Trends in reported incidence of primary malignant brain tumors in children in the United States
Trends in reported incidence of primary malignant brain tumors in children in the United States
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DOI：
10.1093/jnci/90.17.1269
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发表时间：
1998-09-02
期刊：
影响因子：
--
通讯作者：
Simon, R
中科院分区：
文献类型：
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作者：
Smith, MA;Freidlin, B;Simon, R
背景：报告的美国儿童原发性恶性脑肿瘤发病率在 1973 年至 1994 年期间增加了 35%。我们研究的目的有两个：1) 确定该时期报告的发病率是否可以通过整个时期的线性增加（“线性模型”）更好地表示，或者通过阶跃函数，在 1984-1985 年之前的几年中发病率较低，之后的发病率恒定较高（“跳跃”）。模型”）； 2) 确定发病率增加的特定大脑区域和组织学亚型。方法：使用来自国家癌症研究所 1973 年至 1994 年期间儿童原发性恶性脑肿瘤监测、流行病学和最终结果项目的发病率数据，通过使用线性模型或跳跃模型，将一年中的病例数建模为泊松分布的随机变量。结果/结论：报告的儿童原发性恶性脑肿瘤发病率的增加最好用跳跃模型来解释，发病率在 20 世纪 80 年代中期出现逐步增加，脑干和大脑是据报道肿瘤发病率增加的主要部位。大脑和脑干低级别神经胶质瘤报告发病率的增加（不伴随这些部位死亡率的增加）支持低级别神经胶质瘤对儿童脑肿瘤报告发病率总体增加的重大贡献。意义：数据与跳跃模型的显着更好的拟合支持了以下假设：观察到的发病率增加在某种程度上是由于 20 世纪 80 年代中期儿童原发性恶性脑肿瘤的检测和/或报告的变化造成的。
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.