Incidence patterns for ependymoma: a Surveillance, Epidemiology, and End Results study

Clinical article

Restricted access

Object

Previous small studies disagree about which clinical risk factors influence ependymoma incidence. The authors analyzed a large, population-based cancer registry to examine the relationship of incidence to patient age, sex, race, and tumor location, and to determine incidence trends over the past 3 decades.

Methods

Data were obtained from the Surveillance, Epidemiology, and End Results (SEER-9) study, which was conducted from 1973 to 2003. Histological codes were used to define ependymomas. Age-adjusted incidence rates were compared by confidence intervals in the SEER*Stat 6.2 program. Multiplicative Poisson regression and Joinpoint analysis were used to determine annual percentage change and to look for sharp changes in incidence, respectively.

Results

From the SEER database, 1402 patients were identified. The incidence rate per 100,000 person-years was significantly higher in male than in female patients (males 0.227 ± 0.029, females 0.166 ± 0.03). For children, the age at diagnosis differed significantly by tumor location, with the mean age for patients with infratentorial tumors calculated as 5 ± 0.4 years; for supratentorial tumors it was 7.77 ± 0.6 years, and for spinal lesions it was 12.16 ± 0.8 years. (Values are expressed as the mean ± standard error [SE].) Adults showed no difference in the mean age of incidence by location, although most tumors in this age group were spinal. Between 1973 and 2003, the incidence increased significantly among adults but not among children, and there were no sharp changes at any single year, both before and after age adjustment.

Conclusions

Males have a higher incidence of ependymoma than do females. A biological explanation remains elusive. Ependymoma occurs within the CNS at distinct locations at different ages, consistent with hypotheses postulating distinct populations of radial glial stem cells within the CNS. Ependymoma incidence appears to have increased over the past 3 decades, but only in adults.

Abbreviations used in this paper: ICD-O = International Classification of Diseases for Oncology; SE = standard error; SEER-9 = Surveillance, Epidemiology, and End Results Program, 9 registries.

Article Information

Address correspondence to: Paul Graham Fisher, M.D., Room CC22200, Stanford Cancer Center, 875 Blake Wilbur Drive, Palo Alto, California 94305-5826. email: pfisher@stanford.edu.

Please include this information when citing this paper: published online December 5, 2008; DOI: 10.3171/2008.9.JNS08117.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Scatterplots showing age-adjusted incidence trends from 1973 to 2003. There are no significant changes in incidence over time and no sharp changes at any single year among all patients (A) or children (C), but the incidence rises significantly among adults (B). APC = annual percentage change.

References

  • 1

    Barone BMElvidge AR: Ependymomas. A clinical survey. J Neurosurg 33:4284381970

  • 2

    Benvenuti SFrattini MArena SZanon CCappelletti VCoradini D: PIK3CA cancer mutations display gender and tissue specificity patterns. Hum Mutat 29:2842882008

    • Search Google Scholar
    • Export Citation
  • 3

    de Kok IMWong CSChia KSSim XTan CSKiemeney LA: Gender differences in the trend of colorectal cancer incidence in Singapore, 1968. Int J Colorectal Dis 23:461 4672008

    • Search Google Scholar
    • Export Citation
  • 4

    Dohrmann GJFarwell JR: Ependymal neoplasms in children. Trans Am Neurol Assoc 101:1251291976

  • 5

    Dohrmann GJFarwell JRFlannery JT: Ependymomas and ependymoblastomas in children. J Neurosurg 45:2732831976

  • 6

    Farwell JRDohrmann GJFlannery JT: Central nervous system tumors in children. Cancer 40:312331321977

  • 7

    Fokes EC JrEarle KM: Ependymomas: clinical and pathological aspects. J Neurosurg 30:5855941969

  • 8

    Gurney JGSmith MABunin GRCNS and miscellaneous intracranial and intraspinal neoplasms. Ries LAGSmith MAGurney JGLinet MTamra TYoung JL: Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975–1995 NIH Pub No. 99–4649Bethesda, MDNational Cancer Institute, SEER Program1999. 5163

    • Search Google Scholar
    • Export Citation
  • 9

    Kricheff IIBecker MSchneck SATaveras JM: Intracranial ependymomas: factors influencing prognosis. J Neurosurg 21:7141964

  • 10

    Preston-Martin SMack WJNeoplasms of the nervous system. Schottenfeld DFraumeni JF: Cancer Epidemiology and Prevention ed 2New YorkOxford University Press1996. 12311281

    • Search Google Scholar
    • Export Citation
  • 11

    Smith MAFeidlin BRies LASimon R: Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90:126912771998

    • Search Google Scholar
    • Export Citation
  • 12

    Surveillance Epidemiology and End Results Program: SEER Statistics Database: Incidence—SEER 17 Registries Public-Use, Nov 2005 Sub (1973–2003 varying)—Linked To County Attributes—Total U.S., 1969–2003 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. Bethesda, MDNational Cancer InstituteApril 2006 (www.seer.cancer.gov) [Accessed 26 September 2008]

    • Export Citation
  • 13

    Taylor MDPoppleton HFuller CSu XLiu YJensen P: Radial glia cells are candidate stem cells of ependymoma. Cancer Cell 8:3233352005

    • Search Google Scholar
    • Export Citation

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 258 258 14
Full Text Views 204 204 1
PDF Downloads 108 108 0
EPUB Downloads 0 0 0

PubMed

Google Scholar