Medical Professional Publications

The Numbers Are In: Deaths From Central Nervous System Cancers

(From the March 2015 Issue of PediatricsOnline)

A recent multi-institutional study has revealed that cancers of the central nervous system are now the most common solid tumor, the most common cancer and the most common cause of cancer-related death to U.S. children aged 0-14. The project, funded by a grant from Alex’s Lemonade Stand Foundation, provides a comprehensive epidemiological summary on CNS cancers using data from the Central Brain Tumor Registry of the United States from 2007-2011.

“The study is important, first and foremost, because it documents with the most current data what many of us have been suspecting for a long time — that childhood central nervous system cancer now represents the major form of cancer-related death in the United States in all children between birth and 14 years of age,” says Jonathan L. Finlay, MD, program director of Neuro-Oncology at Nationwide Children’s Hospital and a consultant on the recent endeavor. “Knowledge of the epidemiology of childhood brain cancer provides justification for prioritization of local, regional and national funding to support research endeavors to improve diagnosis, treatment and quality-of-life outcomes for these diseases.”

The principal incidence-related findings of the study include the following:

  • Leukemias were the most commonly occurring cancers for children aged 1-4 years, but CNS tumors were the most common in all other age groups (<1, 5-9 and 10-14 years) and the most commonly occurring solid tumor overall for children ages 0-14.
  • Incidence of these tumors was highest in children younger than 1 year of age with an overall rate of 6.22 per 100,000. Incidence was lowest among children 5-14 with an age-adjusted incidence of 5.00 per 100,000.
  • One in every 2,000 children born from 2009-2011 will be diagnosed with a CNS tumor by the age of 14.
  • The cerebellum was the most common site of CNS tumors overall.
  • Glioma was the most common histologic group of these cancers in all ages.
  • Nearly 53 percent of all CNS tumors occurred in males.
  • Incidence of CNS tumors was highest among White and Asian/Pacific Islander children, with an overall age-adjusted incidence rate of 5.46 and 6.05 per 100,000 respectively. 
  • The estimated number of new CNS cancers in children 0-14 years old is 3,420 in 2015 and 3,440 in 2016.
  • Overall age-adjusted incidence of these tumors was highest in the Mid-Atlantic region of the country, followed closely by the West-South-Central region.

The study’s reported statistics are believed to be highly reflective of CNS cancers’ true occurrence. 

“These data are generated from the largest population-based registry in the country for primary brain tumors, encompassing 99.8 percent of the U.S. population,” Dr. Finlay says. “However, the survival analyses are drawn from a subset of approximately 26 percent of the U.S. population and therefore may be somewhat less reliable than the demographic data evaluating tumor incidence.”

The principal survival-related findings of the study include the following:

  • CNS tumors are the primary cause of cancer-related deaths in children aged 0-14.
  • Cancer is the fourth and second most common cause of death among children ages 1-4 and 5-14 years, respectively.
  • The lowest survival rates result from brain stem tumors, with a one-year survival rate of 69 percent and a 10-year survival rate of nearly 46 percent.
  • Cranial nerve tumors had the highest survival rates of all CNS tumors, with 99.9 percent one-year and 97.8 percent 10-year survival.
  • Older children had better survival rates overall.

Dr. Finlay and his collaborators already have plans to incorporate the study’s findings into their upcoming research.

“Factors causing relatively higher than average annual incidence and mortality of childhood brain cancer in the Mid-Atlantic region remain unexplained and merit study,” says Dr. Finlay, who also is a tenured professor of Pediatrics at The Ohio State University College of Medicine. “We propose to study delayed diagnosis of childhood brain cancer within Ohio and its ultimate impact upon survival and quality of life. We also intend to introduce a community-based program for physicians and parents throughout Ohio to reduce these delays in diagnosis of brain cancer in childhood.”

Ostrom QT, de Blank PM, Kruchko C, Petersen CM, Liao P, Finlay JL, Stearns DS, Wolff JE, Wolinsky Y, Letterio JJ, Barnholtz-Sloan JS. Alex's Lemonade Stand Foundation infant and childhood primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro-Oncology. 2015 Jan, 16 Suppl 10:x1-x36.

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