following diagnosis with a primary malignant brain and other CNS tumor was highest in persons age 0-14 years (75.4%), compared to those ages 15-39 years (72.5%) or 40+ years (21.5 %).

  • The five-year relative survival rate following diagnosis of a primary non-malignant brain and other CNS tumor was 91.7%. Survival following diagnosis with a primary non-malignant brain and other CNS tumor was highest in persons age 15-39 years (98.2%), compared to those ages 0-14 years (97.3%) or 40+ years (90.2%).

https://academic.oup.com/neuro-oncology/article/22/Supplement_1/iv1/5943281

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Cancer Statistics, 2020: Brain and other nervous system cancer incidence and death rates

Death rates for brain & other nervous system cancers increased over past decade.

Siegel RL, Miller KD, Jemal A.  Cancer statistics, 2020. CA: A Cancer Journal for Clinicians. doi: 10.3322/caac.21590. Open access paper: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21590

Brain & ONS cancer incidence

The American Cancer Society estimates there will be 23,890 new cases of brain & other nervous system (ONS) cancers this year in the U.S., and 18,020 people will die from these cancers (see Table 1).

Leukemia is the most common cancer in childhood (birth to 19 years of age), accounting for 28% of cases, followed by brain & ONS tumors (26%), greater than one-quarter of which are benign or borderline malignant (see Table 12).

In adolescents 15 to 19 years of age, brain & ONS cancers are most the common tumor (21%), greater than one-half of which are benign or borderline malignant, followed closely by lymphoma (20%). (p. 18)

Brain & ONS cancer deaths

Death rates increased over the past decade for brain & ONS cancers. (p. 13)

Brain & ONS cancers are the leading cause of cancer death among men aged younger than 40 years and women aged younger than 20 years. These cancers are the fourth leading cause of cancer death among women aged 20 to 39 years and the fifth leading cause of cancer death among men aged 40 to 59 years (see Table 8). 

Excerpts

"Brain and other CNS tumors (both malignant and non-malignant) were the most common cancer site in persons age 0-14 years, with an AAAIR of 5.83 per 100,000 population. Brain and other CNS tumors were the most common cancer in both males and females in this age group."

"Brain and other CNS tumors (both malignant and non-malignant) among those age 15-39 years had an AAAIR of 11.54 per 100,000 population. These tumors were the 3rd most common cancer overall, the 2nd most common cancer in males in this age group, and the 3rd most common cancer in females in this age group."

"The incidence rates for all primary brain and other CNS tumors, 2013-2017, did not differ substantially by year (both overall and by behavior)."

"For malignant tumors, frontal (24.3%), temporal (17.5%), parietal (10.4%), and occipital (2.6%) accounted for 54.8% of tumors (Fig. 7).

The most common of all malignant CNS tumors was glioblastoma (48.6%).

For non-malignant tumors, 53.9% of all tumors occurred in the meninges (Fig. 9C).

The most common histology among non-malignant tumors was meningioma (53.9%).

The most common non-malignant nerve sheath tumor (based on multiple sites in the brain and other CNS) was schwannoma (defined by histology code 9560). These tumors can occur in many sites (Supplementary Figure 6), but most commonly occur on the acoustic nerve, where they are called vestibular schwannoma (also formerly called acoustic neuromas) (74.7% of all nerve sheath tumors)."

"Glioblastoma accounted for the majority of gliomas (57.7%)."

"From birth, a person in the US has a 0.62% chance of ever being diagnosed with a primary malignant brain and other CNS tumor (excluding lymphomas, leukemias, tumors of the pituitary and pineal glands, and olfactory tumors of the nasal cavity) and a 0.48% chance of dying from a primary malignant brain/other CNS tumor."

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Brain Cancer Increased in the U.S. from 2001-2014 among Youth 0-19 Years of Age

Overview. According to the Centers for Disease Control and Prevention, overall cancer incidence increased among individuals less than 20 years of age in the U.S. from 2001–2014. The incidence of brain cancer, thyroid cancer and lymphoma increased during this period. Central nervous system neoplasms which primarily consist of brain cancers increased 0.4 per cent per year on average across these years. Thyroid cancer increased 4.8% per year on average. In 2014, leukemia was the only cancer more common than brain cancer in young people.


