Global Disease Burden, Trends, and Inequalities of Brain and Central Nervous System Cancers, 1990-2021: A Population-Based Study with Projections to 2036.

Abstract

Brain and central nervous system (CNS) cancers pose a significant global health challenge, with marked regional variations. Updated evidence is essential to optimize resource allocation and inform targeted interventions. Data from the Global Burden of Disease 2021 were systematically analyzed, including incidence, mortality, and disability-adjusted life years (DALYs), along with their corresponding age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR). Temporal trends were evaluated using Joinpoint regression, health disparities were assessed with inequality metrics, and burden contributors were identified through decomposition analysis. Future trends were projected using Bayesian age-period-cohort models. Over the past 30 years, CNS cancer incidence rose by 106.52%, DALYs by 49.59%, and mortality by 89.87%. High-Socio-Demographic Index (SDI) regions (e.g., Europe, North America, East Asia) reported the highest ASIR, with aging as the primary driver of increasing DALYs and mortality. In low-SDI regions (e.g., Africa, Latin America), population growth was the leading contributor to the rising burden. Although ASDRs and ASMRs have declined in high-SDI regions, significant increases have been detected among individuals aged 65 years and more. Low-SDI regions continue to bear a heavy disease burden, particularly among those aged more than 10 years. Disparities across SDI levels are projected to widen, especially in low-income areas. Nonetheless, advances in neuroscience suggest declines in ASIR, ASDR, and ASMR over the next 15 years. The growing CNS cancer burden highlights the urgent need for targeted interventions. Enhancing healthcare access and bolstering prevention and treatment in underserved regions are critical priorities.