Prevalence, incidence, mortality, and MIR in the globe and Asia in both sexes
Worldwide, there were 837,152 cases of brain and CNS cancers diagnosed within the previous five years in 2020, with a 5-year prevalence rate of 10.70 per 100,000. Moreover, there were 308,102 estimated new cases of brain and CNS cancers in 2020 (95% UI: 295,692.0–321,033.0), indicating a crude rate of 4.00 per 100,000, an ASIR value of 3.50 per 100,000, and a cumulative risk of 0.61%. In 2020, brain and CNS cancers led to 251,329 estimated deaths worldwide (95% UI: 244,434.0–258,418.0), representing a crude rate of 3.20 per 100,000, an ASMR of 2.80 per 100,000, and a cumulative risk of 0.54%. Accordingly, we measured the MIR of brain and CNS cancers equal to 0.80 globally (Table 1).
In Asia, the estimated 5-year prevalence rate of brain and CNS cancers was 9.40 per 100,000, indicating a total of 435,532 cases. Additionally, 166,925 new cases were estimated of brain and CNS cancers (95% UI: 159,699.0–174,478.0), representing a crude rate of 3.60 per 100,000, an ASIR value of 3.20 per 100,000, and a cumulative risk of 0.52%. These cancers led to 137,646 estimated deaths in Asia in 2020 (95% UI: 131,171.0–144,440.0), resulting in a crude rate of 3.00 per 100,000, an ASMR of 2.60 per 100,000, and a cumulative risk of 0.47%. The MIR of these cancers was 0.83 in Asia (Table 1).
Among Asian countries, Armenia and Bangladesh, with estimated 5-year prevalence rates of 25.92 and 1.80, had the highest and lowest values, respectively (Fig. 1A). Additionally, Armenia had the highest ASIR per 100,000 (7.40), followed by Iran (7.20), Georgia (6.30), and Turkey (6.30) (Fig. 1B). The ASMR values were highest in Armenia, Iran, and Turkey at 6.20, 6.20, and 5.10 per 100,000, respectively (Fig. 1C). Country-specific metrics in Asia in both sexes are provided in Table 2.
Distribution of (A) five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of brain and central nervous system cancers among both sexes in Asia in 2020.
Age patterns
The 70 + age group accounted for the highest crude incidence rate (12.70 per 100,000) and crude mortality rate (12.20 per 100,000) in both sexes in Asia (Table 3). In terms of MIR, this age group also presented the highest MIR, 0.96. Moreover, people within the age range of 10–19 years presented the lowest crude incidence rate (1.00 per 100,000) and crude mortality rate (0.60 per 100,000). The lowest MIR belonged to the 0–9 age group (0.53). There were minimal variations in the incidence (Fig. 2A) and mortality rates (Fig. 2B) of brain and CNS cancers until the age of 40–49, after which there was a substantial increase in both incidence and mortality rates. The number of incident cases decreased up to the 15–19 year age group, then increased to the 55–59 year age group, and peaked in the 70 + year age group (Fig. 2A). Deaths generally exhibited an increasing trend with advancing age (Fig. 2B).
(A) Incident numbers and incidence rate, and (B) mortality numbers and mortality rate of brain and central nervous system cancers among males and females in each age group in Asia in 2020. The column bars represent the numbers of incident cases and deaths related to the left y-axis. The lines represent the incidence and mortality rates related to the right y-axis.
Sex patterns
Men
In 2020, the estimated 5-year prevalence rate was 9.40 per 100,000 men in Asia. Our study also highlighted a total of 91,992 new male cases were estimated of brain and CNS cancers (95% UI: 86,579.5–97,742.8), representing a crude rate of 3.90 per 100,000, an ASIR of 3.50 per 100,000, and a cumulative risk of 0.59%. With respect to the mortality of Asian men, brain and CNS cancers resulted in 76,169 estimated deaths in 2020 (95% UI: 71,192.7–81,493.1). The crude mortality rate was estimated 3.20 per 100,000, with an ASMR of 2.90 per 100,000 and a cumulative risk of 0.53%. We measured the MIR of brain and CNS cancers as 0.82 in men in Asia (Table 1). Similar to the total population, the 70 + year age group presented the highest crude rates of incidence (14.50) and mortality (13.90) in men (Table 3).
