A population-based description of glioblastoma multiforme in Los Angeles County, 1974-1999.
BACKGROUND
There have been reports that the incidence rates of brain tumors have increased over the past few decades, but most have considered all brain tumors together. The authors analyzed the pattern of glioblastoma multiforme (GBM) occurrence in Los Angeles County, California to shed light on the incidence and descriptive epidemiology of this type of brain tumor.


METHODS
Data were obtained from the Los Angeles County Cancer Surveillance Program. Incidence rates were analyzed by gender, race, age at diagnosis, period of diagnosis (1974-1981, 1982-1988, or 1989-1999), and socioeconomic status (SES). In addition, data were stratified according to anatomic subsite. A multivariate model describing changes in rates by each of these variables was constructed.


RESULTS
Age-specific incidence rates (ASIR) rose sharply after age 30 years. The peak ASIR was at age 70-74 years in males and at age 75-79 years in females. The age-adjusted incidence rate (AAIR) of GBM increased from 1974 to 1999 by an estimated 2.4% per year among males and 2.8% per year among females. Overall, males had a 60% increased risk of brain tumors compared with females. Males had a higher incidence of GBM compared with females at each anatomic subsite except the posterior fossa. The largest male:female ratio occurred in the occipital lobes. Non-Latino whites had the highest incidence rates (2.5 per 100,000) followed by Latino whites (1.8 per 100,000), and blacks (1.5 per 100,000). After 1989, compared with the period before magnetic resonance imaging (MRI) was available, there was an increase in GBM incidence rates among those with of higher SES that was most pronounced in females. The incidence of GBM was highest for frontal lobe tumors and for tumors that involved two or more lobes (overlapping tumors), followed by tumors in the temporal and parietal lobes. In the multivariate analysis, year of diagnosis, SES, gender, race (Latino but not black), site, and age at diagnosis all were important predictors of incidence rate.


CONCLUSIONS
GBM incidence increased in Los Angeles County over the last 30 years and especially after 1989, suggesting that the introduction of MRI may have contributed to the increase. Individuals older than age 65 years experienced the greatest increase in incidence over time. Older age, male gender, higher SES, and non-Latino white race increased the risk of GBM. Previously unreported incidence rates for GBM among Latino whites were significantly lower than among non-Latino whites but were intermediate between non-Latino whites and blacks.
Chakrabarti
Indro
I
Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, 90032, USA. indro500@yahoo.com
Cockburn
Myles
M
Cozen
Wendy
W
Wang
Ya-Ping
YP
Preston-Martin
Susan
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D002140:California / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016012:Poisson Distribution; D044469:Racial Groups / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D017678:Sex Distribution