Global trends and heterogeneity in the burden of brain and central nervous system cancers among children and adolescents: An analysis based on GBD 2021 data.
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BACKGROUND: Brain and central nervous system (CNS) cancers are among the most challenging pediatric malignancies, with significant impacts on neurodevelopment, quality of life, and long-term outcomes. However, comprehensive global assessments across demographic and socio-economic strata remain limited. METHODS: Using data from the Global Burden of Disease Study 2021 (GBD 2021), we analyzed trends in incidence and disability-adjusted life years (DALYs) for pediatric brain and CNS cancers from 1990 to 2021. Estimates included age-standardised incidence rates (ASIR) and age-standardised DALYs rates (ASDR), stratified by age, sex, socio-demographic index (SDI), and region. Temporal trends were assessed using estimated annual percentage change (EAPC). RESULTS: Globally, incident cases increased slightly from 38,817 in 1990 to 40,535 in 2021, while ASIR declined modestly (EAPC = -0.29 %). DALYs decreased from 2.13 million to 1.63 million, with ASDR falling by 33.7 % (EAPC = -1.34 %). Children under 5 had the highest ASIR and ASDR, but also experienced the greatest reductions. Males consistently exhibited higher rates than females. ASIR and ASDR increased in low and low-middle SDI regions but declined in high and high-middle SDI areas. Regionally, Central Asia, South Asia, and sub-Saharan Africa showed rising burdens, whereas Central and Eastern Europe and East Asia demonstrated marked improvements. CONCLUSION: Pediatric brain and CNS cancer burden shows considerable global heterogeneity. While high-SDI regions have achieved substantial reductions, low-SDI regions face increasing burdens, reflecting disparities in diagnosis, treatment, and healthcare access. Strengthening early detection, multidisciplinary care, and international collaboration is essential to reduce global inequities and improve outcomes.