Global, Regional, and National Burden of Brain and Central Nervous System Cancer, with a Secondary Analysis of Retinoblastoma, 1990-2021: Analysis for the Global Burden of Disease Study.

Abstract

Brain and central nervous system cancers represent a significant and increasing global health burden. Although biologically distinct, retinoblastoma was included as a secondary objective to assess its unique impact on pediatric populations. A comprehensive analysis of the burden of these cancers was conducted, evaluating incidence, prevalence, mortality, and disability-adjusted life years in 2021. Temporal trends in disease burden from 1990 to 2019 were analyzed using a linear regression model. To explore potential risk factors, correlations between estimated annual percentage changes (EAPCs) and age-standardized rates in 1990, along with Human Development Index scores in 2021, were assessed. Five forecasting models were applied to predict future burden. Decomposition analyses were employed to examine the factors influencing changes in disease burden between 1990 and 2021. Frontier analysis visually illustrated the potential for burden reduction in various regions based on their development levels. Brain and central nervous system cancers, along with retinoblastoma, contributed significantly to global disease burden in 2021, with children identified as high-risk populations. The disease burden varied considerably across different socio-demographic index regions, Global Burden of Disease regions, and countries. From 1990 to 2021, the number of cases increased. Projections indicated that the disease burden for both sexes would remain substantial from 2022 to 2046. Regions and countries with higher socio-demographic index exhibited greater potential for burden reduction. Spearman correlation analyses revealed a significant negative correlation between EAPCs of disability-adjusted life years and 1990 age-standardized death rates (P = 0.002), while retinoblastoma EAPCs showed a positive correlation with age-standardized rates (P < 0.001). These findings highlight the urgent need for global efforts to address brain and central nervous system cancers, with the secondary analysis of retinoblastoma emphasizing specific priorities for childhood cancer control.