title: Are pediatric brain tumors on the rise in the USA? Significant incidence and survival findings from the SEER database analysis.
abstract: BACKGROUND
  Central nervous system tumors are the second most common form of cancer in children between the ages of 1 and 19 years. We aimed to provide the most recent data on the incidence and survival of these tumors in the USA and to assess the literature.
  
  
  METHODS
  Frequency, rates, and survival sessions were calculated using the November 2008 submission for the US Surveillance Epidemiology and End Results Program. Data were collected and analyzed for children and adolescents aged 1 to 19 years with primary brain tumors.
  
  
  RESULTS
  We found that the incidence rate of all pediatric brain tumors has been on a gradual but steady increase from 1973 to 2008 (p < 0.001). The average annual increase was 1.37 %. Our survival analysis of the individual tumors revealed that the 5-year overall survival for children diagnosed between 1974 and 1978 with medulloblastoma was 43.7 %. However, this increased to 62.8 % for children diagnosed between 1999 and 2003. A similar survival trend was also observed when all the other pediatric brain cancer histologies were collectively analyzed (p < 0.001).
  
  
  CONCLUSIONS
  From our study, we can conclude that contrary to previous reports indicating a plateau in the incidence rates of pediatric brain tumors since the mid-1980s, there has been an increase from 1973 to 2008. Potential causes include environmental carcinogens, but more research is needed to investigate the factors behind this sustained rise in incidence over the years.
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, St. George's, Grenada.
authors.forename: Swetal
authors.initials: S
authors.lastname: Patel
authors.forename: Amit
authors.initials: A
authors.lastname: Bhatnagar
authors.forename: Christopher
authors.initials: C
authors.lastname: Wear
authors.forename: Stephen
authors.initials: S
authors.lastname: Osiro
authors.forename: Abigail
authors.initials: A
authors.lastname: Gabriel
authors.forename: David
authors.initials: D
authors.lastname: Kimball
authors.forename: Alana
authors.initials: A
authors.lastname: John
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Fields
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D013223:Statistics as Topic / Q000639:trends*; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult