Brain and other central nervous system cancers: Recent trends in incidenceand mortality

Background: During the 1980s, the incidence of primary malignant brain and other central nervous system tumors (hereafter called brain cancer) was rep orted to be increasing among all age groups in the United States, while mor tality was declining for persons younger than 65 years. We analyzed these d ata to provide updates on incidence and mortality trends for brain cancer i n the United States and to examine these patterns in search of their causes . Methods: Data on incidence, overall and according to histology and anatom ic site, and on relative survival were obtained from the Surveillance, Epid emiologyl and End Results (SEER) Program of the National Cancer Institute f or 1975 through 1995, Mortality data were obtained from the National Center for Health Statistics. Medicare procedure claims from the National Cancer Institute's SEER-Medicare database were used for imaging trends. Statistica lly significant changes in incidence trends were identified, and annual per cent changes mere computed for log linear models. Results/Conclusions: Rate s stabilized for all age groups during the most recent period for which SEE R data were available, except for the group containing individuals 85 years of age or older, Mortality trends continued to decline for the younger age groups, and the steep increases in mortality seen in the past for the elde rly slowed substantially, Patterns differed by age group according to the s ite and grade of tumors between younger and older patients. During the last decade, use of computed tomography scans was relatively stable for those 6 5-74 years old but increased among those 85 years old or older. Implication s: Improvements in diagnosis and changes in the diagnosis and treatment of elderly patients provide likely explanations for the observed patterns in b rain cancer trends.