Abstract
Background: Brain and CNS cancers (collectively referred to as CNS cancers) are a source of mortality and morbidity for which diagnosis and treatment require extensive resource allocation and sophisticated diagnostic and therapeutic technology. Previous epidemiological studies are limited to specific geographical regions or time periods, making them difficult to compare on a global scale. In this analysis, we aimed to provide a comparable and comprehensive estimation of the global burden of brain cancer between 1990 and 2016. Methods: We report means and 95% uncertainty intervals (UIs) for incidence, mortality, and disability-adjusted life-years (DALYs) estimates for CNS cancers (according to the International Classification of Diseases tenth revision: malignant neoplasm of meninges, malignant neoplasm of brain, and malignant neoplasm of spinal cord, cranial nerves, and other parts of CNS) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. Data sources include vital registration and cancer registry data. Mortality was modelled using an ensemble model approach. Incidence was estimated by dividing the final mortality estimates by mortality to incidence ratios. DALYs were estimated by summing years of life lost and years lived with disability. Locations were grouped into quintiles based on the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. Findings: In 2016, there were 330 000 (95% UI 299 000 to 349 000) incident cases of CNS cancer and 227 000 (205 000 to 241 000) deaths globally, and age-standardised incidence rates of CNS cancer increased globally by 17·3% (95% UI 11·4 to 26·9) between 1990 and 2016 (2016 age-standardised incidence rate 4·63 per 100 000 person-years [4·17 to 4·90]). The highest age-standardised incidence rate was in the highest quintile of SDI (6·91 [5·71 to 7·53]). Age-standardised incidence rates increased with each SDI quintile. East Asia was the region with the most incident cases of CNS cancer for both sexes in 2016 (108 000 [95% UI 98 000 to 122 000]), followed by western Europe (49 000 [37 000 to 54 000]), and south Asia (31 000 [29 000 to 37 000]). The top three countries with the highest number of incident cases were China, the USA, and India. CNS cancer was responsible for 7·7 million (95% UI 6·9 to 8·3) DALYs globally, a non-significant change in age-standardised DALY rate of −10·0% (−16·4 to 2·6) between 1990 and 2016. The age-standardised DALY rate decreased in the high SDI quintile (−10·0% [–27·1 to −0·1]) and high-middle SDI quintile (−10·5% [–18·4 to −1·4]) over time but increased in the low SDI quintile (22·5% [11·2 to 50·5]). Interpretation: CNS cancer is responsible for substantial morbidity and mortality worldwide, and incidence increased between 1990 and 2016. Significant geographical and regional variation in the incidence of CNS cancer might be reflective of differences in diagnoses and reporting practices or unknown environmental and genetic risk factors. Future efforts are needed to analyse CNS cancer burden by subtype. Funding: Bill & Melinda Gates Foundation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 376-393 |
| Number of pages | 18 |
| Journal | The Lancet Neurology |
| Volume | 18 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2019 |
ASJC Scopus subject areas
- Clinical Neurology
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Global, regional, and national burden of brain and other CNS cancer, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016. / GBD 2016 Brain and Other CNS Cancer Collaborators.
In: The Lancet Neurology, Vol. 18, No. 4, 04.2019, p. 376-393.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Global, regional, and national burden of brain and other CNS cancer, 1990–2016
T2 - a systematic analysis for the Global Burden of Disease Study 2016
AU - GBD 2016 Brain and Other CNS Cancer Collaborators
AU - Patel, Anoop P.
AU - Fisher, James L.
AU - Nichols, Emma
AU - Abd-Allah, Foad
AU - Abdela, Jemal
AU - Abdelalim, Ahmed
AU - Abraha, Haftom Niguse
AU - Agius, Dominic
AU - Alahdab, Fares
AU - Alam, Tahiya
AU - Allen, Christine A.
