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Brain tumours: incidence, survival, and aetiology
  1. P A McKinney
  1. Correspondence to:
 Dr Patricia A McKinney
 Paediatric Epidemiology Group, Unit of Epidemiology and Health Services Research, University of Leeds, 32 Hyde Terrace, Leeds LS2 9LN, UK; p.a.mckinneyleeds.ac.uk

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The term “brain tumours” refers to a mixed group of neoplasms originating from intracranial tissues and the meninges with degrees of malignancy ranging from benign to aggressive. Each type of tumour has its own biology, treatment, and prognosis and each is likely to be caused by different risk factors. Even “benign” tumours can be lethal due to their site in the brain, their ability to infiltrate locally, and their propensity to transform to malignancy. This makes the classification of brain tumours a difficult science and creates problems in describing the epidemiology of these conditions. Public perception generally fails to distinguish between different tumour subtypes and although treatments and prognosis may vary, the functional neurological consequences are frequently similar. This article will give an overview of the burden of brain tumours in the population, looking at the major subtypes where possible, in addition to giving a summary of current views on possible causes.

INCIDENCE

The descriptions in this paper focus on primary tumours of the brain. It excludes data on spinal cord tumours, metastatic tumours, whose origins are external to the central nervous system, and primary brain lymphomas, which are essentially haematological malignancies.

Malignant tumours of the brain are a rare occurrence accounting for approximately 2% of all cancers in adults. Approximately 4400 people are newly diagnosed with a brain tumour each year in the UK compared to over 40 000 women with breast cancer and approximately 25 000 men with prostate cancer. Figure 1 shows additional comparative data for different cancers. The overall annual incidence rate of all brain tumours is 7 per 100 000 population. UK data are listed in table 1.

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Table 1

Brain and central nervous system tumours: UK incidence 1999

Figure 1

UK incidence 1999: cancers which contribute 1% or more to total cancer burden.

The greatest proportion of adult tumours …

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