Relative survival rates and patterns of diagnosis analyzed by time period for individuals with primary malignant brain tumor, 1973–1997

View More View Less
  • 1 Department of Internal Medicine, Division of Hematology/Oncology, Department of Neurosurgery, Wayne State University School of Medicine; and the Barbara Ann Karmanos Cancer Institute, Detroit, Michigan

Object. The purpose of this study was to examine patterns of diagnosis and relative survival rates in individuals in whom a primary malignant brain tumor was diagnosed between 1973 and 1997; follow-up review of these patients continued through the end of 1999.

Methods. The study population was composed of 21,493 patients with primary malignant brain tumors that were diagnosed between 1973 and 1997. Data on these patients were obtained from the population-based Surveillance, Epidemiology, and End Results Program. The study population was divided into three cohorts based on the year of diagnosis, and these groups were compared with respect to variables of interest by performing chi-square tests and relative survival analysis with the life table method.

Over time, there were consistently more men, more Caucasians, more patients undergoing surgery, and more individuals 70 years and older who received the diagnosis of primary malignant brain tumor. An examination of proportions of individuals with astrocytoma, other; oligodendroglioma, other; and oligodendroglioma Grade III showed significant temporal changes with frontal and temporal lobe tumors occurring most often. The diagnosis was obtained at an earlier age in African-American than in Caucasian patients. Caucasians had higher proportions of glioblastoma multiforme (GBM), which was associated with decreased survival times, and of oligodendroglioma, other, whereas African Americans had higher proportions of astrocytoma, other; ependymoma Grade II or III; and medulloblastoma, all of which were associated with increased survival times. The relative survival case demonstrated a continuous improvement over time, although older patients, those who underwent biopsy only, and those with GBMs continue to have the poorest survival times. The relative survival rates of African Americans consistently were similar or worse than those of Caucasians when the groups were stratified by prognostic factors.

Conclusions. Over time, the relative survival rate of individuals with primary malignant brain tumor has improved and differences in survival are seen by examining the race of the patients.

Contributor Notes

Address reprint requests to: Jill Barnholtz-Sloan, Ph.D., Wayne State University-Karmanos Cancer Institute, 110 East Warren, Detroit, Michigan 48201. email: jbsloan@med.wayne.edu.
  • 1.

    American Cancer Society: Cancer Facts & Figures 2002. (http://www.cancer.org/docroot/STT/content/STT_1x_Cancer_Facts__Figures_2002.asp) [Accessed 24 June 2003] American Cancer Society: Cancer Facts & Figures 2002. (http://www.cancer.org/docroot/STT/content/STT_1x_Cancer_Facts__Figures_2002.asp) [Accessed 24 June 2003]

    • Search Google Scholar
    • Export Citation
  • 2.

    Barnholtz-Sloan JS, , Sloan AE, & Schwartz AG: Racial differences in survival after diagnosis with primary malignant brain tumor. Cancer (In press) Barnholtz-Sloan JS, Sloan AE, Schwartz AG: Racial differences in survival after diagnosis with primary malignant brain tumor. Cancer (In press)

    • Search Google Scholar
    • Export Citation
  • 3.

    Cairncross JG, , Ueki K, & Zlatescu MC, et al: Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 90:14731479, 1998 Cairncross JG, Ueki K, Zlatescu MC, et al: Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 90:1473–1479, 1998

    • Search Google Scholar
    • Export Citation
  • 4.

    Central Brain Tumor Registry of the United States: Year 2001 Annual Statistics Report: Brain Tumors in the US, 1992–1997. (http://cbtrus.org/2001/2001stats_report.htm) [Accessed 24 June 2003] Central Brain Tumor Registry of the United States: Year 2001 Annual Statistics Report: Brain Tumors in the US, 1992–1997. (http://cbtrus.org/2001/2001stats_report.htm) [Accessed 24 June 2003]

    • Search Google Scholar
    • Export Citation
  • 5.

    Coons SW, , Johnson PC, & Scheithauer BW, et al: Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 79:13811393, 1997 Coons SW, Johnson PC, Scheithauer BW, et al: Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 79:1381–1393, 1997

    • Search Google Scholar
    • Export Citation
  • 6.

