ORIGINAL ARTICLE Brain Tumor Res Treat 2013;1:16-23 / Print ISSN 2288-2405 / Online ISSN 2288-2413 An Updated Nationwide Epidemiology of Primary Brain Tumors in Republic of Korea Kyu-Won Jung1, Johyun Ha1, Seung Hoon Lee2, Young-Joo Won1, Heon Yoo2 1Cancer Registration and Statistics Branch, 2Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea Received April 12, 2013 Objective The aim of this report is to provide accurate nationwide epidemiologic data on prima- Accepted April 19, 2013 ry brain and central nervous system (CNS) tumors in Republic of Korea. In 2010, we had reported first nationwide epidemiologic data on primary brain tumors diagnosed in 2005. In this report, we updated Correspondence Heon Yoo the data by analyzing primary brain and CNS tumors diagnosed in 2010 using the data from national Neuro-Oncology Clinic, cancer incidence database. National Cancer Center, Methods Data on primary brain and CNS tumors diagnosed in 2010 were collected from the 323 Ilsan-ro, Ilsandong-gu, Korean Central Cancer Registry. Crude and age-standardized rates were calculated in terms of gen- Goyang 410-769, Korea der, age, and histological type. Tel: +82-31-920-2435 Fax: +82-31-920-1520 Results A total of 10,004 patients diagnosed with primary brain and CNS tumors in 2010 were E-mail: [email protected] included in this study. Brain and CNS tumors occurred in females more often than in males (female to Correspondence male, 1.59 : 1). The most common tumor was meningioma (35.5%). Pituitary tumors (18.7%), gliomas Young-Joo Won (15.1%), and nerve sheath tumors (10.3%) were followed in incidence. Glioblastoma accounted for Cancer Registration and 34.6% of all gliomas. In children (<20 years), sellar region tumors (pituitary and craniopharyngioma), Statistics Branch, National Cancer embryonal/primitive/medulloblastoma, and germ cell tumors were the most common tumors. Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea Conclusion Data from this study should provide valuable information regarding the primary brain Tel: +82-31-920-2015 tumors epidemiology in Republic of Korea. Fax: +82-31-920-1520 E-mail: [email protected] Key Words Epidemiology; Brain; Central nervous system; Tumor; Registry; Korea. INTRODUCTION excluding benign and borderline tumors. Since benign brain tumors can recur and may be inopera- Primary brain and central nervous system (CNS) tumors ble, non-malignant brain tumors may impose the same cost are not common. However, the incidence of brain and CNS on the society in terms of medical care and case fatality as tumors has increased gradually [1-3]. These tumors may re- malignant brain tumors. sult in mental alteration and neurologic deficits, and the so- In order to include benign and borderline tumors of the br- cial burden of brain tumors is just as large as that of other tu- ain and CNS, the KCCR revised its criteria for cancer registr- mors. An accurate understanding of the epidemiology is ne- ation in 2004, and started national collection of nonmalignant eded to facilitate early detection and treatment. Many coun- brain tumors since 2005. As a result, there was a first nation- tries have established brain tumor registries, and their desc- wide epidemiologic report in 2010 by analyzing registered tu- riptive epidemiology have been reported [1,2,4-7]. mors in 2005 [9]. In this report, we updated the data by ana- The Korean Ministry of Health and Welfare started a na- lyzing primary brain and CNS tumors diagnosed in 2010 us- tionwide, hospital-based cancer registry (Korea Central Can- ing the data from the KCCR. cer Registry, KCCR) in 1980. In 2005, the first national can- The objective of this report is to provide an accurate nation- cer incidence between 1999 and 