Siegel D, Li J, Henley SJ, Wilson R, Lunsford RB, Tai E, Van Dyne E. Incidence Rates and Trends of Pediatric Cancer United States 2001–2014. Poster presentation at the American Society of Pediatric Hematology/Oncology Conference, Pittsburgh, PA. May 2-5, 2018.

Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Background: Cancer is one of the leading disease-related causes of death among individuals aged <20 years in the United States. Recent evaluations of national trends of pediatric cancer used data from before 2010, or covered ≤28% of the US population.

Objectives: This study describes pediatric cancer incidence rates and trends by using the most recent and comprehensive cancer registry data available in the US.

Design/Method: Data from US Cancer Statistics were used to evaluate cancer incidence rates and trends among individuals aged <20 years during 2001–2014. Data were from 48 states and covered 98% of the US population. We assessed trends by calculating average annual percent change (AAPC) in rates using joinpoint regression. Rates and trends were stratified by sex, age, race/ethnicity, US Census region, county-based economic status, and county-based rural/urban classification, and cancer type, as grouped by the International Classification of Childhood Cancer (ICCC).

Results: We identified 196,200 cases of pediatric cancer during 2001–2014. The overall cancer incidence rate was 173.0 per 1 million; incidence rates were highest for leukemia (45.6), brain tumors (30.8), and lymphoma (26.0). Rates were highest among males, aged 0–4 years, non-Hispanic whites, the Northeast US Census region, the top 25% of counties by economic status, and metropolitan counties. The overall pediatric cancer incidence rate increased (AAPC=0.7, 95% CI, 0.5–0.8) during 2001–2014 and contained no joinpoints. Rates increased in each stratum of sex, age, race/ethnicity (except non-Hispanic American Indian/Alaska Native), region, economic status, and rural/urban classification.

Rates were stable for most individual cancer types, but increased for non-Hodgkin lymphomas except Burkitt lymphoma (ICCC group II(b), AAPC=1.2, 95% CI, 0.4–2.0), central nervous system neoplasms (group III, AAPC=0.4, 95% CI, 0.1–0.8), renal tumors (group VI, AAPC=0.6, 95% CI, 0.1–1.1), hepatic tumors (group VII, AAPC=2.5, 95% CI, 1.0–4.0), and thyroid carcinomas (group XI(b), AAPC=4.8, 95% CI, 4.2–5.5). Rates of malignant melanoma decreased (group XI (d), AAPC=-2.6, 95% CI, -4.7– -0.4).

Conclusion: This study documents increased rates of pediatric cancer during 2001–2014, in each of the demographic variables examined. Increased overall rates of hepatic cancer and decreased rates of melanoma are novel findings using data since 2010. Next steps in addressing changing rates could include investigation of diagnostic and reporting standards, host biologic factors, environmental exposures, or potential interventions for reducing cancer risk. Increasing pediatric cancer incidence rates may necessitate changes related to treatment and survivorship care capacity.



Incidence Rates and Trends of Pediatric Cancer — United States, 2001–2014
  • Childhood cancer varies geographically. This research may help states assess their needs in order to make sure that cancer patients have access to high quality cancer treatment and long-term care to monitor for side effects of their treatment after they have completed therapy.
  • Overall, we found a slight increase in pediatric cancer from 2001 to 2014. Cancer was increasing for lymphoma, thyroid, brain, kidney, and liver cancer and was decreasing for melanoma. This study could help researchers more effectively study why pediatric cancer is increasing or decreasing and why certain groups of children and adolescents are more affected.

