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Cancer. 2017 Nov 15;123(22):4458-4471. doi: 10.1002/cncr.30884. Epub 2017 Jul 14.

Malignant central nervous system tumors among adolescents and young adults (15-39 years old) in 14 Southern-Eastern European registries and the US Surveillance, Epidemiology, and End Results program: Mortality and survival patterns.

Author information

1
Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
2
Department of Neurology, University Hospital, Linköping, Sweden.
3
National Cancer Registry of Ukraine, National Institute of Cancer, Kiev, Ukraine.
4
Institute of Public Health of Serbia, Belgrade, Serbia.
5
Izmir Cancer Registry, Izmir Hub, Izmir and Hacettepe University Institute of Public Health, Ankara, Turkey.
6
Greater Poland Cancer Registry, Department of Cancer Prevention and Epidemiology, Greater Poland Cancer Center, Poznan, Poland.
7
Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia.
8
Cancer Registry of the Republic of Slovenia, Institute of Oncology, Ljubljana, Slovenia.
9
North Region Cancer Registry of Portugal, Portuguese Oncology Institute of Porto, Porto, Portugal.
10
Belarusian Research Center for Pediatric Oncology, Hematology, and Immunology, Childhood Cancer Subregistry of Belarus, Minsk, Belarus.
11
Central Region Cancer Registry of Portugal, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal.
12
Regional Cancer Registry of Iasi, National Institute of Public Health, Iasi, Romania.
13
Regional Cancer Registry of Cluj, Ion Chiricuta Oncological Institute, Cluj-Napoca, Romania.
14
Cyprus Cancer Registry, Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus.
15
Malta National Cancer Registry, Department of Health Information and Research, Valletta, Malta.
16
Cancer Registry, Department for Epidemiology of Noncommunicable Diseases, Center for Disease Prevention and Control, Institute of Public Health, Podgorica, Montenegro.
17
Department of Neurosurgery, Aghia Sophia Children's Hospital, Athens, Greece.
18
Second Department of Radiology, Radiotherapy Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece, Athens.
19
Neurosurgery Department, Errikos Dunant Hospital Center, Athens, Greece.
20
Neurosurgical Institute, Ioannina University School of Medicine, Ioannina, Greece.
21
Neurosurgical Department, General Nikaia Piraeus Hospital, Athens, Greece.
22
Department of Neurosurgery and Gamma Knife Radiosurgery, Hygeia Hospital, Athens, Greece.
23
Department of Pediatric Hematology and Oncology, Panagiotis and Aglaia Kyriakou Children's Hospital, Athens, Greece.
24
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.

Abstract

BACKGROUND:

Unique features and worse outcomes have been reported for cancers among adolescents and young adults (AYAs; 15-39 years old). The aim of this study was to explore the mortality and survival patterns of malignant central nervous system (CNS) tumors among AYAs in Southern-Eastern Europe (SEE) in comparison with the US Surveillance, Epidemiology, and End Results (SEER) program.

METHODS:

Malignant CNS tumors diagnosed in AYAs during the period spanning 1990-2014 were retrieved from 14 population-based cancer registries in the SEE region (n = 11,438). Age-adjusted mortality rates were calculated and survival patterns were evaluated via Kaplan-Meier curves and Cox regression analyses, and they were compared with respective 1990-2012 figures from SEER (n = 13,573).

RESULTS:

Mortality rates in SEE (range, 11.9-18.5 deaths per million) were higher overall than the SEER rate (9.4 deaths per million), with decreasing trends in both regions. Survival rates increased during a comparable period (2001-2009) in SEE and SEER. The 5-year survival rate was considerably lower in the SEE registries (46%) versus SEER (67%), mainly because of the extremely low rates in Ukraine; this finding was consistent across age groups and diagnostic subtypes. The highest 5-year survival rates were recorded for ependymomas (76% in SEE and 92% in SEER), and the worst were recorded for glioblastomas and anaplastic astrocytomas (28% in SEE and 37% in SEER). Advancing age, male sex, and rural residency at diagnosis adversely affected outcomes in both regions.

CONCLUSIONS:

Despite definite survival gains over the last years, the considerable outcome disparities between the less affluent SEE region and the United States for AYAs with malignant CNS tumors point to health care delivery inequalities. No considerable prognostic deficits for CNS tumors are evident for AYAs versus children. Cancer 2017;123:4458-71. © 2017 American Cancer Society.

KEYWORDS:

adolescents and young adults; brain tumors; central nervous system tumors; epidemiology; mortality; outcome; survival

PMID:
28708937
DOI:
10.1002/cncr.30884
[Indexed for MEDLINE]

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