Pediatric Brain Tumors: Descriptive Epidemiology, Risk Factors, and Future Directions

Abstract

Brain tumors are the most common solid tumors in children and remain a significant contributor to death by disease in this population. Pediatric brain tumors (PBT) are broadly classified into two major categories: glial and neuronal tumors. Various factors, including tumor histology, tumor location, and demographics, influence the incidence and prognosis of this heterogeneous group of neoplasms. Numerous epidemiologic studies have been conducted to identify genetic and environmental risk factors for these malignancies. Thus far, the only established risk factors for PBTs are exposure to ionizing radiation and some rare genetic syndromes. However, relatively consistent evidence of positive associations for birth defects, markers of fetal growth, advanced parental age, maternal dietary N-nitroso compounds, and exposure to pesticides have been reported. The genetic variants associated with susceptibility to PBTs were predominantly identified by a candidate-gene approach. The identified genetic variants belong to four main pathways, including xenobiotic detoxification, inflammation, DNA repair, and cell-cycle regulation. Conducting large and multi-institutional studies is warranted to systematically detect genetic and environmental risk factors for different histologic subtypes of PBTs. This, in turn, might lead to a better understanding of etiology of PBTs and eventually developing risk prediction models to prevent these clinically significate malignancies.

Brain and other central nervous system tumor statistics, 2021

“…Childhood and adolescent brain and other CNS tumors are broadly classified into 2 categories, glial and neuronal tumors 29 . The most common gliomas in children are astrocytomas, oligodendrogliomas, ependymomas, brainstem gliomas (including the rare but highly fatal diffuse midline glioma, previously referred to as diffuse intrinsic pontine glioma, for which population‐based data are not available because of the lack of a specific ICD‐O‐3 site code for the pons), and optic nerve gliomas.…”

“…Most notably, pilocytic astrocytomas are substantially more common in children and adolescents compared with adults, accounting for one‐quarter of all cases reported as malignant (see the discussion of pilocytic astrocytoma coding in historical surveillance data, above) (Table 1). 4 Most neuronal tumors are embryonal in nature, with the most common subtypes including medulloblastoma, atypical teratoid/rhabdoid tumors, and CNS primitive neuroectodermal tumors 29 . Germ cell tumors and cystic tumors are also more common among children and adolescents than among adults.…”

“…Childhood and adolescent brain and other CNS tumors are broadly classified into 2 categories, glial and neuronal tumors. 29 The most common gliomas in children are astrocytomas, oligodendrogliomas, ependymomas, brainstem gliomas (including the rare but highly fatal diffuse midline glioma, previously referred to as diffuse intrinsic pontine glioma, for which population-based data are not available because of the lack of a specific ICD-O-3 site code for the pons), and optic nerve gliomas. Most notably, pilocytic astrocytomas are substantially more common in children and adolescents compared with adults, accounting for one-quarter of all cases reported as malignant (see the discussion of pilocytic astrocytoma coding in historical surveillance data, above) (Table 1).…”

“…4 Most neuronal tumors are embryonal in nature, with the most common subtypes including medulloblastoma, atypical teratoid/rhabdoid tumors, and CNS primitive neuroectodermal tumors. 29 Germ cell tumors and cystic tumors are also more common among children and adolescents than among adults.…”

Epidemiology, Clinical Presentation, and Prognosis of Pediatric Brain Tumors: Experience of National Center for Children’s Health

“…Despite of improved treatment for the past years, brain tumors are still the leading cause of cancer-related death among children [8]. Brain tumors are heterogeneous, which varies from race, gender, age and so on [9][10][11]. The epidemic studies in China are scare and are based on dated CNS WHO classi cation [3].…”