AU - Anber, Nahla Hamed
AU - Awasthi, Ashish
AU - Badali, Hamid
AU - Belachew, Abate Bekele
AU - Bijani, Ali
AU - Bjørge, Tone
AU - Carvalho, Félix
AU - Catalá-López, Ferrán
AU - Choi, Jee Young J.
AU - Daryani, Ahmad
AU - Degefa, Meaza Girma
AU - Demoz, Gebre Teklemariam
AU - Do, Huyen Phuc
AU - Dubey, Manisha
AU - Fernandes, Eduarda
AU - Filip, Irina
AU - Foreman, Kyle J.
AU - Gebre, Abadi Kahsu
AU - Geramo, Yilma Chisha Dea
AU - Hafezi-Nejad, Nima
AU - Hamidi, Samer
AU - Harvey, James D.
AU - Hassen, Hamid Yimam
AU - Hay, Simon I.
AU - Irvani, Seyed Sina Naghibi
AU - Jakovljevic, Mihajlo
AU - Jha, Ravi Prakash
AU - Kasaeian, Amir
AU - Khalil, Ibrahim A.
AU - Khan, Ejaz Ahmad
AU - Khang, Young Ho
AU - Kim, Yun Jin
AU - Mengistu, Getnet
AU - Mohammad, Karzan Abdulmuhsin
AU - Mokdad, Ali H.
AU - Nagel, Gabriele
AU - Naghavi, Mohsen
AU - Naik, Gurudatta
AU - Nguyen, Huong Lan Thi
N1 - Funding Information: Department of Neurosurgery, University of Washington Medical Center, Seattle, WA, USA (A P Patel MD); James Cancer Hospital, Ohio State University, Columbus, OH, USA (J L Fisher PhD); Institute for Health Metrics and Evaluation (E Nichols BA, T Alam MPH, C A Allen BA, K J Foreman PhD, J D Harvey BS, Prof S I Hay FMedSci, I A Khalil MD, Prof A H Mokdad PhD, Prof M Naghavi MD, M R Nixon PhD, R C Reiner PhD, M Smith MPA, Prof T Vos PhD, Prof V L Feigin PhD, Prof C J L Murray DPhil, C Fitzmaurice MD), Department of Health Metrics Sciences (Prof S I Hay, I A Khalil, Prof A H Mokdad, Prof M Naghavi, R C Reiner, Prof T Vos, Prof C J L Murray), Department of Neurology (Prof R G Ellenbogen MD), Division of Hematology (C Fitzmaurice), University of Washington, Seattle, WA, USA; Department of Neurology, Cairo University, Cairo, Egypt (Prof F Abd-Allah MD, Prof A Abdelalim MD); School of Pharmacy, Haramaya University, Harar, Ethiopia (J Abdela MSc, G Mengistu MSc); Clinical Pharmacy Unit (H N Abraha MSc, K G Weldegwergs MSc), School of Public Health (A B Belachew MSc), Department of Nutrition and Dietetics (M G Degefa BSc), School of Pharmacy (A K Gebre MSc, E M Yimer MSc), Mekelle University, Mekelle, Ethiopia; Department of Health, Directorate for Health Information and Research, Pietá, Malta (D Agius MD); Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA (F Alahdab MD); Faculty of Medicine, Mansoura University, Mansoura, Egypt (N H Anber PhD); Indian Institute of Public Health, Gandhinagar, India (A Awasthi PhD); Public Health Foundation of India, Gurugram, India (A Awasthi); Department of Medical Mycology (H Badali PhD), Toxoplasmosis Research Center (Prof A Daryani PhD, S Sarvi PhD), Mazandaran University of Medical Sciences, Sari, Iran; Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran (A Bijani PhD); Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (Prof T Bjørge PhD); Department of Research (Prof E Weiderpass PhD) and Department of Global Public Health and Primary Care (Prof T Bjørge), Cancer Registry of Norway, Oslo, Norway; Institute of Public Health (Prof F Carvalho PhD), REQUIMTE/LAQV (Prof E Fernandes PhD, Prof D M Pereira PhD), Applied Molecular Biosciences Unit (Prof F Carvalho), University of Porto, Porto, Portugal; Department of Health Planning and Economics, Institute of Health Carlos III, Madrid, Spain (F Catalá-López PhD); Biochemistry, Biomedical Science, Seoul National University Hospital, Seoul, South Korea (J-YJ Choi PhD); Department of Clinical Pharmacy, Aksum University, Aksum, Ethiopia (G T Demoz MSc); Addis Ababa University, Addis Ababa, Ethiopia (G T Demoz); Center for Excellence in Behavioral Health, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam (H P Do PhD, L H Nguyen PhD, T H Nguyen BMedSc); United Nations World Food Programme, New Delhi, India (M Dubey PhD); Psychiatry, Kaiser Permanente, Fontana, CA, USA (I Filip MD); Department of Health Sciences (I Filip), A T Still University, Mesa, Arizona, USA (A Radfar MD); Department of Public Health, Arba Minch University, Arba-minch, Ethiopia (Y C D Geramo MSc); Department of Radiology (N Hafezi-Nejad MD), Department of Radiology and Radiological Sciences (S Sheikhbahaei MD), Johns Hopkins University, Baltimore, MD, USA; School