Epidemiology of High Grade Glioma in Saudi Arabia
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1 Epidemiology of High Grade Glioma in Saudi Arabia Ali Abdullah Balbaid, MB ChB, FPCPC Assistant Professor of Radiation Oncology King Saud Bin Abdulaziz University for Health Sciences Chairman of Radiation Oncology Department Comprehensive Cancer Center King Fahad Medical City 6/17/2016 1
2 Outlines Introduction Incidence Risk Factors Saudi Cancer Registry CNS Tumors in Saudi Arabia High Grade Glioma in Saudi Arabia 6/17/2016 2
3 INTRODUCTION 6/17/2016 3
4 Introduction Gliomas are the most common primary malignant brain tumors in adults They can occur anywhere in the central nervous system but primarily occur in the brain and arise in the glial tissue High grade gliomas include: Anaplastic Astrocytoma Anaplastic Oligodendroglioma Anaplastic Oligoastrocytoma Glioblastoma 6/17/2016 4
5 INCIDENCE 6/17/2016 5
6 Incidence Incidence rates of glioma vary significantly by histologic type, age at diagnosis, gender, race, and country. Overall age-adjusted incidence rates for all gliomas range from 4.67 to 5.73 per100,000 persons. Age-adjusted incidence of glioblastoma ranges from 0.59 to 3.69 per 100,000 persons. Lee CH, et al. J Korean Neurosurg, 2010 Larjavaara S, et al. Neuro-oncol, 2007 Gousias K, et al. Neuroepidemiology, /17/2016 6
7 Incidence The incidence of anaplastic astrocytoma and glioblastoma increases with age, peaking in the age group. In general, gliomas are more common in men than women. In the United States, gliomas are more common in non- Hispanic whites than in blacks. Ostrom QT, et al. Neuro-oncol, 2013 Larjavaara S, et al. Neuro-oncol, 2007 Gigineishvili D, et al. J Neurooncol, 2013 Dubrow R, et al. BMC Cancer, /17/2016 7
8 Incidence Varies between countries: Norway Australia Saudi Arabia 14 : 100,000 population. 5.2 : 100,000 population. 1.7 : 100,000 population. Many analytic studies concluded that the incidence rate of glioma overall and glioma subtypes to be fairly stable over the time periods assessed. Saudi Cancer Registry, 2011 Deltour I, et al. Epidemiology, 2012 Little MP, et al. BMJ, /17/2016 8
9 Incidence (USA) Pathology Rate/100,000 Glioblastoma 3.19 Anaplastic Astrocytoma 0.37 Anaplastic Oligodendroglioma 0.11 Ostrom et al. CBTRUS, Neuro-oncol /17/2016 9
10 RISK FACTORS 6/17/
11 Epidemiologic Risk Factors Allergy: Decreased risk with history of allergies or atopic diseases by nearly 40%. Drug Use: Antihistamine use showed inconsistent relation with high grade glioma Short term (< 10 years) use of anti-inflammatory medications is associated with a protective effect against GBM??? Linos E, et al. J Natl Cancer Inst, 2007 McCarthy BJ, et al. Can Epid Biom Prev, 2011 Scheurer ME, et al. Int. J. Can, /17/
12 Epidemiologic Risk Factors Ionizing Radiation: Atomic Radiation Therapeutic Radiation Diagnostic Radiation Clear association with high grade glioma for atomic and therapeutic radiation. Inconsistent results for diagnostic radiation and brain tumors Preston DL, et al. Radiat Res., 2007 Sadetzki S, et al. Radiat Res., 2005 Davis F, et al. Radiat Res /17/
13 Epidemiologic Risk Factors Nonionizing Radiation: 1. Cellular Phones No clear association. Latency period might not be enough Deserves continued monitoring 2. Low Frequency Magnetic Fields Possible relation Mixed data Frei P, et al. BMJ, 2011 Hardell L, et al. Int J Oncol.2013 Baan R, et al. Lancet Oncol, /17/
14 Epidemiologic Risk Factors Occupational Chemicals Pesticides Solvents No clear association Pukkala E, et al. Acta Oncol Samanic CM, et al. Am J Epidemiol Ruder AM, et al. Occup Environ Med /17/
15 GLIOMA IN SAUDI ARABIA 6/17/
16 SAUDI CANCER REGISTRY 6/17/
17 Saudi Cancer Registry Saudi Cancer Registry (SCR) reports the annual incidence of cancer. Established in 1992 under the authority of Ministry of Health. It was moved to the Saudi Health Council in It commenced reporting cancer cases from Jan Last report was published this year for 2011 cancer incidence 6/17/
18 Saudi Cancer Registry It has representative from: Ministry of Health Ministry of Defense and Aviation Ministry of Interior Ministry of National Guard King Faisal Specialist Hospital & Research Center, and King Saud University 6/17/
19 Saudi Cancer Registry Main office located in the Saudi Health Council. There are five regional offices: Central Region: King Fahad Medical City Eastern Region: King Fahad University Hospital Western Region: King Abdulaziz Hospital Southern Region: Asir Central Hospital Northern Region: Maternity and Children Hospital Five other offices related to Oncology Establishments: KFSH&RC, AFH, SFH, NGH, & KKUH 6/17/
20 CANCER INCIDENCE IN SAUDI ARABIA 6/17/
