Epidemiology of Brain and Other Central Nervous System Cancers in the North Africa and Middle East Region: A Systematic Analysis of the Global Burden of Disease Study 1990-2019

Esmaeil Mohammadi; Sahar Saeedi Moghaddam; Sina Azadnajafabad; Seyed Farzad Maroufi; Mohammad-Mahdi Rashidi; Mohammadreza Naderian; Ali Jafari; Guive Sharifi; Erfan Ghasemi; Nazila Rezaei; Mohammad-Reza Malekpour; Farzad Kompani; Negar Rezaei; Bagher Larijani; Farshad Farzadfar

doi:10.1016/j.wneu.2022.12.112

Epidemiology of Brain and Other Central Nervous System Cancers in the North Africa and Middle East Region: A Systematic Analysis of the Global Burden of Disease Study 1990-2019

World Neurosurg. 2023 Mar:171:e796-e819. doi: 10.1016/j.wneu.2022.12.112. Epub 2022 Dec 28.

Authors

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
² Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Kiel Institute for the World Economy, Kiel, Germany.
³ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ Division of Hematology and Oncology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism, Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism, Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism, Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: f-farzadfar@tums.ac.ir.

PMID: 36586579
DOI: 10.1016/j.wneu.2022.12.112

Abstract

Objective: To present estimates of prevalence and incidence of and contributors to central nervous system (CNS) cancers, death, years of life lost, years lived with disability, and disability-adjusted life years from 1990 to 2019 in North Africa and the Middle East.

Methods: Primary measures were retrieved from Global Burden of Disease 2019. Contribution of various factors to observed incidence and mortality changes was investigated with decomposition and age-period-cohort analyses.

Results: In 2019, 27,529 (95% uncertainty interval [UI]: 18,554-32,579; percent change compared with 1990: +152.5%) new CNS cancers and 17,773 (95% UI:12,096-20,936; percent change compared with 1990: +111.5%) deaths occurred. Meanwhile, 71.0% increase led to 71,6271 (95% UI: 493,932-848,226) disability-adjusted life years in 2019 with a halved years of life lost/years lived with disability ratio of 66.3% (proxy of worse care quality). Altogether, 97,195 (95% UI: 64,216-115,621; percent change compared with 1990: +280.5%) patients with prevalent cases were alive in 2019. All decomposed indices, including aging, cause-specific incidence, and population growth, contributed substantially to increased incidence of CNS cancers. Moreover, age brackets, study period (1990-2019), and 5-year cohorts all demonstrated positive effects, while age had a mixed influence in different age groups. Palestine harbored the highest age-standardized disability-adjusted life years rate in 2019 (232.0 [95% UI: 175.6-279.5]), while Tunisia had the lowest (41.8 [95% UI: 27.6-57.1] per 100,000). The greatest burden increase was found in Saudi Arabia (32.3%).

Conclusions: The burden of CNS cancers is rising in North Africa and the Middle East, with major heterogeneities among countries. Improved early detection and health care access across countries are required to bridge inequalities and address the rising burden of CNS malignancies.

Keywords: Brain and other central nervous system cancers; Brain tumor; Epidemiology; Glioblastoma multiforme; Glioma; Global burden of disease; North Africa and Middle East region; Spinal cord tumor.

MeSH terms

Brain
Central Nervous System
Central Nervous System Neoplasms*
Early Detection of Cancer
Global Burden of Disease*
Global Health
Humans
Incidence
Middle East
Prevalence
Quality-Adjusted Life Years
Tunisia