    Davis FG, , Freels S, & Grutsch J, et al: Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973–1991. J Neurosurg 88:110, 1998 Davis FG, Freels S, Grutsch J, et al: Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973–1991. J Neurosurg 88:1–10, 1998

    • Search Google Scholar
    • Export Citation
  • 7.

    Davis FG, , McCarthy BJ, & Freels S, et al: The conditional probability of survival of patients with primary malignant brain tumors: surveillance, epidemiology and end results (SEER) data. Cancer 85:485491, 1999 Davis FG, McCarthy BJ, Freels S, et al: The conditional probability of survival of patients with primary malignant brain tumors: surveillance, epidemiology and end results (SEER) data. Cancer 85:485–491, 1999

    • Search Google Scholar
    • Export Citation
  • 8.

    Desmeules M, , Mikkelsen T, & Mao Y: Increasing incidence of primary malignant brain tumors: influence of diagnostic methods. J Natl Cancer Inst 84:442445, 1992 Desmeules M, Mikkelsen T, Mao Y: Increasing incidence of primary malignant brain tumors: influence of diagnostic methods. J Natl Cancer Inst 84:442–445, 1992

    • Search Google Scholar
    • Export Citation
  • 9.

    Greenlee RT, , Hill-Harmon MB, & Murray T, et al: Cancer Statistics, 2001. CA Cancer J Clin 51:1536, 2001 Greenlee RT, Hill-Harmon MB, Murray T, et al: Cancer Statistics, 2001. CA Cancer J Clin 51:15–36, 2001

    • Search Google Scholar
    • Export Citation
  • 10.

    Greig NH, , Ries LG, & Yancik R, et al: Increasing annual incidence of primary malignant brain tumors in the elderly. J Natl Cancer Inst 82:16211624, 1990 Greig NH, Ries LG, Yancik R, et al: Increasing annual incidence of primary malignant brain tumors in the elderly. J Natl Cancer Inst 82:1621–1624, 1990

    • Search Google Scholar
    • Export Citation
  • 11.

    Kaplan EL, & Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457481, 1958 Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481, 1958

    • Search Google Scholar
    • Export Citation
  • 12.

    Kleihues P, , Burger PC, & Scheithauer BW: Histological Typing of Tumours of the Central Nervous System. Berlin: Springer-Verlag, 1993 Kleihues P, Burger PC, Scheithauer BW: Histological Typing of Tumours of the Central Nervous System. Berlin: Springer-Verlag, 1993

    • Search Google Scholar
    • Export Citation
  • 13.

    Kwok RK, & Yankaskas BC: The use of census data for determining race and education as SES indicators: a validation study. Ann Epidemiol 11:171177, 2001 Kwok RK, Yankaskas BC: The use of census data for determining race and education as SES indicators: a validation study. Ann Epidemiol 11:171–177, 2001

    • Search Google Scholar
    • Export Citation
  • 14.

    Legler JM, , Ries LAG, & Smith MA, et al: Cancer surveillance series [corrected]: brain and other central nervous system cancers: recent trends in incidence and mortality. J Natl Cancer Inst 91:13821390, 1999 Legler JM, Ries LAG, Smith MA, et al: Cancer surveillance series [corrected]: brain and other central nervous system cancers: recent trends in incidence and mortality. J Natl Cancer Inst 91:1382–1390, 1999

    • Search Google Scholar
    • Export Citation
  • 15.

    Mahaley MS Jr, , Mettlin C, & Natarajan N, et al: Analysis of patterns of care of brain tumor patients in the United States: a study of the Brain Tumor Section of the AANS and the CNS and the Commission on Cancer of the ACS. Clin Neurosurg 36:347352, 1990 Mahaley MS Jr, Mettlin C, Natarajan N, et al: Analysis of patterns of care of brain tumor patients in the United States: a study of the Brain Tumor Section of the AANS and the CNS and the Commission on Cancer of the ACS. Clin Neurosurg 36:347–352, 1990

    • Search Google Scholar
    • Export Citation
  • 16.