Among Asian countries, the highest 5-year prevalence rate in men was 28.70 per 100,000, as estimated in Armenia (Fig. 3A, Fig. S1, and Supplementary File 1). Armenia (9.60), Iran (8.00), Georgia (7.50), and Turkey (7.20) presented the highest estimated ASIRs per 100,000 men (Fig. 3B, Fig. S2, and Supplementary File 1). The countries with the largest ASMRs in men also included Armenia (7.90), Iran (6.90), Georgia (6.00), and Turkey (6.00) per 100,000 (Fig. 3C, Fig. S3, and Supplementary File 1).
(A) Five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of brain and central nervous system cancers in Asia in 2020, by country and sex.
Women
Among women, the estimated 5-year prevalence rate of these cancers was 9.40 per 100,000. In this regard, 74,933 new cases were estimated of brain and CNS cancers (95% UI: 70,236.4–79,943.6). The crude incidence rate among women was 3.30 per 100,000, the ASIR was 2.80 per 100,000, and the cumulative risk was 0.46%. Brain and CNS cancers also led to 61,477 deaths among Asian women in 2020 (95% UI: 57,294.0–65,965.4), with a crude mortality rate of 2.70 per 100,000, an ASMR of 2.30 per 100,000, and a cumulative risk of 0.41%. The MIR of brain and CNS cancers was 0.82 in women, which was the same as that in men (Table 1). Moreover, compared with the total population and men, the 70 + age group presented the highest crude rates of incidence (11.10) and mortality (10.80) among the other age groups (Table 3).
The highest 5-year prevalence rate in women was 23.70 per 100,000, as estimated in Georgia (Fig. 3A, Fig. S4, and Supplementary File 1). The Asian countries with the highest values of ASIRs (per 100,000) were as follows: Iran (6.40), Armenia (5.80), Turkey (5.60), and Georgia (5.40) (Fig. 3B, Fig. S5, and Supplementary File 1). Furthermore, the countries with the highest ASMRs of women included Iran (5.50), Armenia (4.80), Iraq (4.50), Turkey, and Georgia (both 4.30) (Fig. 3C, Fig. S6, and Supplementary File 1).
Correlations with the HDI and CHE/GDP%
The HDI demonstrated a significant strong negative correlation with MIR (correlation coefficient: – 0.538, p value < 0.001; Fig. 4C). We also found moderately significant positive correlations between CHE/GDP% and ASIR (correlation coefficient: 0.388, p value: 0.010; Fig. 4D) and between CHE/GDP% and ASMR (correlation coefficient: 0.373, p value: 0.014; Fig. 4E). However, no significant correlations were found between HDI and ASIR (p value: 0.603, Fig. 4A) or ASMR (p value: 0.746, Fig. 4B) or between CHE/GDP% and MIR (p value: 0.806, Fig. 4F).
Association of human development index (HDI) with (A) age-standardized incidence rate (correlation coefficient: 0.079, p value: 0.603), (B) age-standardized mortality rate (correlation coefficient: -0.049, p value: 0.746), and (C) mortality-to-incidence ratio (correlation coefficient: − 0.538, p value < 0.001). Association of the current healthcare expenditure to gross domestic product (CHE/GDP%) with (D) age-standardized incidence rate (correlation coefficient: 0.388, p value: 0.010), (E) age-standardized mortality rate (correlation coefficient: 0.373, p value: 0.014), and (F) mortality-to-incidence ratio (correlation coefficient: 0.039, p value: 0.806) of brain and central nervous system cancers in Asia in 2020.
Projections to 2040
We estimated that the number of newly diagnosed cases of brain and CNS cancers in Asia will increase by 39.30%, from 166,925 in 2020 to 232,000 cases in 2040 (Fig. 5A). Similarly, deaths caused by brain and CNS cancers are estimated to increase by 45.00%, from 137,646 in 2020 to 200,000 deaths in 2040 (Fig. 5B). There is a need for annual decreases of more than 1.60% in incidence and 1.80% in mortality in Asia to ensure that there would be fewer brain and CNS cancer cases in 2040 than in 2020.
Estimated brain and central nervous system cancers (A) incidence and (B) mortality from 2020 to 2040. The baseline scenario (represented by the black line), posits that there are no alterations in incidence and mortality, meaning that any rise in numbers is solely attributed to changes in population size and composition. Due to the unlikelihood of stable incidence rates, alternative scenarios are provided.
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