RESULTS
We identified 8713 cases newly diagnosed with brain and CNS tumor from 2000-2015. 56.75% were non-Hispanic whites, 9.59% were non-Hispanic black, 25.46% were Hispanic, and 8.19% belong to “Other” race (Table 1). The majority of cancer diagnoses were children aged 0-4 years (31.49%). The age at diagnosis differed significantly by race/ethnicity (p<0.0001). 53.81% of children diagnosed with brain tumor were males and 46.19% were females. We identified no significant differences in the distribution of patients by gender among the four racial groups (p=0.0660). Yost quintile was significantly different by race (p<0.0001). Non-Hispanic blacks had the largest proportion (35.05%) belonging to Yost quintile Group 1, with non-Hispanic whites having the largest proportion (19.82%) in Group 3, and Other with the largest proportion (32.07% ) in Group 5.
Pilocytic astrocytoma was the most common histological type of tumor (30.08%) and diffuse astrocytoma (protoplasma, fibrillary). The histological type of tumor differed significantly by racial group (p<.0001). Non-Hispanic Whites had the highest proportion of pilocytic astrocytoma and diffuse astrocytoma (protoplasma, fibrillary) and mixed glioma tumor types, Hispanics had the largest proportion of ependymoma/anaplastic ependymoma/ependymoma variants and embryonal/primitive/ medulloblastoma tumor types, and non-Hispanic blacks had the largest proportion of astrocytoma NOS and unique variants and glioma NOS tumor types.
By tumor stage, the majority (78.56%) were localized, with a lesser proportion of tumors being regional (11.61%), distant (6.09%), or unknown/unstaged (3.73%). The racial groups differed by tumor stage (p=0.0003). The grade of the majority (68.72%) of tumors was not described as CNS tumor grade is inferred by name, 16.93% of tumors were described as high grade, and 14.35%, low grade tumors. Significant differences (p=0.0043) were also noted across racial/ethnic groups by tumor grade.
Regarding cancer therapy, among the cases with information on treatment received, we observed a larger proportion of patients having surgery (76.85%) than chemotherapy (41.54%) or radiation (39.60%). We noted significant differences (p<0.0001) in cancer therapy received by the racial/ethnic groups for all three treatment modalities. Hispanics had the largest proportion of patients receiving chemotherapy or radiation therapy with non-Hispanic whites having large proportions of patient not receiving chemotherapy or radiation therapy / status unknown. Non-Hispanic blacks had the largest proportion of patients who received no form of surgical therapy/ surgery status unknown.