    Mahaley MS Jr, , Mettlin C, & Natarajan N, et al: National survey of patterns of care for brain-tumor patients. J Neurosurg 71:826836, 1989 Mahaley MS Jr, Mettlin C, Natarajan N, et al: National survey of patterns of care for brain-tumor patients. J Neurosurg 71:826–836, 1989

    • Search Google Scholar
    • Export Citation
  • 17.

    Messite J, & Stellman SD: Accuracy of death certificate completion: the need for formalized physician training. JAMA 275:794796, 1996 Messite J, Stellman SD: Accuracy of death certificate completion: the need for formalized physician training. JAMA 275:794–796, 1996

    • Search Google Scholar
    • Export Citation
  • 18.

    Modan B, , Wagener DK, & Feldman JJ, et al: Increased mortality from brain tumors: a combined outcome of diagnostic technology and change of attitude toward the elderly. Am J Epidemiol 135:13491357, 1992 Modan B, Wagener DK, Feldman JJ, et al: Increased mortality from brain tumors: a combined outcome of diagnostic technology and change of attitude toward the elderly. Am J Epidemiol 135:1349–1357, 1992

    • Search Google Scholar
    • Export Citation
  • 19.

    National Cancer Institute: Surveillance, Epidemiology, and End Results (SEER). (http://seer.cancer.gov/) [Accessed 24 June 2003] National Cancer Institute: Surveillance, Epidemiology, and End Results (SEER). (http://seer.cancer.gov/) [Accessed 24 June 2003]

    • Search Google Scholar
    • Export Citation
  • 20.

    Polednak AP, & Flannery JT: Brain, other central nervous system, and eye cancer. Cancer 75 (Suppl 1):330337, 1995 Polednak AP, Flannery JT: Brain, other central nervous system, and eye cancer. Cancer 75 (Suppl 1):330–337, 1995

    • Search Google Scholar
    • Export Citation
  • 21.

    Ries LAG, , Eisner MP, & Kosary CL, et al (eds): SEER Cancer Statistics Review, 1973–1999. (http://seer.cancer.gov/csr/1973_1999) [Accessed 24 June 2003] Ries LAG, Eisner MP, Kosary CL, et al (eds): SEER Cancer Statistics Review, 1973–1999. (http://seer.cancer.gov/csr/1973_1999) [Accessed 24 June 2003]

    • Search Google Scholar
    • Export Citation
  • 22.

    Smith MA, , Freidlin B, & Ries LA, et al: Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90:12691277, 1998 Smith MA, Freidlin B, Ries LA, et al: Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90:1269–1277, 1998

    • Search Google Scholar
    • Export Citation
  • 23.

    Surawicz TS, , Davis F, & Freels S, et al: Brain tumor survival: results from the National Cancer Data Base. J Neurooncol 40:151160, 1998 Surawicz TS, Davis F, Freels S, et al: Brain tumor survival: results from the National Cancer Data Base. J Neurooncol 40:151–160, 1998

    • Search Google Scholar
    • Export Citation
  • 24.

    Surawicz TS, , McCarthy BJ, & Kupelian V, et al: Descriptive epidemiology of primary brain and CNS tumors: results from the Central Brain Tumor Registry of the United States, 1990–1994. Neurooncol 1:1425, 1999 Surawicz TS, McCarthy BJ, Kupelian V, et al: Descriptive epidemiology of primary brain and CNS tumors: results from the Central Brain Tumor Registry of the United States, 1990–1994. Neurooncol 1:14–25, 1999

    • Search Google Scholar
    • Export Citation
  • 25.

    Wrensch M, , Minn Y, & Chew T, et al: Epidemiology of primary brain tumors: current concepts and review of the literature. Neurooncol 4:278299, 2002 Wrensch M, Minn Y, Chew T, et al: Epidemiology of primary brain tumors: current concepts and review of the literature. Neurooncol 4:278–299, 2002

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 301 187 19
Full Text Views 123 10 1
PDF Downloads 102 8 1
EPUB Downloads 0 0 0