Incidence and survival of central nervous system tumors in childhood and adolescence in Girona (Spain) 1990–2013: national and international comparisons

  • S. Rivas-Vilela
  • J. Rubió-Casadevall
  • A. Fàbrega-Ribas
  • C. Joly-Torta
  • L. Vilardell
  • R. Marcos-GrageraEmail author
Research Article



Pediatric central nervous system tumors are one of the most frequent types of neoplasms in children but epidemiological data on these tumors have been sparsely reported in the medical literature.

Materials and methods

We analyze the epidemiology of this type of tumors performing a retrospective population-based study in pediatrics and adolescent age in the population of Girona and compare them with series from Spain, Europe and worldwide. Cases were registered using the International Classification of Disease for Oncology, third edition and grouping according the International Classification of Childhood Cancer, third edition (ICCC-3).


For all the histologies and the whole population between 0 and 19 years old, ASRw was 41.8 cases per million person-years. In children population, meaning under 14 years old, we found 104 cases with ASRw of 45.6. Males were the most affected by CNS tumors with a 1.2 sex ratio between 0 and 14 years old, and 1.1 between 0 and 19 years old. The analysis of trends in incidence did not find any statistically significant increase or decrease. Five-year observed survival was 68%, both for patients under 19 and 14 years of age.


The incidence in our area was among the highest in Spain and worldwide, while survival was comparable to others reported.


Childhood cancer CNS tumors Incidence Survival Cancer registries Population-based study Epidemiology 

List of abbreviations


Automated Childhood Cancer Information System


Age-standardized rate (using European Standard Population)


Age-standardized rate (using World Standard Population)


Confidence interval


Central nervous system


Death certificate only


Estimated annual percentage of change


Girona Cancer Registry


International Agency for Research on Cancer


International Classification of Disease for Oncology, third edition


International Classification of Childhood Cancer, third edition


International Incidence of Childhood Cancer


Microscopically verified


Not otherwise specified (unspecified tumors)


Observed survival



We thank Katie Linder for the review of English grammar.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The Epidemiology Unit and Girona Cancer Registry (GCR) is a statistical unit part of the Pla estadístic de Catalunya approved to produce official estiamtes of cancer incidence and mortality. The GCR studies are except of inform consent as they involve large datasets, are retrospective and observational, characteristics that make consent impractical to collect. Nonetheless, security measures are taken accordingly in order to protect patient confidentiality.


  1. 1.
    Stiller CA, Marcos-Gragera R, Ardanaz E, Pannelli F, Almar Marqués E, Cañada Martinez A, et al. Geographical patterns of childhood cancer incidence in Europe, 1988–1997. Report from the Automated Childhood Cancer Information System project. Eur J Cancer. 2006;42(13):1952–60.CrossRefGoogle Scholar
  2. 2.
    Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131(6):803–20.CrossRefGoogle Scholar
  3. 3.
    Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al. International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). Geneva: World Health Organization; 2013. p. 242.Google Scholar
  4. 4.
    Institut d’Estadística de Catalunya. Idescat. Institut d’Estadística de Catalunya. Generalitat de Catalunya.
  5. 5.
    European Network of Cancer Registries. Cited 20 Nov 2018.
  6. 6.
    Steliarova-Foucher E, Colombet M, Ries L, Hesseling P, Moreno F, Shin H, et al. International Incidence of Childhood Cancer, Volume III (electronic version). Int Agency Res Cancer. 2017. Cited 19 Nov 2018.
  7. 7.
    Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P. International classification of childhood cancer, third edition. Cancer. 2005;103(7):1457–67.CrossRefGoogle Scholar
  8. 8.
    National Cancer Institute. Joinpoint regression program. Bethesda: Statistical Research and Applications Branch, National Cancer Institute; 2015.Google Scholar
  9. 9.
    Kohler BA, Ward E, McCarthy BJ, Schymura MJ, Ries LAG, Eheman C, et al. Annual report to the nation on the status of cancer, 1975–2007, featuring tumors of the brain and other nervous system. J Natl Cancer Inst. 2011;103(9):714–36.CrossRefGoogle Scholar
  10. 10.
    Public Health England. Childhood cancer registration in England: 2015–2016. London: Public Health England; 2016.Google Scholar
  11. 11.
    Kaatsch P, Spix C. Deutsches Kinderkrebsregister Jahresbericht/Annual Report 2015. Mainz: German Childhood Cancer Registry; 2015.Google Scholar
  12. 12.
    Desandes E, Guissou S, Chastagner P, Lacour B. Incidence and survival of children with central nervous system primitive tumors in the French National Registry of Childhood Solid Tumors. Neuro Oncol. 2014;16(7):975–83.CrossRefGoogle Scholar
  13. 13.
    Papathoma P, Thomopoulos TP, Karalexi MA, Ryzhov A, Zborovskaya A, Dimitrova N, et al. Childhood central nervous system tumours: incidence and time trends in 13 Southern and Eastern European cancer registries. Eur J Cancer. 2015;51(11):1444–55.CrossRefGoogle Scholar
  14. 14.
    Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Child’s Nerv Syst. 2001;17(9):503–11.CrossRefGoogle Scholar
  15. 15.
    Peris-Bonet R, Martínez-García C, Lacour B, Petrovich S, Giner-Ripoll B, Navajas A, et al. Childhood central nervous system tumours–incidence and survival in Europe (1978–1997): report from Automated Childhood Cancer Information System project. Eur J Cancer. 2006;42(13):2064–80.CrossRefGoogle Scholar
  16. 16.
    Coll G, Combes JD, Isfan F, Rochette E, Chazal J, Lemaire JJ, et al. Incidence and survival of childhood central nervous system tumors: a report of the regional registry of childhood cancers in Auvergne–Limousin. Neurochirurgie. 2015;61(4):237–43.CrossRefGoogle Scholar
  17. 17.
    Gatta G, Peris-Bonet R, Visser O, Stiller C, Marcos-Gragera R, Sánchez M-J, et al. Geographical variability in survival of European children with central nervous system tumours. Eur J Cancer. 2017;82:137–48.CrossRefGoogle Scholar
  18. 18.
    Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, et al. SEER Cancer Statistics Review, 1975–2015. Bethesda: National Cancer Institute; 2017. Cited 6 Sep 2018. Based on November 2017 SEER data submission, posted to the SEER web site, April 2018.

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2019

Authors and Affiliations

  1. 1.Descriptive Epidemiology, Genetics and Cancer Prevention GroupBiomedical Research Institute (IDIBGI)GironaSpain
  2. 2.Medical Oncology DepartmentCatalan Institute of OncologyGironaSpain
  3. 3.School of MedicineUniversity of Girona (UdG)GironaSpain
  4. 4.Department of Neuro-surgeryUniversity Hospital Josep Trueta, Girona, Catalan Institute of HealthGironaSpain
  5. 5.Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health Government of CataloniaCatalan Institute of OncologyGironaSpain
  6. 6.CIBER Epidemiología y Salud PúblicaMadridSpain

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