© 1998 by Oxford University Press
Journal Of The National Cancer Institute, Vol 90, 1269-1277, Copyright © 1998 by Oxford University Press
MA Smith, B Freidlin, LA Ries and R Simon
BACKGROUND: The reported incidence of primary malignant brain tumors among
children in the United States increased by 35% during the period from 1973
through 1994. The purpose of our study was twofold: 1) to determine whether
the reported incidence rates for this period are better represented by a
linear increase over the entire period ("linear model") or, alternatively,
by a step function, with a lower rate in the years preceding 1984-1985 and
a constant higher rate afterward ("jump model"); and 2) to identify the
specific brain regions and histologic subtypes that have increased in
incidence. METHODS: Incidence data from the Surveillance, Epidemiology, and
End Results Program of the National Cancer Institute for the period from
1973 through 1994 for primary malignant brain tumors in children were used
to model the number of cases in a year as a random variable from a Poisson
distribution by use of either a linear model or a jump model.
RESULTS/CONCLUSIONS: The increase in reported incidence of childhood
primary malignant brain tumors is best explained by the jump model, with a
step increase in incidence occurring in the mid-1980s. The brain stem and
the cerebrum are the primary sites for which an increase in tumor incidence
has been reported. The increase in reported incidence of low-grade gliomas
in the cerebrum and the brain stem (unaccompanied by an increase in
mortality for these sites) supports the substantial contribution of low-
grade gliomas to the overall increase in reported incidence for childhood
brain tumors. IMPLICATIONS: The significantly better fit of the data to a
jump model supports the hypothesis that the observed increase in incidence
somehow resulted from changes in detection and/or reporting of childhood
primary malignant brain tumors during the mid- 1980s.
ARTICLES
Trends in reported incidence of primary malignant brain tumors in children in the United States
Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA. smithm@ctep.nci.nih.gov
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