title: Childhood central nervous system tumours: Incidence and time trends in 13 Southern and Eastern European cancer registries.
abstract: OBJECTIVE
  Following completion of the first 5-year nationwide childhood (0-14 years) registration in Greece, central nervous system (CNS) tumour incidence rates are compared with those of 12 registries operating in 10 Southern-Eastern European countries.
  
  
  METHODS
  All CNS tumours, as defined by the International Classification of Childhood Cancer (ICCC-3) and registered in any period between 1983 and 2014 were collected from the collaborating cancer registries. Data were evaluated using standard International Agency for Research on Cancer (IARC) criteria. Crude and age-adjusted incidence rates (AIR) by age/gender/diagnostic subgroup were calculated, whereas time trends were assessed through Poisson and Joinpoint regression models.
  
  
  RESULTS
  6062 CNS tumours were retrieved with non-malignant CNS tumours recorded in eight registries; therefore, the analyses were performed on 5191 malignant tumours. Proportion of death certificate only cases was low and morphologic verification overall high; yet five registries presented >10% unspecified neoplasms. The male/female ratio was 1.3 and incidence decreased gradually with age, apart from Turkey and Ukraine. Overall AIR for malignant tumours was 23/10(6) children, with the highest rates noted in Croatia and Serbia. A statistically significant AIR increase was noted in Bulgaria, whereas significant decreases were noted in Belarus, Croatia, Cyprus and Serbia. Although astrocytomas were overall the most common subgroup (30%) followed by embryonal tumours (26%), the latter was the predominant subgroup in six registries.
  
  
  CONCLUSIONS
  Childhood cancer registration is expanding in Southern-Eastern Europe. The heterogeneity in registration practices and incidence patterns of CNS tumours necessitates further investigation aiming to provide clues in aetiology and direct investments into surveillance and early tumour detection.
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Papathoma
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Thomopoulos
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Karalexi
authors.affiliation: National Cancer Registry of Ukraine, National Institute of Cancer, Kyiv, Ukraine.
authors.forename: Anton
authors.initials: A
authors.lastname: Ryzhov
authors.affiliation: Belarusian Research Center for Pediatric Oncology, Hematology and Immunology , Childhood Cancer Subregistry of Belarus, Minsk, Belarus.
authors.forename: Anna
authors.initials: A
authors.lastname: Zborovskaya
authors.affiliation: Bulgarian National Cancer Registry, National Oncology Hospital, Sofia, Bulgaria.
authors.forename: Nadya
authors.initials: N
authors.lastname: Dimitrova
authors.affiliation: Institute of Public Health of Serbia, Belgrade, Serbia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Zivkovic
authors.affiliation: Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Ankara, Turkey.
authors.forename: Sultan
authors.initials: S
authors.lastname: Eser
authors.affiliation: North Region Cancer Registry of Portugal (RORENO), Portuguese Oncology Institute of Porto, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Antunes
authors.affiliation: Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia.
authors.forename: Mario
authors.initials: M
authors.lastname: Sekerija
authors.affiliation: Cancer Registry of Republic of Slovenia, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Tina
authors.initials: T
authors.lastname: Zagar
authors.affiliation: Registo Oncológico Regional do Centro, Instituto Português de Oncologia de Coimbra, Francisco Gentil E.P.E, Coimbra, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Bastos
authors.affiliation: Cyprus Cancer Registry-Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus.
authors.forename: Anna
authors.initials: A
authors.lastname: Demetriou
authors.affiliation: Northeast Regional Cancer Registry, Regional Center of Public Health, 14 Victor Babes Street, 700465 Iasi, Romania.
authors.forename: Raluca
authors.initials: R
authors.lastname: Cozma
authors.affiliation: Regional Cancer Registry of Cluj, Oncological Institute "Ion Chiricuta", Cluj-Napoca, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Coza
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Bouka
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Nick
authors.initials: N
authors.lastname: Dessypris
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kantzanou
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
authors.forename: Prodromos
authors.initials: P
authors.lastname: Kanavidis
authors.affiliation: Oncology Department, "Mitera" Childrens Hospital, ErythrouStavrou 6 Marousi, Athens, Greece.
authors.forename: Helen
authors.initials: H
authors.lastname: Dana
authors.affiliation: 2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hatzipantelis
authors.affiliation: Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Moschovi
authors.affiliation: Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Polychronopoulou
authors.affiliation: Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Pourtsidis
authors.affiliation: Department of Pediatric Hematology-Oncology, University of Crete, University Hospital of Heraklion, Heraklion, Greece.
authors.forename: Eftichia
authors.initials: E
authors.lastname: Stiakaki
authors.affiliation: Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece.
authors.forename: Evgenia
authors.initials: E
authors.lastname: Papakonstantinou
authors.affiliation: Department of Neurosurgery, "G. Gennimatas" Athens General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Oikonomou
authors.affiliation: Department of Neurosurgery, "Mitera" Childrens Hospital, Erythrou Stavrou 6 Marousi, Athens, Greece.
authors.forename: Spyros
authors.initials: S
authors.lastname: Sgouros
authors.affiliation: Department of Neurosurgery, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Vakis
authors.affiliation: Department of Neurosurgery, St. Luke's Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Basilios
authors.initials: B
authors.lastname: Zountsas
authors.affiliation: First Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece.
authors.forename: Charis
authors.initials: C
authors.lastname: Bourgioti
authors.affiliation: 2nd Department of Radiology, Radiotherapy Unit, Medical School, National Kapodistrian University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kelekis
authors.affiliation: Department of Radiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Panos
authors.initials: P
authors.lastname: Prassopoulos
authors.affiliation: Department of Pathology, "G. Gennimatas" Athens General Hospital, Athens, Greece.
authors.forename: Theodosia
authors.initials: T
authors.lastname: Choreftaki
authors.affiliation: Department of Pathology, Hygeia Hospital, Athens, Greece.
authors.forename: Savvas
authors.initials: S
authors.lastname: Papadopoulos
authors.affiliation: Histopathology Department, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Stefanaki
authors.affiliation: Histopathology Department, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Strantzia
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cardis
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Steliarova-Foucher
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece. Electronic address: epetrid@med.uoa.gr.
authors.forename: Eleni Th
authors.initials: ET
authors.lastname: Petridou
mesh_terms: D000293:Adolescent; D016543:Central Nervous System Neoplasms / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012042:Registries
keywords: Age distribution; Central nervous system neoplasms; Child; Europe; Gender; Incidence; Registries; Time factors