Epidemiology of pediatric brain tumors

Brain tumor research is unlike some other areas of cancer research, in which definite causes have been identified and prevention and treatment strategies may be developed. Primary brain tumors are heterogeneous with respect to several characteristics, and brain tumor research is hampered by this fact, as well as by the small numbers of cases, by the lack of a clearly established and consistently applied histopathologic classification scheme, and by geographical variations in diagnostic capabilities and mechanisms for case reporting. The current movement toward molecular epidemiology has resulted in several changes in the ways we will be able to investigate cancer etiologies in the future, and promises to be especially fruitful in the area of brain tumor research. The search is under way for biologic markers of risk exposures for various cancers, and for laboratory methods to identify those individuals who, because of their genetic qualities, are most likely to have brain tumors. There are probably multiple causes for brain tumors, incorporating both genetic and environmental pathways. Prior research has consistently identified few risk factors for brain tumors, such as ionizing radiation. Thus, collaborative efforts among clinicians, laboratory scientists, and epidemiologists, which make use of molecular epidemiologic methods, are perhaps of greater importance in this field than for cancers arising at other sites.