Abstract
Background
Several studies report increasing incidence of primary CNS tumors. The reasons for this are unclear.
Methods
Data on all 188,340 individuals diagnosed with a primary CNS tumor in England (1993-2017) were obtained from the National Cancer Registry. Data on all CT head and MRI brain scans in England (2013-2017) were obtained from NHS Digital. Age-sex-standardized annual incidence rates per 100,000 population (ASR) were calculated by calendar year, tumor behavior, tumor location and method of diagnosis. Temporal trends were quantified using average annual percent change (AAPC).
Results
The ASR for all CNS tumors increased from 13.0 in 1993 to 18.6 in 2017 (AAPC: 1.5%, 95% CI: 1.3, 1.7). The ASR for malignant tumors (52% overall) remained stable (AAPC: +0.5%, 95% CI: -0.2, 1.3), while benign tumors (37% overall) increased (AAPC: +2.6%, 95% CI: 1.2, 4.0). Among the 66% of benign tumors that were microscopically confirmed, the ASR increased modestly (AAPC: 1.3%, 95% CI: 0.5, 2.1). However, among the 25% of benign tumors that were radiographically confirmed, the ASR increased substantially (AAPC: 10.2%, 95% CI: 7.9, 12.5), principally driven by large increases in those aged 65+. The rate of CT head scans in Accident & Emergency (A&E) increased during 2013-2017, with especially large increases in 65-84 and 85+ year olds (AAPCs: 18.4% and 22.5%).
Conclusion
Increases in CNS tumor incidence in England are largely attributable to greater detection of benign tumors. This could be the result of increasing use of neuroimaging, particularly CT head scans in A&E in people aged 65+.
Several studies report increasing incidence of primary CNS tumors. The reasons for this are unclear.
Methods
Data on all 188,340 individuals diagnosed with a primary CNS tumor in England (1993-2017) were obtained from the National Cancer Registry. Data on all CT head and MRI brain scans in England (2013-2017) were obtained from NHS Digital. Age-sex-standardized annual incidence rates per 100,000 population (ASR) were calculated by calendar year, tumor behavior, tumor location and method of diagnosis. Temporal trends were quantified using average annual percent change (AAPC).
Results
The ASR for all CNS tumors increased from 13.0 in 1993 to 18.6 in 2017 (AAPC: 1.5%, 95% CI: 1.3, 1.7). The ASR for malignant tumors (52% overall) remained stable (AAPC: +0.5%, 95% CI: -0.2, 1.3), while benign tumors (37% overall) increased (AAPC: +2.6%, 95% CI: 1.2, 4.0). Among the 66% of benign tumors that were microscopically confirmed, the ASR increased modestly (AAPC: 1.3%, 95% CI: 0.5, 2.1). However, among the 25% of benign tumors that were radiographically confirmed, the ASR increased substantially (AAPC: 10.2%, 95% CI: 7.9, 12.5), principally driven by large increases in those aged 65+. The rate of CT head scans in Accident & Emergency (A&E) increased during 2013-2017, with especially large increases in 65-84 and 85+ year olds (AAPCs: 18.4% and 22.5%).
Conclusion
Increases in CNS tumor incidence in England are largely attributable to greater detection of benign tumors. This could be the result of increasing use of neuroimaging, particularly CT head scans in A&E in people aged 65+.
| Original language | English |
|---|---|
| Article number | noad001 |
| Pages (from-to) | 1177-1192 |
| Number of pages | 16 |
| Journal | Neuro-oncology |
| Volume | 25 |
| Issue number | 6 |
| Early online date | 4 Jan 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 4 Jan 2023 |
Bibliographical note
Funding Information:UMA was supported by a doctoral scholarship from the Nuffield Department of Population Health, University of Oxford. ADJ was supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. PP was supported by Oxford University Hospitals and a 5-year grant from the NIHR Efficacy and Mechanism Evaluation (EME) programme (grant no. 127930). SCD was supported by the Nuffield Department of Population Health, University of Oxford and Cancer Research UK (grant no C8225/A21133). None of the funding sources had any involvement in the conduct of this study or the preparation of this manuscript.
Publisher Copyright:
© The Author(s) 2023.