Global Burden and Temporal Trends of Brain and Central Nervous System Tumors in Children and Adolescents: A Systematic Analysis for the Global Burden of Disease Study 2021.

BACKGROUND: Central nervous system (CNS) tumors pose major global health challenges. Previous studies often assessed all-age populations without focusing on children and adolescents. We analyzed the burden and temporal trends of CNS tumors among individuals aged < 20 years from 1990 to 2021, with projections to 2036. METHODS: Data were obtained from the Global Burden of Disease Study 2021, including annual incidence, mortality, and disability-adjusted life years (DALYs) for brain and CNS tumors. Regions were classified by Socio-demographic Index (SDI) to examine associations between burden and development. Temporal trends were analyzed using the age-period-cohort (APC) model and future projections via the Bayesian APC model. RESULTS: In 2021, an estimated 40,534.53 (95% uncertainty interval [UI]: 33,345.94-49,609.04) new cases of brain and CNS tumors occurred worldwide. The global age-standardized incidence rate (ASIR) was 1.54 (95% UI: 1.27-1.88), and the death rate (ASDR) was 0.76 (0.61-0.93) per 100,000. High-SDI regions showed the highest ASIR and ASDR, while lower-SDI regions faced growing burdens. Mortality and DALYs improved most in Greenland, Serbia, and China. The APC model showed a mild global decline in incidence (p = 0.099) and significant mortality reduction (-1.16% annually, p < 0.01). CONCLUSIONS: Global CNS tumor burden declined but remains uneven. Enhanced prevention and healthcare access are needed, especially in low-SDI regions.