Trends in paediatric central nervous system tumour incidence by global region from 1988 to 2012

Lindsay A. Williams, Aubrey K. Hubbard, Michael E. Scheurer, Logan G. Spector, Jenny N. Poynter

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: Central nervous system (CNS) tumours comprise 20% of childhood cancers worldwide. Whether childhood CNS tumour incidence has increased over time across geographic regions remains to be explored. Methods: We identified CNS cancers in the Cancer in Five Continents (CI5) data and estimated age standardized incidence rates (ASRs; cases/million children) and 95% confidence intervals (95% CI), male-to-female incidence rate ratios (IRR; 95% CI) and average annual percent change in incidence (AAPC; 95% CI) by geographic region for children aged 0-19 years where data were available using Poisson regression and generalized estimating equations (GEE). Cancers included: astrocytic tumours, medulloblastoma, ependymal, oligodendroglial and mixed glioma, glioma of uncertain origin, and other embryonal tumours. Geographic regions were defined using the United Nations geoscheme. Results: There were 56 468 CNS cancers included in the study. ASRs were highest for astrocytic tumours globally in 2012 (ASR: 5.83; 95% CI: 5.68-5.99). Globally, all cancers exhibited a male excess in incidence. Regionally, only medulloblastoma had a consistently elevated male-to-female IRR at 1.4-2.2. Globally, incidence decreased for astrocytic tumours in GEE models (AAPC: -1.66; 95% CI: -3.04 to -0.26) and increased for medulloblastoma (AAPC 0.66; 95% CI: 0.19-1.14), ependymal tumours (AAPC: 1.49; 95% CI: 1.49; 95%: 0.69-2.30), glioma of uncertain origin (AAPC: 4.76; 95% CI: 1.17-1.14) and other embryonal tumours (AAPC: 3.58; 95% CI: 2.03-5.15). Regional variation in incidence trends was observed. Countries moving from lower to higher Human Development Index (HDI) over time did not appear to drive observed incidence trends. Conclusions: Epidemiologic and molecular studies on underlying mechanisms for changes in the global incidence of CNS tumours are necessary.

Original languageEnglish (US)
Pages (from-to)116-127
Number of pages12
JournalInternational journal of epidemiology
Issue number1
StatePublished - Nov 21 2020

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (grant T32 CA099936 [L.A.W. and A.K.H.]) and the Children's Cancer Research Fund.

Publisher Copyright:
© 2020 The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.


  • Epidemiology
  • International incidence
  • Paediatric central nervous system tumours
  • Sex differences


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