Incidence and survival for childhood central nervous system tumours in Australia, 1983–2016

Abstract

To investigate incidence and survival of childhood tumours of the central nervous system (CNS) by histological subtype, tumour behaviour and tumour grade. Methods: National, population-based data on all children under 15 years old diagnosed with a CNS tumour between 1983 and 2016 were sourced from the Australian Childhood Cancer Registry. Incidence rate trends were calculated using Joinpoint regression. Relative survival was calculated using the cohort method, with changes in survival over time by cancer type and tumour grade assessed by multivariable flexible parametric survival modelling. Results:The study cohort included 4,914 patients, with astrocytoma (n=2,181, 44%) and embryonal tumours (n=931, 19%) the most common diagnostic subgroups. Almost half (n=2,181, 44%) of all tumours were classified as high grade (III or IV). Incidence rates increased by 29% between 1983-2016, with high grade tumours rising by an annual average of +1.1% (95% CI = +0.7%,+1.5%, p<0.001). Five-year survival for all patients combined was 72% (95% CI = 71%-74%), ranging from 50% (46%-54%) for those with other gliomas to 81% (79%-83%) for astrocytoma (p<0.001). Survival improved over time for grade II and III ependymomas but not for patients with astrocytoma irrespective of grade. Conclusion:Improvements in diagnostic technology leading to more precise tumour classification are likely to explain some of the differences in incidence rate trends by histological type and grade. While improvements in survival over time were noted for some tumours, outcomes remained poor among patients with high-grade astrocytoma.

Childhood and Adolescent Central Nervous System Tumours in Spain: Incidence and Survival over 20 Years: A Historical Baseline for Current Assessment

“…However, if k = 1, then a first stage of increased incidence becomes visible in both groups, followed by the stabilisation of the trend until 2007. An increase in total CNS tumour incidence throughout the period is consistent with the findings published in some studies, e.g., a 0.8% increase in Australia from 1983 to 2016 [62]. When non-malignant tumours were excluded, however, no rising trend was present, a finding in line with the absence of rising trends observed by Steliarova-Foucher et al [20] from 1991 to 2010 in Southern Europe (including Spain) and in the North and East (despite which, there was a rising trend in Western Europe and Europe as a whole).…”

“…The overall survival for Group III-ICCC3 over this long time period (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005) is in line with previous reports by different groups for different time periods and geographical areas [8,9,19,37,62,63,[66][67][68], including some individual Spanish registries [64]. Examination of the differences between children and adolescents reveals a dissimilarity with some EUROCARE-5 [69] results for Europe in that while our results show no difference between the two groups, the EUROCARE study reports better survival in adolescents for malignant cases.…”

“…There was a significant rise in the incidence trend for the subgroup of astrocytomas (malignant and non-malignant combined) in children from 1983 to 1997 (APC = 4%ˆ), which levelled off thereafter. Similar results were observed in Australia from 1983 to 1993 (APC = 4.1% (0.5; 7.8)) [62]. When non-malignant tumours were removed from the analysis, astrocytomas showed a significant rise (APC = 7.4%ˆ) from 1983 to 1991, followed by a significant fall and subsequent stabilisation until the end of the study period.…”

“…However, these tumours displayed an upward trend in children from the late 1980s until the end of the period (APC = 2.2% (0.1; 4.5)). A more gradual rising trend in this subgroup was found in The Netherlands in patients under 18 years old (APC = 1.2% (0.1; 2.3)) [63], as well as in children in Nordic countries (APC = 0.97% (0.02; 1.94)) [52] and Australia (APC = 0.8% (0.2; 1.3)) [62]. Nevertheless, when k = 2, the three segments observed in our data showed no statistically significant changes and they roughly followed the irregular oscillations that can be seen for this subgroup in Figure 5A.…”

Editorial: Bench to bedside: translating pre-clinical research into clinical trials for childhood brain tumors

“…They are the major cause of childhood cancer deaths and worryingly, malignant brain tumor incidence rates have increased 0.5% to 0.7% annually among children and adolescents from 2008 to 2017 ( 1 ). Despite improvement in cure rates towards the end of the 20th century, survival statistics have remained unchanged over the past two decades and remain at a level well below that of other childhood cancers, such as leukemia ( 2 ), and this remains a major unmet clinical need. Also, survivors have a high risk of significant permanent adverse side effects that require a lifetime of clinical management, significantly impacting health systems and quality of life for patients ( 3 ).…”