Trends and patterns of incidence of diffuse glioma in adults in the United States, 1973‐2014

Abstract

IntroductionThe objective of the study was to identify trends in incidence of adult diffuse gliomas in the United States and evaluate the contribution of age, period, and cohort effects to the trends.MethodsUsing the Surveillance, Epidemiology, and End Results 9 database, primary diffuse glioma patients (≥20 years old) diagnosed from 1973 to 2014 were identified. Incidence trends were analyzed using joinpoint regression and age‐period‐cohort modeling.ResultsOverall, the incidence for adult glioma decreased slowly from 1985 to 2014 (annual percent change [APC] = 0.5%, 95% confidence intervals [CI], 0.3%‐0.6%). In histology subtype‐stratified analysis, glioblastoma and nonglioblastoma exhibited opposite trends. The incidence for glioblastoma increased from 1978 to 2014 (APC for year 1978‐1992 = 2.7%, 95% CI, 1.8%‐3.6%; APC for 1992‐2014 = 0.3%, 95% CI, 0%‐0.6%), while the incidence for nonglioblastoma decreased significantly from 1982 to 2014 (APC = 2.2%, 95% CI, 2.0%‐2.5%). Age‐period‐cohort modeling revealed significant period and cohort effects, with the patterns for glioblastoma and nonglioblastoma distinctive from each other. Compared with adults born 1890s, those born 1920s had approximately 4‐fold the risk of glioblastoma after adjustment of age and period effects, while the risk of nonglioblastoma was reduced by half in individuals in the 1939 cohort as compared with those in the 1909 cohort.ConclusionsThe results support the hypothesis of etiological heterogeneity of diffuse gliomas by histology subtypes. The established risk factors cannot fully explain the distinct patterns by histology subtypes, which necessitate further epidemiological studies.

The Intratumoral Heterogeneity Reflects the Intertumoral Subtypes of Glioblastoma Multiforme: A Regional Immunohistochemistry Analysis

“…Glioblastoma is the most common malignant primary brain tumor, accounting for ∼50% of all gliomas (1). The average survival rate is ∼15 months (2) despite extensive therapy.…”

A novel Cas9-targeted long-read assay for simultaneous detection of IDH1/2 mutations and clinically relevant MGMT methylation in fresh biopsies of diffuse glioma

“…Diffuse gliomas (DG) comprise 80% of primary malignant central nervous system tumors in adults and traditionally were diagnosed with pathological criteria to define histological type (e.g., astrocytoma, oligodendroglioma, or oligoastrocytoma) and malignancy grade (e.g., grades I-IV) [1][2][3]. In 2016, the World Health Organization (WHO) diagnostic guidelines incorporated molecular markers into the classification of DGs [4,5].…”

Patterns of recurrence and outcomes of glioblastoma multiforme treated with chemoradiation and adjuvant temozolomide

“…Although high-grade gliomas are relatively rare tumors in adults, they are the most common primary tumors from the brain, accounting for 2% of all cancer cases in adults ( 1 ). High-grade gliomas are generally classified as anaplastic astrocytomas, anaplastic oligodendrogliomas, and glioblastoma multiforme (GBM) ( 2 ).…”

“…High-grade gliomas are generally classified as anaplastic astrocytomas, anaplastic oligodendrogliomas, and glioblastoma multiforme (GBM) ( 2 ). GBM is the most common high-grade glioma and is considered a lethal disease affecting young adults ( 1 ). The treatment outcomes of patients with GBM are better with multidisciplinary team approaches than with isolated modalities ( 3 ).…”