21 Saudi Cancer Incidence A total of 14,776 new cancer cases in ,870 (46.6%) affected males 7,780 (53.4%) affected females Male to female ratio of 87:100 Crude incidence rate (CIR) of 65/100,000 Age Standardized Rate (ASR) of: 78.8/100,000 in males 90.1/100,000 in females 6/17/
22 Saudi Cancer Incidence 6/17/
23 Saudi Cancer Incidence 6/17/
24 CNS TUMORS IN SAUDI ARABIA 6/17/
25 CNS Tumors in Saudi Arabia In 2011: 269 new cases of brain cancer 2.5% of all cancers (2% in USA)* The 14 th common site overall The second most common in children Highest incidence among males was in Makkah followed by Riyadh Highest incidence among females was in Northern region followed by Riyadh *Ostrom et al. CBTRUS, Neuro-oncol /17/
26 CNS Tumors in Saudi Arabia Site Male Female All % 1 Breast Colorectal Thyroid NHL Leukemia Liver Lung HD Skin Uterus Prostate Stomach Kidney Brain Bladder Others /17/
27 CNS Tumors in Saudi Arabia (Children) Site No % 1 Leukemia CNS HD NHL Kidney Bone Eye Adrenal Soft tissue Liver /17/
28 CNS Tumors in Saudi Arabia Year Male Female No % Crude ASR* No % Crude ASR* *ASR per 100,000 population 6/17/
29 CNS Tumors in Saudi Arabia 6/17/
30 HIGH GRADE GLIOMA IN SAUDI ARABIA 6/17/
31 High Grade Glioma (Adults) Morphology Male Female Total No % No % No % Glioblastoma Anaplastic Astro /17/
32 High Grade Glioma (Adults) 6/17/
33 High Grade Glioma (Children) Morphology Male Female Total No % No % No % Glioblastoma Anaplastic Astro /17/
34 High Grade Glioma (Children) 6/17/
35 Summery 14,776 new cancer cases in (2.5%) CNS cases. In adults: 99 (36.7%) GBM cases. 9 (3.3%) Anaplastic Astro. cases Total 108 (40%) High Grade Glioma In Children: 4 (12.1%) GBM cases. 1 (2.7%) Anaplastic Astro. Cases Total 5 (14.8%) High Grade Glioma 6/17/
36 Thank You 6/17/
37 References Lee CH, Jung KW, Yoo H, et al. Epidemiology of primary brain and central nervous system tumors in Korea. J Korean Neurosurg Soc. 2010;48(2): Larjavaara S, Mantyla R, Salminen T, et al. Incidence of gliomas by anatomic location. Neuro-oncol 2007;9(3): Gousias K, Markou M, Voulgaris S, et al. Descriptive epidemiology of cerebral gliomas in northwest Greece and study of potential predisposing factors, Neuroepidemiology. 2009;33(2): Ostrom QT, Gittleman H, Farah P, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in Neuro-oncol. 2013;15(sup 6):ii1 56. Gigineishvili D, Shengelia N, Shalashvili G, et al. Primary brain tumour epidemiology in Georgia: first-year results of a populationbased study. J Neurooncol. 2013;112(2): Dubrow R, Darefsky AS. Demographic variation in incidence of adult glioma by subtype, United States, BMC Cancer. 2011;11:325. Deltour I, Auvinen A, Feychting M, et al. Mobile phone use and incidence of glioma in the Nordic countries : consistency check. Epidemiology. 2012;23(2): Little MP, Rajaraman P, Curtis RE, et al. Mobile phone use and glioma risk: comparison of epidemiological study results with incidence trends in the United States. BMJ. 2012;344:e1147. Linos E, Raine T, Alonso A, et al. Atopy and risk of brain tumors: a meta-analysis. J Natl Cancer Inst. 2007;99(20): McCarthy BJ, Rankin K, Il yasova D, et al. Assessment of type of allergy and antihistamine use in the development of glioma. Cancer Epidemiol Biomarkers Prev. 2011;20(2): Scheurer ME, Amirian ES, Davlin SL, Rice T, Wrensch M, Bondy ML. Effects of antihistamine and anti-inflammatory medication use on risk of specific glioma histologies. International journal of cancer Journal international du cancer. 2011; 129: Preston DL, Ron E, Tokuoka S, et al. Solid cancer incidence in atomic bomb survivors: Radiat Res. 2007;168(1):1 6. Sadetzki S, Chetrit A, Freedman L, et al. Long-term follow-up for brain tumor development after childhood exposure to ionizing radiation for tinea capitis. Radiat Res. 2005;163(4): Davis F, Il yasova D, Rankin K, et al. Medical diagnostic radiation exposures and risk of gliomas. Radiat Res. 2011;175(6): Frei P, Poulsen AH, Johansen C, et al. Use of mobile phones and risk of brain tumours: update of Danish cohort study. BMJ. 2011;343:d6387. Hardell L, Carlberg M, Soderqvist F, et al. Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone use. Int J Oncol.2013;43(6): Baan R, Grosse Y, Lauby-Secretan B, et al. Carcinogenicity of radiofrequency electromagnetic fields. Lancet Oncol. 2011;12(7): Pukkala E, Martinsen JI, Lynge E, et al. Occupation and cancer follow-up of 15 million people in five Nordic countries. Acta Oncol. 2009;48(5): Ruder AM, Yiin JH, Waters MA, et al. The Upper Midwest Health Study: gliomas and occupational exposure to chlorinated solvents. Occup Environ Med. 2013;70(2): Samanic CM, De Roos AJ, Stewart PA, et al. Occupational exposure to pesticides and risk of adult brain tumors. Am J Epidemiol. 2008;167(8): Saudi Health Council, Cancer registry reports, 6/17/
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