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BRAIN TUMORS
There are many different types of brain tumors. No matter what type of brain tumor you are told you have your life is dramatically altered. Brain tumors are not unusual. Among adults primary brain tumors are the sixth frequent of all cancers. Metastatic brain tumors are being seen more frequently due to the fact that systemic tumors are being controlled.
INCIDENCE
There are approximately 12 primary brain tumors per 100,000 people annually in the United States, or 29,000 individuals. There may be as many as 125,000 people with metastatic brain tumors or 50 per 100,000. Primary brain tumors account for 2% of cancer deaths and are responsible for 7% of the years of life lost from the cancer before the age of 70. Of all the deaths in the western world 30% are due to cancer and 20% of these will have intracranial disease. Mortality rate from primary brain tumors varies in the United States and is highest for males, Caucasian and rises until 70 years of age. The incidence of brain tumors peaks at two years old, declines, starts to rise at 10 years of age doubling after 40 years old peaking to a rate of 20 per 100,000 at age 70. The age standardized incidence rate for malignant CNS male tumors is highest in Israel for males born in Europe and America followed by New Zealand, Sweden, Caucasians in Los Angeles and lowest in males from Hawaii, Bombay, India and Myagi, Japan. For woman it is highest in Israel if the females are born in Israel, followed by Iceland, Sweden, New Zealand and then Israelis born in Europe and America, followed by Caucasians from Los Angeles. It is lowest in females from Osaka, Myagi and finally lowest in females from Bombay, India.
Tumors may be coming more prevalent in our society from the 1970's, possible due to earlier testing and more sensitive diagnostic tests. The incidence of different types of primary brain tumors varies with age with malignant gliomas and meningiomas the most common primary tumors in adults. Medulloblastomas and malignant astrocytomas are more common in children. Meningiomas and pituitary adenomas occur more in woman and more in blacks than whites. There are other less known tumors.
RISK OF BRAIN TUMORS
Most types of brain tumors are not inherited. Familial occurrences are seen in neurofibromatosis Type I and II, tuberous sclerosis, Von Hippel-Lindau disease, Bourneville's disease, Li-Fraumeni tumor syndrome, ataxia telangiectasia, Gorlin syndrome and Turcot syndrome. These syndromes are rare. There have been many investigations into what can cause brain tumors. There may be a higher risk among female stroke victims and meningiomas and glioblastomas, epilepsy and brain tumors as well as trauma and meningiomas. In utero radiation may lead to increased childhood and adult CNS tumors. Children irradiated for tinea capitis have an increased risk of meningiomas and gliomas. With high dose radiation, adults demonstrate an increased risk of meningioma. CNS tumors have been shown to be slightly increased in almost any occupation including electronics, oil refining, rubber workers, air plane manufacturing, pharmaceutical, artist, embalmers, statisticians and mathematicians. It appears that nobody is safe from brain tumors. Tumors have been related to consumption of N- nitrosyl compounds, fried bacon, passive smoking, and (Continued on page 38)
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