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BACKGROUND Significant sex differences exist in cancer, and males have higher incidence and lower survival compared to females for most cancers. No large-scale studies have systematically examined sex differences in incidence and survival across all primary brain histologies. We performed a comprehensive investigation of the differences in incidence and survival in patients diagnosed with primary malignant brain and other CNS tumors by specific histologies. METHODS Age-adjusted incidence rate ratios (IRR) and 95% confidence intervals (945% CI) were generated from the United States Cancer Statistics (USCS) Public Use Database. Data from the Surveillance, Epidemiology, and End-Results (SEER) program were used to calculate overall survival. Data was restricted to patients with histologically or radiologically confirmed, primary malignant tumors diagnosed between 2001 and 2015. Histological groupings were categorized based on the Central Brain Tumor Registry of the United States (CBTRUS). Cox proportional hazards models were used to calculate hazard ratios (HR) adjusted for age for males as compared to females. RESULTS Males exhibited higher incidence than females in all brain histologies except meningioma (IRR=0.83; 95% CI 0.73–0.93) and other neuroepithelial tumors (i.e. polar spongioblastomas and astroblastomas) (IRR=0.48; 95% CI 0.26–0.88). Males experienced better overall survival in germ cell tumors, cysts and heterotopias (HR=0.68; 95% CI 0.49–0.94) compared to females, but were observed to have lower survival in all other histologies. Survival was lowest for males among patients with nerve sheath tumors (HR=2.32; 95% CI 1.31–4.12) and other neoplasms related to the meninges (e.g. chondrosarcomas and chordomas) (HR=2.23; 95% CI 1.24–3.99). Survival in meningioma patients was significantly higher in females (HR=1.49; 95% CI 1.25–1.77). Patients with glioblastomas, had a slightly worse survival outcome in males (HR=1.02, 95% CI 1.00–1.05). CONCLUSION Understanding the role of sex differences is critical for addressing sex based inequalities and needs to be taken into account in clinical paradigms.

EPID-03. HISTOLOGY-SPECIFIC BRAIN TUMOR INCIDENCE AND SURVIVAL VARIES BY SEX