Survival from Brain Tumours in Children: A Systematic Review of Geographical Variation and Time Trends

2019 ◽  
Author(s):  
Fabio Girardi ◽  
Claudia Allemani ◽  
Michel P. Coleman
2019 ◽  
Author(s):  
Fabio Girardi ◽  
Claudia Allemani ◽  
Michel P Coleman

Abstract Background Brain tumours represent an important cause of cancer-related death in adolescents and young adults. Most are diagnosed in low-income and middle-income countries. We aimed to conduct the first systematic review of time trends and geographical variation in survival in this age group. Methods We included observational studies describing population-based survival from astrocytic tumours in patients aged 15-39 years. We queried six electronic databases from database inception to 30 September 2018. This review is registered with PROSPERO, number CRD42018111981. Results Among 5,245 retrieved records, 20 studies fulfilled the inclusion criteria. Only one study was partly conducted in middle-income countries. Five-year survival from astrocytoma (broad morphology group) varied between 48% and 71% (1973-2004), without clear trends or geographic differences. Adolescents with astrocytoma had better outcomes than young adults, but survival values were similar when non-malignant tumours were excluded. During 2002-2007, five-year survival for WHO grade I-II tumours was in the range 75-93% in England, Germany, and the US, but lower in South-Eastern Europe (59%). Five-year survival for anaplastic astrocytoma varied between 40% and 55% (2002-2007). Five-year survival from glioblastoma was in the range 15-23% (1991-2009). Conclusions Survival from astrocytic tumours remained somewhat steady over time, with little change between 1973 and 2009. Survival disparities were difficult to examine, because nearly all the studies were conducted in affluent countries. Studies often adopted the International Classification of Childhood Cancer, which, however, did not allow to accurately describe variation in survival. Larger studies are warranted, including under-represented populations and providing more recent survival estimates. Keywords Population-based survival, brain tumours, adolescents, young adults, time trends.


1992 ◽  
Vol 37 (4) ◽  
pp. 112-115 ◽  
Author(s):  
W.C.S. Smith ◽  
W.J. Mutch

Parkinson's disease is a common and disabling condition which principally affects the elderly. The time and space distribution of Parkinson's disease has been examined to determine if it provides clues as to aetiology and factors affecting its distribution. Previous studies have used mortality data,1 data from epidemiological studies,2 and pre scribing information particularly with regard to the use of levodopa.3 These studies have looked within countries and between countries.


2021 ◽  
Author(s):  
Hanifa Bouziri ◽  
Alexis Descatha ◽  
Yves Roquelaure ◽  
William Dab ◽  
Kévin Jean

Background: Musculoskeletal disorders (MSDs) accounted for nearly 1.71 billion people worldwide in 2019 with an estimate of over 126.6 million Americans (or one in two adults) affected and 40 million European workers in 2017. Since age constitutes an important risk factor for MSDs, the overall aging of the working population is expected to influence the burden of disease. However, factors other than aging may play a role in the global trends in MSDs We conducted a systematic review to summarize the evidence on the role of demographic and temporal changes in the occurrence of MSDs. Methods: The study protocol was registered in PROSPERO with the number CRD42020221499. Following the PRISMA guidelines, we searched PubMed, ScienceDirect and Web of Science over the 1990-2020 period for articles reporting temporal trends in MSDs incidence or prevalence in the general working-age population. We only included articles controlling for age in the analysis. To ensure the quality of the articles, the bias risk was assessed using the RoB-SPEO tool. The main indicators we extracted were age-controlled time trends in MSDs incidence or prevalence. Results: Among 966 articles, 16 fulfilled the inclusion criteria, representing 23 results according to the indicators extracted. No study was found with a high risk of bias. Nine used a definition of MSDs based on pain and 14 based on repercussions on work or social life. Twelve results presented time trends in prevalence and 11 in incidence. After controlling for age, temporal trends in MSDs presented some heterogeneity. Indeed, 10 results documented increases and 12 reported non-monotonic changes. Only 1 result reported a decreasing trend in the incidence of MSDs. Several factors other than aging were suggested to explain temporal trends in MSDs, mainly trends in obesity, changing occupational exposures, and cultural factors regarding pain tolerance. Conclusion: This review shows that factors in addition to aging of the working population may contribute to varying or increasing trends in MSDs. Results also highlight the scarcity of available evidence on time trends in the burden of MSDs and their underlying causes.


