Long-term trends and disparities in primary intracranial germ cell tumor incidence and mortality for child and adolescent in the USA.
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OBJECTIVE: To investigate disparities and long-term trends in primary intracranial germ cell tumors (GCTs) incidence and mortality. METHODS: Data from the National Cancer Institute 22-registry Surveillance, Epidemiology, and End Results (SEER) database were analyzed. Age-adjusted rates were calculated using SEER*Stat, and trends were assessed using Joinpoint regression at a significance level of P < 0.05. RESULTS: This study systematically analyzed the epidemiological characteristics of GCTs from 1975 to 2021. Germinoma incidence first increased (1975-2001: + 2.42% per year) and then decreased in males, while remaining stable in females. Non-germinomatous GCTs incidence plateaued but mortality in males increased within 3 years of diagnosis. Embryonal carcinoma incidence decreased in age 1-4 (APC = -1.29) and 15-19 (APC = -1.73), with distant mortality peaking within 5 years. Teratoma incidence rose in infants (males: APC = 3.66; females: APC = 2.48), with a 5-year mortality rate of 22.4% in metastatic disease. Choriocarcinoma declined in adolescents, with cumulative mortality rates higher in males. Distant stage disease showed significantly higher mortality than localized, peaking within 5 years of diagnosis. Sex-based disparities were evident across subtypes, with males exhibiting a higher overall risk of mortality. CONCLUSION: Cancer stage and sex are critical prognostic factors. Increased localized cases suggest advancements in early diagnosis and treatment, while rising long-term mortality underscores challenges in managing complications. These trends highlight the need for optimized therapeutic strategies to address disparities in GCT outcomes.