LAUSR

Abstract AIMS To describe the temporal and geographic variation in the incidence of pediatric CNS malignancies worldwide, presenting analyses by sex, period, region, and histological subtype between 1998 and 2012. METHODS Data were extracted from volumes IX to XI of the Cancer Incidence in 5 Continents, covering the periods 1998–2002 (1), 2003–2007 (2), and 2008–2012 (3). We pooled data from 44 countries, classifying them into 6 regions (Africa (AF), Asia (AS), Oceania (O), Europe (E), Central/South America (CSA), North America (NA)). Age-standardized incidence rates (ASIR per million, 0–19 years) were calculated and temporal variation was evaluated using incidence rate ratios (IRR) (95% CI). RESULTS The highest incidence (Period 3) was observed in NA (34.0 and 30.2 for males and females, respectively). Astrocytic tumors were predominant in all regions, with percentages ranging between 24.5% (E, females) and 45.6% (NA, females). Increasing trends (Period 3 x 1) were observed in AS (IRR=1.15, 95% CI 1.06–1.25), CSA (IRR=1.25, 95% CI 1.01–1.55), and NA (IRR=1.05, 95% CI 1.03–1.07), for males and in AS (IRR=1.15, 95% CI 1.05–1.26) and NA (IRR=1.08, 95% CI 1.06–1.11) for females. Geographic discrepancies in time-trends were observed for astrocytomas, ependymomas, medulloblastomas, other embryonal tumors, and other specified tumors. Reductions in the incidence of unspecified tumors from period 1 to 3 were noted in E, AS, and NA, ranging from -20% (E, females) to -66% (AS, females). CONCLUSIONS Heterogeneous trends and improvement in the registration of histological types were noted. Geographic variation can help to raise hypotheses to investigate etiologic factors.