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Comparative Study of Brain & Central Nervous System Tumor Incidence between the U.S. and Taiwan

Chien LN, Gittleman H, Ostrom QT, Hung KS, Sloan AE, Hsieh YC, Kruchko C, Rogers LR, Wang YF, Chiou HY, Barnholtz-Sloan JS. Comparative Brain and Central Nervous System Tumor Incidence and Survival between the United States and Taiwan Based on Population-Based Registry. Front Public Health. 2016 Jul 21;4:151.

Abstract


PURPOSE: Reasons for worldwide variability in the burden of primary malignant brain and central nervous system (CNS) tumors remain unclear. This study compares the incidence and survival of malignant brain and CNS tumors by selected histologic types between the United States (US) and Taiwan.

METHODS: Data from 2002 to 2010 were selected from two population-based cancer registries for primary malignant brain and CNS tumors: theCentral Brain Tumor Registry of the United States and the Taiwan Cancer Registry. Two registries had similar process of collecting patients with malignant brain tumor, and the quality of two registries was comparative. The age-adjusted incidence rate (IR), IR ratio, and survival by histological types, age, and gender were used to study regional differences.

RESULTS: The overall age-adjusted IRs were 5.91 per 100,000 in the US and 2.68 per 100,000 in Taiwan. The most common histologic type for both countries was glioblastoma (GBM) with a 12.9% higher proportion in the US than in Taiwan. GBM had the lowest survival rate of any histology in both countries (US 1-year survival rate = 37.5%; Taiwan 1-year survival rate = 50.3%). The second largest group was astrocytoma, excluding GBM and anaplastic astrocytoma, with the distribution being slightly higher in Taiwan than in the US.

CONCLUSION: Our findings revealed differences by histological type and grade of primary malignant brain and CNS tumors between two sites.

Open access paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954825/


Excerpts

Between 2002 and 2010, there were 183,740 newly diagnosed cases of malignant brain and CNS tumors in the US and 5,855 in Taiwan.

The most common histologic group for both countries was GBM; 47.8% of all tumors in the US and 34.9% of all tumors in Taiwan (Figure 3).

The IR of GBM was 2.9 times in the US (2.48 per 100,000) as compared with Taiwan (0.85 per 100,000). The second highest histologic group was astrocytoma (excluding GBM and AA) in both the US (0.95 per 100,000) and Taiwan (0.44 per 100,000).

In the US, the IRs by primary site were highest for tumors located in the frontal lobe (1.34 per 100,000), followed by tumors located in all other sites within the brain, temporal lobe, parietal lobe, and the other parts of brain and CNS. In Taiwan, the IRs were highest for tumors located in all other parts of the brain (0.70 per 100,000), followed by tumors located in the frontal lobe, temporal lobe, and cerebrum.

In this study, the lower age-adjusted IRs of malignant brain and CNS tumors in Taiwan was less likely due to differences in imaging diagnostic techniques as the standards for imaging for brain and CNS tumors was the same in both countries.


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Adolescent and Young Adult Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012

Ostrom QT, Gittleman H, de Blank PM, Finlay JL, Gurney JG, McKean-Cowdin R, Stearns DS, Wolff JE, Liu M, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. American Brain Tumor Association Adolescent and Young Adult Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012. Neuro Oncol. 2016 Jan;18 Suppl 1:i1-i50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690545/


The incidence of the most common non-malignant tumors (e.g., meningioma, pituitary) has increased in recent years among adolescents and young adults (AYA) in the U.S; however, some of this increase may be due to better reporting over time.

