Objective To evaluate evidence for differences in pediatric brain tumor diagnoses by race and ethnicity using a cross-sectional study design in individuals with neurofibromatosis type 1 (NF1). Study design Subjects with NF1 were ascertained from the NF1 Patient Registry Initiative (NPRI) and through a clinical record database of patients at a large academic medical center. Logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to analyze differences in the odds of brain tumor diagnosis by race (White, Black, Asian, Other/Unknown) and ethnic (Hispanic vs. non-Hispanic) groups. Results Data from a total of 1546, 629, and 2038 individuals who were ascertained from the NPRI, clinical records, and pooled datasets were analyzed, respectively. After adjusting for birth year, we observed a significantly reduced odds of brain tumor diagnoses in individuals self identified or clinically reported as Black (OR=0.13, 95% CI 0.05–0.31), Asian (OR=0.15, 95% CI 0.04–0.64), and Other/Unknown (OR=0.61, 95% CI 0.41–0.93) race compared with those with reported as White race. There was no significant difference in the odds of pediatric brain tumor diagnosis by Hispanic ethnicity. Conclusion Consistent with prior smaller studies, these data suggest that pediatric brain tumor diagnoses vary by race in individuals with NF1. Reasons underlying observed differences by race warrant further investigation.

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Background Individuals with Neurofibromatosis type 1 (NF1) are at increased risk for pediatric brain tumors (PBTs), especially optic gliomas; however, factors influencing their development are largely unknown. Extensive research suggests that allergic conditions protect against brain tumors, particularly gliomas in individuals without NF1. In this large cross-sectional study, we employed two different data sources to evaluate evidence for the hypothesis that allergic conditions (allergies, asthma, and eczema) may protect against PBT development in individuals with NF1. Methods We used self- and parent/legal guardian reported questionnaire data from participants in the NF1 Patient Registry Initiative (NPRI, n=1660) born from 1933–2014 to ascertain allergic condition and PBT diagnosis histories. Medical records (MRs) of 629 NF1 patients at a large medical center born from 1930–2012 were also reviewed for PBT and allergic condition diagnoses to evaluate additional evidence for our hypothesis. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between allergic condition diagnoses and PBTs. Results Both data sources provided limited to no support for a protective effect of allergies or eczema on PBT development. Non-significant inverse associations between asthma and PBTs were observed (NPRI: OR=0.80, 95% CI 0.55–1.17; MR: OR=0.71, 95% CI 0.40–1.28) with stronger associations for optic gliomas specifically. Additionally, a significant inverse association was observed in an NPRI subgroup analysis where the reported asthma diagnosis age was younger than the reported PBT diagnosis age (OR=0.57; 95% CI 0.36–0.89). Conclusion Our study supports the hypothesis that asthma protects against PBT development in NF1.

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