of Medicine (N Hafezi-Nejad), Non-Communicable Diseases Research Center (S S N Irvani MD), Hematology-Oncology and Stem Cell Transplantation Research Center (A Kasaeian PhD), Digestive Diseases Research Institute (H Poustchi PhD, G Roshandel PhD), Endocrinology and Metabolism Research Center (S Sheikhbahaei), Cancer Research Institute (R Shirkoohi PhD), Hematologic Malignancies Research Center (A Kasaeian), Cancer Biology Research Center (R Shirkoohi), Tehran University of Medical Sciences, Tehran, Iran; School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates (Prof S Hamidi DrPH); Public Health Department, Mizan-tepi University, Teppi, Ethiopia (H Y Hassen MPH); Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium (H Y Hassen); Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (S N Irvani); Medical Sciences Department, University of Kragujevac, Kragujevac, Serbia (Prof M Jakovljevic PhD); Department of Community Medicine, Banaras Hindu University, Varanasi, India (R P Jha MSc); Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan (E A Khan MPH); Institute of Health Policy and Management (Prof Y-H Khang MD), Department of Health Policy and Management (Prof Y-H Khang), Seoul National University, Seoul, South Korea; School of Medicine, Xiamen University Malaysia, Sepang, Malaysia (Y J Kim PhD); Department of Pharmacy, Wollo University, Dessie, Ethiopia (G Mengistu); Department of Biology, Salahaddin University, Erbil, Iraq (K A Mohammad PhD); Erbil, Ishik University, Erbil, Iraq (K A Mohammad); Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany (Prof G Nagel PhD); Department of Epidemiology (G Naik MPH, J A Singh MD), Department of Medicine (J A Singh), University of Alabama at Birmingham, Birmingham, AL, USA; Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam (H L T Nguyen MPH); University of Adelaide, Adelaide, SA, Australia (A T Olagunju MD); Department of Psychiatry, University of Lagos, Lagos, Nigeria (A T Olagunju); Cartagena University, Cartagena, Colombia (Prof D M Pereira); Institute for Regional Projection and Distance Education, Industrial University of Santander, Bucaramanga, Colombia (G D Pinilla-Monsalve MD); Cardiovascular Institute, International Hospital of Colombia, Floridablanca, Colombia (G D Pinilla-Monsalve); Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran (M Qorbani PhD); Medichem, Barcelona, Spain (A Radfar); Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran (G Roshandel); Department of Neurosurgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (H Safari MD); Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran (S Safiri PhD); Department of Entomology, Ain Shams University, Cairo, Egypt (A M Samy PhD); Independent Consultant, Karachi, Pakistan (M A Shaikh MD); Department of Laboratory Sciences (Prof M Sharif PhD), and Department of Basic Sciences (Prof M Sharif), Islamic Azad University, Sari, Iran; University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India (R Sharma PhD); Department of Medicine, University of Valencia, Valencia, Spain (Prof R Tabarés-Seisdedos PhD); Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain (Prof R Tabarés-Seisdedos); Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam (B X Tran PhD); Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand (K B Tran MD); Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam (K B Tran); Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan (I Ullah PhD); TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan (I Ullah); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (Prof E Weiderpass); Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia (Prof V Zadnik PhD); Department of Epidemiology, University Hospital of Setif, Setif, Algeria (Prof Z Zaidi PhD); Department of Surgery, Seattle Children's Hospital, Seattle, WA, USA (Prof R G Ellenbogen); and National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand (Prof V L Feigin). Funding Information: AA received funding support from the Department of Science and Technology, Government of India, New Delhi through INSPIRE Faculty programme. HB was financially supported by the Mazandaran University of Medical