“Collection of data on non-malignant brain and CNS tumors began in 2004, after the passage of the Benign Brain Tumor Act in 2002. Previous analyses have suggested that increased incidence in the time period between 2004 and 2006 may be the result of the initiation of this collection rather than a ‘true’ increase in incidence.”
  • "Incidence of oligodendroglioma (APC = 22.9) and anaplastic oligodendroglioma (APC = 24.1) in AYA has significantly decreased from 2004-2012. 
  • Incidence of tumors of the meninges in AYA has significantly increased from 2004-2012 (APC = 2.5), which is largely driven by the increase of meningioma incidence during that time (APC = 2.6).  
  • Incidence of lymphomas and hematopoietic neoplasms has significantly decreased from 2004-2012 (APC = 22.8) in AYA. 
  • Incidence of tumors of the sellar region in AYA has significantly increased from 2004-2008 (APC = 8.5), which is largely driven by the increase of tumors of the pituitary incidence from 2004-2009 (APC = 7.6).
  • Incidence of unclassified tumors in AYA has significantly increased from 2004-2012 (APC = 5.5), which is largely driven by the increase of hemangioma incidence from 2004-2010 (APC = 18.8)."
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Malignant Brain Tumors Most Common Cause of Cancer Deaths in Adolescents & Young Adults

Press Release, American Brain Tumor Association, Feb 24, 2016

A new report published in the journal Neuro-Oncology and funded by the American Brain Tumor Association (ABTA) finds that malignant brain tumors are the most common cause of cancer-related deaths in adolescents and young adults aged 15-39 and the most common cancer occurring among 15-19 year olds.

The 50-page report, which utilized data from the Central Brain Tumor Registry of the United States (CBTRUS) from 2008-2012, is the first in-depth statistical analysis of brain and central nervous system (CNS) tumors in adolescents and young adults (AYA). Statistics are provided on tumor type, tumor location and age group (15-19, 20-24, 25-29, 30-34 and 35-39) for both malignant and non-malignant brain and CNS tumors.

"When analyzing data in 5-year age increments, researchers discovered that the adolescent and young adult population is not one group but rather several distinct groups that are impacted by very different tumor types as they move into adulthood," said Elizabeth Wilson, president and CEO of the American Brain Tumor Association.

"For these individuals -- who are finishing school, pursuing their careers and starting and raising young families -- a brain tumor diagnosis is especially cruel and disruptive," added Wilson. "This report enables us for the first time to zero-in on the types of tumors occurring at key intervals over a 25-year time span to help guide critical research investments and strategies for living with a brain tumor that reflect the patient's unique needs."

Although brain and CNS tumors are the most common type of cancer among people aged 15-19, the report shows how other cancers become more common with age. By ages 34-39 years, brain and CNS tumors are the third most common cancer after breast and thyroid cancer.

"What's interesting is the wide variability in the types of brain tumors diagnosed within this age group which paints a much different picture than what we see in adults or in pediatric patients," explained the study's senior author Jill Barnholtz-Sloan, Ph.D., associate professor, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine and Scientific Principal Investigator for CBTRUS.

"For example, the most common tumor types observed in adults are meningiomas and glioblastomas, but there is much more diversity in the common tumor types observed in the adolescent and young adult population. You also clearly see a transition from predominantly non-malignant and low-grade tumors to predominantly high-grade tumors with increasing age," Barnholtz-Sloan said.

There are nearly 700,000 people in the U.S. living with brain and CNS tumors and approximately 15 percent of these tumors occurred in the AYA population during the 2008-2012 time frame analyzed in this report. Approximately 10,617 brain and CNS tumors are diagnosed among adolescents and young adults each year and are the cause of approximately 434 deaths annually.

"The American Brain Tumor Association's recognition of this understudied population, and their commitment to data and information sharing should be applauded," added Barnholtz-Sloan. "There are clearly unique characteristics of the 15-39 age group that we need to more comprehensively understand and the information in the ABTA report starts that important dialogue."

The full report is available at http://www.abta.org/about-us/news/brain-tumor-statistics/.

