Epidemiology of brain and central nervous system cancers in children and adolescents
摘要
Brain and other central nervous system (CNS) cancers represent the leading cause of mortality from solid tumors among children and adolescents, significantly contributing to long-term morbidity on a global scale. Despite their substantial impact, detailed evaluations of the global burden across different age groups and sociodemographic strata are essential for the development of targeted health policies.
MethodsThis study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to estimate the incidence, mortality, and disability-adjusted life years (DALYs) associated with brain and other CNS cancers in individuals under 20 years of age across 204 countries and territories from 1990 to 2021. Age-standardized rates were calculated by sex, age group, region, and sociodemographic index (SDI). Temporal trends were assessed using joinpoint regression, and age-period-cohort models were employed to project the disease burden from 2022 to 2046.
ResultsIn 2021, it was estimated that there were 40,535 new cases, 19,923 deaths, and 1.63 million DALYs associated with brain and other CNS cancers among children and adolescents worldwide. Although the global age-standardized rates for incidence, mortality, and DALYs decreased from 1990 to 2021, the trends exhibited age-specific variations; notably, incidence rates increased among adolescents (ages 10–19) despite declines in younger age groups. Regions with high SDI levels reported the highest incidence rates, whereas regions with low and low-middle SDI levels experienced a disproportionately high burden of mortality and DALYs. Although the gap between sexes has narrowed, the burden remains higher among males. While projections for incidence showed some uncertainty in sensitivity analyses, mortality and DALY rates were consistently projected to decline through 2046.
ConclusionsAlthough the global burden of brain and CNS cancers in children and adolescents has decreased over the past thirty years, these cancers still significantly impact early mortality and health loss. Rising incidence in adolescents and disparities across SDI levels highlight the need for age-specific research and global strategies to improve diagnosis and survivorship care.