Sciences, Sari, Iran. FC and EF acknowledge support from the European Union (FEDER funds POCI/01/0145/FEDER/007728 and POCI/01/0145/FEDER/007265 ) and National Funds (FCT/MEC, Fundação para a Ciência e a Tecnologia and Ministério da Educação e Ciência) under the Partnership Agreements PT2020 UID/MULTI/04378/2013 and PT2020 UID/QUI/50006/2013 . MJ acknowledges the Ministry of Education Science and Technological Development of the Republic of Serbia , which has co-financed the Serbian component of this project ( grant OI 175 014 ). Publication of results was not contingent upon the Ministry's censorship or approval. YJK received support from the Office of Research and Innovation, Xiamen University, Malaysia. AMS was supported by the Egyptian Fulbright Mission Program. RT-S was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. KBT acknowledges funding support from the Maurice Wilkins Centre for Biodiscovery, Cancer Society of New Zealand, Health Research Council, Gut Cancer Foundation, and the University of Auckland. Publisher Copyright: © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/4
Y1 - 2019/4
N2 - Background: Brain and CNS cancers (collectively referred to as CNS cancers) are a source of mortality and morbidity for which diagnosis and treatment require extensive resource allocation and sophisticated diagnostic and therapeutic technology. Previous epidemiological studies are limited to specific geographical regions or time periods, making them difficult to compare on a global scale. In this analysis, we aimed to provide a comparable and comprehensive estimation of the global burden of brain cancer between 1990 and 2016. Methods: We report means and 95% uncertainty intervals (UIs) for incidence, mortality, and disability-adjusted life-years (DALYs) estimates for CNS cancers (according to the International Classification of Diseases tenth revision: malignant neoplasm of meninges, malignant neoplasm of brain, and malignant neoplasm of spinal cord, cranial nerves, and other parts of CNS) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. Data sources include vital registration and cancer registry data. Mortality was modelled using an ensemble model approach. Incidence was estimated by dividing the final mortality estimates by mortality to incidence ratios. DALYs were estimated by summing years of life lost and years lived with disability. Locations were grouped into quintiles based on the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. Findings: In 2016, there were 330 000 (95% UI 299 000 to 349 000) incident cases of CNS cancer and 227 000 (205 000 to 241 000) deaths globally, and age-standardised incidence rates of CNS cancer increased globally by 17·3% (95% UI 11·4 to 26·9) between 1990 and 2016 (2016 age-standardised incidence rate 4·63 per 100 000 person-years [4·17 to 4·90]). The highest age-standardised incidence rate was in the highest quintile of SDI (6·91 [5·71 to 7·53]). Age-standardised incidence rates increased with each SDI quintile. East Asia was the region with the most incident cases of CNS cancer for both sexes in 2016 (108 000 [95% UI 98 000 to 122 000]), followed by western Europe (49 000 [37 000 to 54 000]), and south Asia (31 000 [29 000 to 37 000]). The top three countries with the highest number of incident cases were China, the USA, and India. CNS cancer was responsible for 7·7 million (95% UI 6·9 to 8·3) DALYs globally, a non-significant change in age-standardised DALY rate of −10·0% (−16·4 to 2·6) between 1990 and 2016. The age-standardised DALY rate decreased in the high SDI quintile (−10·0% [–27·1 to −0·1]) and high-middle SDI quintile (−10·5% [–18·4 to −1·4]) over time but increased in the low SDI quintile (22·5% [11·2 to 50·5]). Interpretation: CNS cancer is responsible for substantial morbidity and mortality worldwide, and incidence increased between 1990 and 2016. Significant geographical and regional variation in the incidence of CNS cancer might be reflective of differences in diagnoses and reporting practices or unknown environmental and genetic risk factors. Future efforts are needed to analyse CNS cancer burden by subtype. Funding: Bill & Melinda Gates Foundation.
