International Trends in Brain Cancer: An Overview

Global Incidence and Mortality in Males and Females

Brain and central nervous system (CNS) cancer plays a substantial role in the global burden of disease. A study in 2022 revealed there was a significant increase (94.35%) in brain and CNS cancers from the period between 1990 to 2019. In 2022, there were almost 322,000 cases of brain and CNS cancer (ranking 19th overall for incidence) and close to 249,000 deaths (ranking 12th for overall mortality). There was also a significant difference between males and females. Overall, males had a higher incidence of brain and CNS cancer (over 173,000 new cases in males versus over 148,000 cases in females) as well as mortality (over 139,000 deaths in males versus close to 109,000 deaths in females).

Global Incidence and Mortality by Region

Further breaking down these numbers, we can also see a pattern by geography. Using age-standardized rates (ASR) per 100,000 persons to account for differences in populations, the highest incidence of brain and CNS cancer was seen in Europe (5.6), North America (5.5), Oceania (4.5) (see figures below for more information).

Global Incidence and Mortality by Age

 Analysing the global data by age reveals the larger, albeit grim, picture. Brain cancer is known to be devastating for children in Australia. Unfortunately, this follows suit with the global population. Behind Leukemia, brain and CNS cancer ranks 2nd in both incidence and mortality (see the image below).

Global Survival Statistics

It is well known that brain cancer has a dismal survival rate in Australia and the United States. Even more so when looking at certain subtypes (e.g., glioblastoma, diffuse midline glioma). A study in 2022 set out to provide a comprehensive examination of worldwide variation and trends in adult brain tumours. Between 2010–2014, the global range in age-standardized 5-year survival was 4%–17% for glioblastoma, 20%–38% for diffuse and anaplastic astrocytoma, and 32%–69% for oligodendroglioma. Another study from 2019 conducted a systematic review of global variation and time trends in survival from brain tumors in children and found five-year survival from embryonal tumors increased from 37% to 60% between 1980 and 2009. While survival rates for medulloblastoma showed significant improvement, jumping from 29% to 73% between 1959 and 2009, five-year survival rates for astrocytoma remained relatively stagnant over a 27-year period from 1982 to 2009, with only a minimal increase from 78% to 89%. Lastly, findings from a 2021 study involving patients over 10 years old with DIPG, who were enrolled in the International DIPG Registry, revealed a median survival of just 13 months. Overall, incomplete databases and heterogeneity of studies contribute to variations seen in these reports. However, brain cancer subtypes clearly play an important role in survival rates.

Global Quality of Care

Brain cancer poses a major burden that requires significant care. A 2021 study introduced a measure named the Quality-of-Care Index (QCI), a metric to evaluate the quality of care given to brain and CNS cancer patients. It is a scale of 0-100 to which higher values represent better quality of care. They also attempted to compare geographic and socioeconomic patterns. Globally, the QCI was calculated as 55 in 2017. Western Pacific Regions presented with the highest QCI’s (76.9), while African Regions presented with the lowest QCIs (9.9).  It was concluded high and high-middle income regions are suited to confront the rising burden of brain and CNS cancers; and regions with economic constraints is an indicator of poorer standards of care.

Conclusion

In conclusion, brain cancer remains a challenge that continues to burden thousands of lives on an annual basis. From understanding the differences between various subtypes and navigating various pathways of treatment and care, it is imperative we continue to populate not only national, but international databases. By pooling our resources and insights with a unified purpose, we can endeavour to construct a more comprehensive and more cohesive understanding of brain cancer, ultimately paving the way for more effective treatments and improved outcomes for patients worldwide.

Disclaimer: Information in this article is sourced from published materials; readers are advised to independently verify facts. Opinions expressed are the author's own and do not necessarily reflect those of the publisher. If you or someone you know experience symptoms related to brain cancer, consult with a medical professional for personalized advice and guidance.

References

Burden and trends of brain and central nervous system cancer from 1990 to 2019 at the global, regional, and country levels | Archives of Public Health | Full Text (biomedcentral.com)

Global Cancer Observatory (iarc.fr)

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3) | Neuro-Oncology | Oxford Academic (oup.com)

Worldwide Trends in Survival From Common Childhood Brain Tumors: A Systematic Review (ascopubs.org)

A global, regional, and national survey on burden and Quality of Care Index (QCI) of brain and other central nervous system cancers; global burden of disease systematic analysis 1990-2017 | PLOS ONE

Characteristics of patients ≥10 years of age with diffuse intrinsic pontine glioma: a report from the International DIPG/DMG Registry - PMC (nih.gov)