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Incidence of brain tumours

Brain scan showing a single metastasis, masquerading as a primary brain tumour
Brain scan showing a single metastasis, masquerading as a primary brain tumour
 

The primary tumours of the brain/central nervous system (CNS) i.e. those that originate within the brain/spinal cord, are a mixed group of tumours, some of which are benign and some are malignant, the latter carrying a high risk of death. Following some general remarks, each group will be discussed in turn.

 

The incidence of tumours of the central nervous system is approximately 15 per 100,000 and they account for approximately 2% of all deaths in Western society. Curiously, there is one age peak of incidence in youth (in the age range 5-10 years) and a second one in the sixth decade of life. In general, the incidence of brain tumours occurs throughout life rather than being concentrated in the elderly as for many carcinomas. For some tumours (such as germ cell tumours and medulloblastoma) there is a male preponderance of incidence, whereas for some others (e.g. meningioma) there is a female predisposition.

 

Of tumours presenting to a neurosurgical service in the U.K., and apparently as primary brain tumours, the breakdown by tumour types is as follows: glioma 45%, meningioma 15%, acoustic neuroma 8%, pituitary adenoma and craniopharyngioma 8%.

 

Metastases (i.e. secondary spread of cancer which started outside the brain - but here masquerading as primary brain tumours) appear as high as 15%-20% of 'apparently' primary brain tumours (i.e. at time of presentation: no evidence of a primary outside the brain even though this will ultimately be found).

 

Other rarer forms of primary brain tumours account for up to 10% of the total.

 

In the community at large, the incidence of metastatic brain disease is higher (the point here being that many cases of brain metastases are managed outside a neurosurgical unit).


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