AB - Background: Brain and CNS cancers (collectively referred to as CNS cancers) are a source of mortality and morbidity for which diagnosis and treatment require extensive resource allocation and sophisticated diagnostic and therapeutic technology. Previous epidemiological studies are limited to specific geographical regions or time periods, making them difficult to compare on a global scale. In this analysis, we aimed to provide a comparable and comprehensive estimation of the global burden of brain cancer between 1990 and 2016. Methods: We report means and 95% uncertainty intervals (UIs) for incidence, mortality, and disability-adjusted life-years (DALYs) estimates for CNS cancers (according to the International Classification of Diseases tenth revision: malignant neoplasm of meninges, malignant neoplasm of brain, and malignant neoplasm of spinal cord, cranial nerves, and other parts of CNS) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. Data sources include vital registration and cancer registry data. Mortality was modelled using an ensemble model approach. Incidence was estimated by dividing the final mortality estimates by mortality to incidence ratios. DALYs were estimated by summing years of life lost and years lived with disability. Locations were grouped into quintiles based on the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. Findings: In 2016, there were 330 000 (95% UI 299 000 to 349 000) incident cases of CNS cancer and 227 000 (205 000 to 241 000) deaths globally, and age-standardised incidence rates of CNS cancer increased globally by 17·3% (95% UI 11·4 to 26·9) between 1990 and 2016 (2016 age-standardised incidence rate 4·63 per 100 000 person-years [4·17 to 4·90]). The highest age-standardised incidence rate was in the highest quintile of SDI (6·91 [5·71 to 7·53]). Age-standardised incidence rates increased with each SDI quintile. East Asia was the region with the most incident cases of CNS cancer for both sexes in 2016 (108 000 [95% UI 98 000 to 122 000]), followed by western Europe (49 000 [37 000 to 54 000]), and south Asia (31 000 [29 000 to 37 000]). The top three countries with the highest number of incident cases were China, the USA, and India. CNS cancer was responsible for 7·7 million (95% UI 6·9 to 8·3) DALYs globally, a non-significant change in age-standardised DALY rate of −10·0% (−16·4 to 2·6) between 1990 and 2016. The age-standardised DALY rate decreased in the high SDI quintile (−10·0% [–27·1 to −0·1]) and high-middle SDI quintile (−10·5% [–18·4 to −1·4]) over time but increased in the low SDI quintile (22·5% [11·2 to 50·5]). Interpretation: CNS cancer is responsible for substantial morbidity and mortality worldwide, and incidence increased between 1990 and 2016. Significant geographical and regional variation in the incidence of CNS cancer might be reflective of differences in diagnoses and reporting practices or unknown environmental and genetic risk factors. Future efforts are needed to analyse CNS cancer burden by subtype. Funding: Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85062733113&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062733113&partnerID=8YFLogxK
U2 - 10.1016/S1474-4422(18)30468-X
DO - 10.1016/S1474-4422(18)30468-X
M3 - Article
C2 - 30797715
AN - SCOPUS:85062733113
VL - 18
SP - 376
EP - 393
JO - The Lancet Neurology
JF - The Lancet Neurology
SN - 1474-4465
IS - 4
ER -