Geographical variation in malignant and benign/borderline brain and CNS tumor incidence: a comparison between a high-inc
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CLINICAL STUDY
Geographical variation in malignant and benign/borderline brain and CNS tumor incidence: a comparison between a high‑income and a middle‑income country Miriam Wanner1,2 · Sabine Rohrmann1,2 · Dimitri Korol1 · Nino Shenglia3 · Teimuraz Gigineishvili3 · David Gigineishvili3 Received: 2 June 2020 / Accepted: 8 August 2020 © The Author(s) 2020
Abstract Purpose There is large variability in reported incidence rates of primary brain/CNS tumors across the world, with mostly higher rates in higher-income countries. The aim was to compare malignant and benign brain/CNS tumor incidence between Zurich (Switzerland), a high-income country, and Georgia, a lower middle-income country. Methods For the period March 2009 to February 2012, we extracted the following tumors based on topography according to ICD-O3: C70.0–C72.9, and C75.1 (pituitary gland). Data were categorized into histology groups based on the WHO 2007 histological classification. Age-standardized rates per 100,000 person-years were calculated by subgroups. Results We included 1104 and 1476 cases of primary brain/CNS tumors for Zurich and Georgia, respectively. Mean age of patients was significantly lower in Georgia compared to Zurich (50.0 versus 58.3 years). Overall age-standardized incidence rates for malignant and benign brain/CNS tumors were 10.5 (95% CI 9.9–11.0) for Georgia and 23.3 (95% CI 21.9–24.7) for Zurich with a ratio of benign to malignant tumors of 1.656 for Georgia and 1.946 for Zurich. The most frequent histology types were meningiomas in both regions, followed by glioblastomas in Zurich, but pituitary tumors in Georgia. Conclusion Age-adjusted incidence rates of brain/CNS tumors were considerably higher in Zurich compared to Georgia, both for benign and malignant tumors, which is in line with other studies reporting higher rates in high-income than in lowand middle-income countries. The frequency distribution may be related to differences in diagnosing techniques and the population age structure. Keywords Brain tumors · CNS tumors · Epidemiology · Benign/borderline · Malignant
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11060-020-03595-5) contains supplementary material, which is available to authorized users. * Miriam Wanner [email protected] 1
Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, Zurich, Switzerland
2
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
3
Department of Neurology & Neurosurgery, Tbilisi State University, Tbilisi, Georgia
Primary brain and central nervous system (brain/CNS) tumors include a collection of neoplasms (gliomas, meningiomas, neuromas etc.) that vary widely by the degree of malignancy. Aside from increasing age, high-dose radiation, and some hereditary syndromes, no risk factors for these tumors have been established and their etiology remains largely unknown [1]. They are rather
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