To learn more or access additional statistics, go to http://www.abta.org.

http://bit.ly/1OvDHYy

Brain Tumor Statistics

Brain tumors are the:
  • most common cancer among those age 0-19 (leukemia is the second).
  • second leading cause of cancer-related deaths in children (males and females) under age 20 (leukemia is the first).
  • Nearly 78,000 new cases of primary brain tumors are expected to be diagnosed this year. This figure includes nearly 25,000 primary malignant and 53,000 non-malignant brain tumors.
  • It is estimated that more than 4,600 children between the ages of 0-19 will be diagnosed with a primary brain tumor this year.
  • There are nearly 700,000 people in the U.S. living with a primary brain and central nervous system tumor.
  • This year, nearly 17,000 people will lose their battle with a primary malignant and central nervous system brain tumor.
  • There are more than 100 histologically distinct types of primary brain and central nervous system tumors.
  • Survival after diagnosis with a primary brain tumor varies significantly by age, histology, molecular markers and tumor behavior.
  • The median age at diagnosis for all primary brain tumors is 59 years.
Tumor-Specific Statistics:
  • Meningiomas represent 36.4% of all primary brain tumors, making them the most common primary brain tumor.  There will be an estimated 24,880 new cases in 2016.
  • Gliomas, a broad term which includes all tumors arising from the gluey or supportive tissue of the brain, represent 27% of all brain tumors and 80% of all malignant tumors.
  • Glioblastomas represent 15.1% of all primary brain tumors, and 55.1% of all gliomas.
  • Glioblastoma has the highest number of cases of all malignant tumors, with an estimated 12,120 new cases predicted in 2016.
  • Astrocytomas, including glioblastoma, represent approximately 75% of all gliomas.
  • Nerve sheath tumors (such as acoustic neuromas) represent about 8% of all primary brain tumors.
  • Pituitary tumors represent 15.5% of all primary brain tumors. There will be an estimated 11,700 new cases of pituitary tumors in 2016.
  • Lymphomas represent 2% of all primary brain tumors.
  • Oligodendrogliomas represent nearly 2% of all primary brain tumors.
  • Medulloblastomas/embryonal/primitive tumors represent 1% of all primary brain tumors.
  • The majority of primary tumors (36.4%) are located within the meninges.
http://www.abta.org/about-us/news/brain-tumor-statistics/

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Central Brain Tumor Registry of the United States: 2018 Fact Sheet

One in 161 Americans (0.62%) will be diagnosed with brain or other central nervous system (CNS) cancer (i.e., malignant tumors) during their lifetime according to the Central Brain Tumor Registry of the United States. 

Excerpts
The incidence rate of all primary malignant and non-malignant brain and CNS tumors is 23.03 cases per 100,000 for a total count of 392,982 incident tumors; (7.12 per 100,000 for malignant tumors for a total count of 121,277 incident tumors and 15.91 per 100,000 for non-malignant tumors for a total count of 271,105 incident tumors). The rate is higher in females (25.31 per 100,000 for a total count of 227,834 incident tumors) than in males (20.59 per 100,000 for a total count of 164,148 incident tumors).

An estimated 86,970 new cases of primary malignant and non-malignant brain and CNS tumors are expected to be diagnosed in the United States in 2019. This includes an estimated 26,170 primary malignant and 60,800 non-malignant tumors expected to be diagnosed in the US in 2019.

Pediatric Incidence (Ages 0-14 Years)
The incidence rate of childhood primary malignant and non-malignant brain and CNS tumors in the US is 5.65 cases per 100,000 for a total 5-year count of 17,273 incident tumors. The rate is higher in males (5.84 per 100,000) than females (5.45 per 100,000).

An estimated 3,720 new cases of childhood primary malignant and non-malignant brain and CNS tumors are expected to be diagnosed in the US in 2019.
Adolescent & Young Adult (AYA) Incidence (Ages 15-39 Years)
The incidence rate of AYA primary malignant and non-malignant brain and CNS tumors is 11.2 cases per 100,000 for a total 5-year count of 57,821 incident tumors.1 The rate is higher for non-malignant tumors (7.94 per 100,000) than malignant tumors (3.26 per 100,000).

An estimated 12,290 new cases of AYA primary malignant and non-malignant brain and CNS tumors are expected to be diagnosed in the US in 2019.
Mortality
The average annual mortality rate in the US between 2011 and 2015 was 4.37 per 100,000 with 77,375 deaths attributed to primary malignant brain and CNS tumors.