2006 ◽  
Vol 13 (6) ◽  
pp. 222-229 ◽  
Author(s):  
J. Perry ◽  
L. Zinman ◽  
A. Chambers ◽  
K. Spithoff ◽  
N. Lloyd ◽  
...  

Questions: Should patients with newly diagnosed brain tumours receive prophylactic anticonvulsants to reduce seizure risk? What is the best practice for patients with brain tumours who are taking anticonvulsant medications but who have never had a seizure? Perspectives: Patients with primary or metastatic brain tumours who have never had a seizure still have a 20% risk of experiencing a seizure over the course of their disease. Because considerable practice variation exists in regard to the management of patients with brain tumours who have never had a seizure, and because conflicting evidence has been reported, the Neuro-oncology Disease Site Group (DSG) of Cancer Care Ontario’s Program in Evidence-based Care felt that a systematic review of the evidence was warranted. Outcomes: Outcomes of interest were incidence of seizures and adverse effects of prophylactic anticonvulsant therapy. Methodology: The MEDLINE and Cochrane Library databases were systematically searched for relevant evidence. The review included fully published reports or abstracts of randomized controlled trials (RCTs), systematic reviews, meta-analyses, and practice guidelines. The present systematic review was reviewed and approved by the Neuro-oncology DSG, which comprises medical and radiation oncologists, surgeons, neurologists, a nurse, and a patient representative. Results: Quality of Evidence: The literature search located one evidence-based practice guideline, one systematic review, and five RCTs that addressed prophylactic anticonvulsants for patients with brain tumours. Evidence for the best management of seizure-naïve patients who are already taking anticonvulsants was limited to one retrospective study and exploratory analyses within several RCTs. Benefits and Harms: Pooled results of the five RCTs suggest that the incidence of seizures in patients who receive prophylactic anticonvulsants is not significantly different from that in patients who do not receive anticonvulsants (relative risk: 1.04; 95% confidence interval: 0.70 to 1.54; p = 0.84). This analysis accords with results from a published meta-analysis. Evidence is insufficient to determine whether patients who are currently taking anticonvulsants but who have never had a seizure should taper the anticonvulsants. Patients who received anticonvulsants reported adverse effects, including rash, nausea, and hypotension, but whether these effects are a result of the anticonvulsants or of other treatments could not be determined. Conclusions: Based on the available evidence, the routine use of postoperative anticonvulsants is not recommended in seizure-naïve patients with newly diagnosed primary or secondary brain tumours, especially in light of a significant risk of serious adverse effects and problematic drug interactions. Because data are insufficient to recommend whether anticonvulsants should be tapered in patients who are already taking anticonvulsants but who have never had a seizure, treatment must be individualized.


2018 ◽  
Author(s):  
Timothy H. Parker ◽  
Emma Greig ◽  
Shinichi Nakagawa ◽  
Marcelina Parra ◽  
Anthony Dalisio

To understand the implications of geographical variation in vocal culture in songbirds, researchers have often compared territorial responses to playback of local songs versus responses to playback of songs from ‘foreign’ conspecifics. This body of work has the potential to help us move towards a general understanding of factors driving divergence in signal recognition. We conducted a systematic review and meta-analysis of 57 playback studies to explain variation in strength of response to local versus foreign songs. Studies with incomplete reporting of results had elevated effects due to selective reporting. Studies that used small numbers of stimuli as exemplars (pseudoreplication) had more variable effects than studies without severe pseudoreplication. Whether or not we controlled for pseudoreplication, we found greater response to playback of local song than to foreign song. In investigating potential biological drivers of the variation in strength of experimental effects, we found that the difference in territorial response to local versus foreign song was stronger if the foreign song was recorded from another subspecies than if the foreign song was recorded from the same subspecies as the focal individuals. Indexes of risk of accidental response to heterospecific song did not coherently explain response to foreign conspecific songs, nor did factors expected to influence individual experience with foreign conspecific songs. Thus, although oscine songbirds clearly react more aggressively to local song than to foreign song and variation in the strength of this effect is influenced by methodological choices and subspecies status, considerable variation in the strength of response to local versus foreign song playback remains to be explained.


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