Adult glioblastoma in England: Incidence, treatment, and outcomes with novel population-based strata

Abstract

Introduction

Malignant brain tumours are the leading cause of cancer death in the under 40’s and they have the highest average-years of life lost. England has a long-running system for national cancer data collection. In this work we present data on incidence, treatment and survival in all adult glioblastoma patients in England diagnosed between 2013 and 2018.

Methods

GlioCova uses a linked pseudo-anonymised data set of all adult patients in England diagnosed with a primary brain tumour between 2013 and 2018. We identified all patients with a glioblastoma (GBM) based on ICD-10 diagnosis and tumour morphology.

Results

In the 6-year period of the study (2013–2018 inclusive), 15,181 patients were diagnosed with a GBM in England. The national age-standardised incidence was 4.98 adult glioblastoma patients per 100,000 per year, with men having a higher incidence than women (6.3 and 3.8 respectively). Overall, 79 % of patients received treatment (76 % female vs. 81 % male, p = 0.22), with younger patients more likely to be treated than older patients. Median overall survival was 16 months in those receiving aggressive treatment, but 7 months in the whole cohort. 21 % of patients received no treatment, and 17 % of patients underwent surgery or biopsy alone.

Conclusion

Age-adjusted incidence of GBM is stable, although absolute numbers are rising, and prognosis remains poor. Only 29 % of patients receive aggressive multi-modality treatment, and we suggest that taking a population-level approach to GBM reveals significant areas for improvement.