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 23.5% and for a non-malignant brain and other CNS tumor was 82.4%.

An updated histology recode for the analysis of primary malignant and nonmalignant brain and other central nervous system tumors in the Surveillance, Epidemiology, and End Results Program

“…Nonmalignant meningioma incidence may have increased simply due to reporting learning curves associated with the implementation of Public Law 107-260, 37 including an improved collection of radiographically diagnosed cases. 1 However, changes in classification may also explain part of the increase, particularly the adoption of the 2000 and 2007 guidelines of the WHO Classification of Central Nervous System Tumors, which downgraded cases of meningioma with brain invasion but without anaplasia from grade III (malignant) to grade II or I (nonmalignant). 38 Part of the decline in malignant meningioma incidence may have resulted from this shift from malignant to nonmalignant.…”

“…We stratified cancer patients by age group (0–14, 15–39, 40–64, and 65+ years), sex, and race/ethnicity [non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic American Indian/Alaska Natives (NHAIAN), non-Hispanic Asian or Pacific Islanders (NHAPI), and Hispanic]. We categorized age groups according to those used by CBTRUS in its Annual Statistical Report, 1 except that we divided older adults into two categories (40–64 years and 65+ years). Standard errors and 95% confidence intervals for rates were calculated using the Tiwari method.…”

“…Primary malignant and nonmalignant brain and other central nervous system (CNS) tumors are relatively rare neoplasms, accounting for only 4% of all new primary cancers diagnosed each year in the United States. 1 An estimated 23,890 cases of malignant brain and other CNS tumors are expected to be diagnosed in the United States in 2020 and 18,020 deaths are expected. 2 These tumors constitute an important source of morbidity and mortality, particularly in younger patients, representing the first and second leading causes of cancer death in ages <20 and 20–39, respectively.…”

“…Primary nonmalignant brain and other CNS tumors include those tumors with the International Classification of Diseases for Oncology (ICD-O) behavior codes /0 (benign) and /1 (borderline) and represent more than half of all brain tumors diagnosed in the United States, with an estimated 58,860 new cases in the United States in 2020. 1 Despite their nonmalignant nature, these tumors also constitute an important source of morbidity due to their location in the brain and CNS, as they may inhibit essential brain functions and cognition. 5 The need for incidence data on benign and borderline primary brain tumors from patient constituents and the fact that site should guide their collection rather than behavior alone 6 influenced Congress to pass the Benign Brain Tumor Cancer Registries Amendment Act (Public Law 107–260) in 2002.…”

“…There are over 100 histologically distinct types of primary brain and other CNS tumors, each with its own spectrum of clinical presentations, treatments, and outcomes. 1 In the SEER Program, these tumors are reported in one single category—Cancer of the Brain and Other Nervous System. 3 However, aggregated data masks heterogeneity among subtypes and makes it difficult to study the risk and prognosis of distinctive brain tumor entities.…”