An estimated 16,830 deaths will be attributed to primary malignant brain and CNS tumors in the US in 2019.
Lifetime Risk
From birth, a person in the US has a 0.62% chance of ever being diagnosed with a primary malignant brain/CNS tumor (excluding lymphomas, leukemias, tumors of pituitary and pineal glands, and olfactory tumors of the nasal cavity) and a 0.47% chance of dying from the primary malignant brain/CNS tumor.

For males in the US, the risk of developing a primary malignant brain/CNS tumor is 0.70%, and the risk of dying from a primary malignant brain/CNS tumor (excluding lymphomas, leukemias, tumors of pituitary and pineal glands, and olfactory tumors of the nasal cavity) is 0.53%.

For females in the US, the risk of developing a primary malignant brain/CNS tumor is 0.54%, and the risk of dying from a primary malignant brain/CNS tumor (excluding lymphomas, leukemias, tumors of pituitary and pineal glands, and olfactory tumors of the nasal cavity) is 0.41%.
Prevalence
The prevalence rate for all malignant primary brain and CNS tumors was estimated to be 47.60 per 100,000. It was estimated that more than 103,634 persons were living with a diagnosis of malignant primary brain and central nervous system tumor in the United States in 2010.
The prevalence rate for all pediatric (ages 0-19) malignant primary brain and central nervous system tumors was estimated at 22.31 per 100,000 with more than 13,657 children estimated to be living with this diagnosis in the United States in 2004.

Note
Estimated numbers of incidence of malignant and non-malignant brain and CNS tumors and deaths due to these tumors were calculated for 2015 and 2016 using age-adjusted annual tumor incidence rates generated for 2000-2012 for non-malignant tumors by state, age, and histologic type.
http://www.cbtrus.org/www.cbtrus.org/factsheet/factsheet.html
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Brain Tumors in Children and Adolescents

According to a recent studythere has been a significant increase in the incidence of primary malignant brain and central nervous system (CNS) tumors in American children (0-14 years of age) between 2000-2010, with an annual percentage change (APC) of 0.6%. In adolescents (15-19 years old), there was a significant increase in the incidence of primary malignant brain and CNS tumors between 2000-2008, with an APC of 1.0%. Adolescents also experienced an increase in non-malignant brain and CNS tumors from 2004-2010, with an APC of 3.9%.

The four-nation CEFALO case-control study found a 36% increased risk of brain tumors among children and adolescents 7-19 years of age who used mobile phones at least once a week for six months. Since this risk estimate was not statistically significant (OR = 1.36; 95% CI = 0.92 to 2.02), the authors dismissed this overall finding. However, in a subsample of 556 youth for whom cell phone company records were available, there was a  significant association between the time since first mobile phone subscription and brain tumor risk. Children who used cellphones for 2.8 or more years were twice as likely to have a brain tumor than those who never regularly used cellphones (OR = 2.15, 95% CI = 1.07 to 4.29). 

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Trends in Incidence of Non-Malignant Head and Neck Tumors in the U.S.

The likelihood of developing a non-malignant brain tumor has increased in recent years in the U.S. According to newly-released data from the Centers for Disease Control and Prevention (CDC), the overall age-adjusted incidence (per 100,000 persons) of non-malignant brain tumors significantly increased from 2004 through 2012. The increase was observed among children 0-19 years of age (1.7 in 2004; 2.3 in 2012) and among adults 20 years and older (15.9 in 2004; 19.7 in 2012).

Almost 200 people per day in the U.S. were diagnosed with brain tumors in 2012 including 67,612 adults and 4,615 children. Among adults, 70% of these tumors were nonmalignant, and among children, 42% were nonmalignant.

The overall incidence of malignant tumors in the U.S. has been stable for children (3.4 in 2004; 3.3 in 2012) and has slightly decreased for adults (9.1 in 2004; 8.4 in 2012). However, lags in reporting to tumor registries are common in the U.S. so official statistics may underestimate the actual incidence of tumors for more recent years (see August 5, 2015 post below). 

