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Malignant central nervous system tumors among adolescents and young adults (15‐39 years old) in 14 Southern‐Eastern European registries and the US Surveillance, Epidemiology, and End Results program: Mortality and survival patterns
Author(s) -
Georgakis Marios K.,
Papathoma Paraskevi,
Ryzhov Anton,
ZivkovicPerisic Snezana,
Eser Sultan,
Taraszkiewicz Łukasz,
Sekerija Mario,
Žagar Tina,
Antunes Luis,
Zborovskaya Anna,
Bastos Joana,
Florea Margareta,
Coza Daniela,
Demetriou Anna,
Agius Domenic,
Strahinja Rajko M.,
Themistocleous Marios,
Tolia Maria,
Tzanis Spyridon,
Alexiou George A.,
Papanikolaou Panagiotis G.,
Nomikos Panagiotis,
Kantzanou Maria,
Dessypris Nick,
Pourtsidis Apostolos,
Petridou Eleni T.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30884
Subject(s) - medicine , epidemiology , surveillance, epidemiology, and end results , demography , relative survival , young adult , proportional hazards model , population , survival analysis , survival rate , pediatrics , cancer registry , environmental health , sociology
BACKGROUND Unique features and worse outcomes have been reported for cancers among adolescents and young adults (AYAs; 15‐39 years old). The aim of this study was to explore the mortality and survival patterns of malignant central nervous system (CNS) tumors among AYAs in Southern‐Eastern Europe (SEE) in comparison with the US Surveillance, Epidemiology, and End Results (SEER) program. METHODS Malignant CNS tumors diagnosed in AYAs during the period spanning 1990‐2014 were retrieved from 14 population‐based cancer registries in the SEE region (n = 11,438). Age‐adjusted mortality rates were calculated and survival patterns were evaluated via Kaplan‐Meier curves and Cox regression analyses, and they were compared with respective 1990‐2012 figures from SEER (n = 13,573). RESULTS Mortality rates in SEE (range, 11.9‐18.5 deaths per million) were higher overall than the SEER rate (9.4 deaths per million), with decreasing trends in both regions. Survival rates increased during a comparable period (2001‐2009) in SEE and SEER. The 5‐year survival rate was considerably lower in the SEE registries (46%) versus SEER (67%), mainly because of the extremely low rates in Ukraine; this finding was consistent across age groups and diagnostic subtypes. The highest 5‐year survival rates were recorded for ependymomas (76% in SEE and 92% in SEER), and the worst were recorded for glioblastomas and anaplastic astrocytomas (28% in SEE and 37% in SEER). Advancing age, male sex, and rural residency at diagnosis adversely affected outcomes in both regions. CONCLUSIONS Despite definite survival gains over the last years, the considerable outcome disparities between the less affluent SEE region and the United States for AYAs with malignant CNS tumors point to health care delivery inequalities. No considerable prognostic deficits for CNS tumors are evident for AYAs versus children. Cancer 2017;123:4458‐71 . © 2017 American Cancer Society .