2001 were reported by the wide incidence of primary malignant and nonmalignant brain KCCR [8]. The KCCR database was especially useful for sh- tumors in Korean by sex, age group, topography and histologi- owing trends of cancer occurrence in Republic of Korea. How- cal type. ever, it only provided the incidence of malignant brain tumors, 16 Copyright © 2013 The Korean Brain Tumor Society and The Korean Society for Neuro-Oncology Table 1. Incidence rates of primary brain and CNS tumors by histology and sex, Republic of Korea, 2010 Male Female Total Histology N CR ASR N CR ASR N % Age* CR ASR Tumors of neuroepithelial tissue 823 3.30 3.15 689 2.77 2.49 1,512 15.1 48.2 3.03 2.81 Pilocytic astrocytoma 34 0.14 0.17 36 0.14 0.19 70 0.7 15.4 0.14 0.18 Diffuse astrocytoma 5 0.02 0.02 4 0.02 0.01 9 0.1 54.7 0.02 0.02 Anaplastic astrocytoma 72 0.29 0.23 51 0.20 0.16 123 1.2 47.7 0.25 0.20 Unique astrocytoma variants 11 0.04 0.04 14 0.06 0.05 25 0.2 44.8 0.05 0.05 Astrocytoma, NOS 54 0.22 0.20 51 0.20 0.18 105 1.0 43.9 0.21 0.19 Glioblastoma 287 1.15 0.89 236 0.95 0.67 523 5.2 60.1 1.05 0.77 Oligodendroglioma 27 0.11 0.09 32 0.13 0.11 59 0.6 45.7 0.12 0.10 Anaplastic oligodendroglioma 29 0.12 0.09 20 0.08 0.07 49 0.5 48.2 0.10 0.07 Ependymoma/anaplastic ependymoma 46 0.18 0.18 44 0.18 0.18 90 0.9 43.4 0.18 0.18 Ependymoma variants 9 0.04 0.04 7 0.03 0.03 16 0.2 30.7 0.03 0.03 Mixed glioma 24 0.10 0.07 18 0.07 0.05 42 0.4 45.6 0.08 0.06 Glioma malignant, NOS 72 0.29 0.28 65 0.26 0.23 137 1.4 42.3 0.27 0.25 Choroid plexus 14 0.06 0.10 11 0.04 0.06 25 0.2 18.5 0.05 0.08 Neuroepithelial 15 0.06 0.06 11 0.04 0.04 26 0.3 53.2 0.05 0.05 Non-malignant and malignant neuronal/glial, neuronal and mixed 62 0.25 0.27 51 0.20 0.24 113 1.1 24.9 0.23 0.26 Pineal parenchymal 10 0.04 0.05 10 0.04 0.03 20 0.2 45.6 0.04 0.04 Embryonal/primitive/medulloblastoma 52 0.21 0.36 28 0.11 0.20 80 0.8 8.6 0.16 0.28 Tumors of cranial and spinal nerves 466 1.87 1.45 569 2.28 1.69 1,035 10.3 52.6 2.07 1.57 Nerve sheath, non-malignant and malignant 466 1.87 1.45 569 2.28 1.69 1,035 10.3 52.6 2.07 1.57 Other tumors of cranial and spinal nerves - - - - - - - - - - - Tumors of meninges 888 3.56 2.79 2,866 11.51 7.71 3,754 37.5 60.0 7.53 5.35 Meningioma 781 3.13 2.44 2,769 11.12 7.39 3,550 35.5 60.5 7.12 5.02 Other mesenchymal, non-malignant and malignant 28 0.11 0.10 35 0.14 0.13 63 0.6 40.1 0.13 0.11 KW Jungetal. Hemangioblastoma 79 0.32 0.25 62 0.25 0.19 141 1.4 49.0 0.28 0.22 Lymphomas and hemopoietic neoplasms 95 0.38 0.30 67 0.27 0.18 162 1.6 61.7 0.32 0.24 17 Lymphoma 95 0.38 0.30 67 0.27 0.18 162 1.6 61.7 0.32 0.24 18 Epidemiology of Primary Brain Tumors inRepublicofKorea Tumors Epidemiology ofPrimaryBrain Table 1. Continued Brain Tumor Res Treat 2013 Treat Res Tumor Brain Male Female Total Histology N CR ASR N CR ASR N % Age* CR ASR Germ cell tumors, and cysts 66 0.26 0.33 20 0.08 0.11 86 0.9 16.8 0.17 0.23 Germ cell tumors, cysts and heterotopias 66 0.26 0.33 20 0.08 0.11 86 0.9 16.8 0.17 0.23 Tumors of sellar region 899 3.60 2.85 1,104 4.43 3.57 2,003 20.0 48.9 4.02 3.17 Pituitary 833 3.34 2.61 1,040 4.18 3.31 1,873 18.7 49.2 3.76 2.92 Craniopharyngioma 66 0.26 0.24 64 0.26 0.26 130 1.3 42.9 0.26 0.25 ; 1 : Local extensions from regional tumors 4 0.02 0.01 4 0.02 0.02 8 0.1 48.8 0.02 0.01 16-23 Chordoma/chondrosarcoma 4 0.02 0.01 4 0.02 0.02 8 0.1 48.8 0.02 0.01 Unclassified tumors 620 2.48 2.13 824 3.31 2.39 1,444 14.4 55.0 2.89 2.27 Hemangioma 80 0.32 0.30 77 0.31 0.26 157 1.6 44.0 0.31 0.28 Neoplasm, unspecified 531 2.13 1.79 741 2.98 2.09 1,272 12.7 56.9 2.55 1.95 All others 9 0.04 0.03 6 0.02 0.04 15 0.1 31.8 0.03 0.03 Total 3,861 15.46 13.01 6,143 24.67 18.16 10,004 100.0 54.4 20.06 15.65 *Median age at diagnosis.