A peer-reviewed study reported a significant Increase over time in the incidence of specific types of malignant brain tumors among adults in the U.S. (see May 7, 2015 post below).

The age-adjusted incidence of the most common non-malignant tumor, meningioma, significantly increased among adults from 2004 through 2012 (8.7 in 2004; 10.6 in 2012). 

A recent study reported a significant increase in meningioma incidence for the period 2004 through 2009 (Dolecek et al., 2015). Several case-control studies have found a significant association between risk of meningioma and wireless phone use (see May 7, 2015 post below).

The age-adjusted incidence of pituitary gland tumors significantly increased among children (0.4 in 2004; 0.6 in 2012) and among adults (3.4 in 2004; 4.7 in 2012). 

A prospective study of 790,000 women in the United Kingdom reported that the risk pituitary gland tumors was more than twice as high among women who used a cell phone for less than five years as compared to never users (Benson et al., 2013).

The web-based report, United States Cancer Statistics: 1999-2012 Incidence and Mortality Web-based Report (USCS) is available at www.cdc.gov/uscs. Although the report includes cancer cases diagnosed (incidence) from 1999 through 2012, brain tumor incidence data are available only since 2004. In 2012, cancer incidence information came from central cancer registries in 49 states, 6 metropolitan areas, and the District of Columbia, covering 99% of the U.S. population.

The Interactive Cancer Atlas (InCA), with exportable data, shows how rates differ by state and change over time. InCA is available at https://nccd.cdc.gov/DCPC_INCA/.

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Limitations of Cancer Registries

Cancer registries are developed to collect data on malignant tumors and often do not collect data on non-malignant (sometimes called benign) tumors. Since about half of primary brain tumors are non-malignant, these tumors are may not be monitored by public health surveillance systems (e.g., Canada).

The U.S has a Central Brain Tumor Registry (CBTRUS): "a resource for gathering and disseminating current epidemiologic data on all primary brain tumors, benign and malignant, for the purposes of accurately describing their incidence and survival patterns, evaluating diagnosis and treatment, facilitating etiologic studies, establishing awareness of the disease, and ultimately, for the prevention of all brain tumors." However, "CBTRUS makes no representations or warranties, and gives no other assurances or guarantees, express or implied, with respect to the accuracy or completeness of the data presented." 

There is a good reason for the disclaimer on the CBTRUS home page. Tumor registries are useful in monitoring disease incidence only to the extent that all procedures are well implemented. Registries are highly dependent upon reporting agencies (e.g., hospitals) to do an accurate and complete job in reporting tumors to the registry.

Registry data typically suffer from various problems: 
"Users must be aware of diverse issues that influence collection and interpretation of cancer registry data, such as multiple cancer diagnoses, duplicate reports, reporting delays, misclassification of race/ethnicity, and pitfalls in estimations of cancer incidence rates." (Izqierdo, JN, Schoenbach, VJ. The potential and limitations of data from population-based state cancer registries. Am J Public Health. 2000;90:695-698. URL: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446235/)
Delays in reporting and late ascertainment are a reality and a known issue influencing registry completeness and, consequently, rate underestimations occur, especially for the most recent years.22 CBTRUS also recognizes that the problem may be even more likely to occur in the reporting of non-malignant brain and CNS tumors, where reporting often comes from non-hospital based sources and mandated collection is relatively recent (2004). Ostrom et al. (2014). URL: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193675/).
For a discussion of the factors that undermine the data quality and completeness of cancer registry coverage of diagnosed tumors see Bray et al (2015)Coebergh et al (2015)and Siesling et al (2015)

The shortcomings of cancer registries are not just hypothetical. For example, Hardell and Carlberg (2015) recently reported that brain cancer rates have been increasing in Sweden based upon the Swedish National Inpatient Registry but not according to the Swedish Cancer Registry. Based upon their results they "postulate(d) that a large part of brain tumours of unknown type are never reported to the Cancer Register ... We conclude that the Swedish Cancer Register is not reliable ..."