Intracranial tumors in Kuwait: a 15-year survey

The dearth of literature on intracranial tumors (ICT) in Kuwait has necessitated this study whose objective is epidemiological. It is based on the records of the Department of Pathology, Al-Sabah Hospital, Kuwait, where virtually all brain biopsies in Kuwait were examined. Between 1995 and 2009, 439 males (53.41%) and 383 females (46.59%) had primary intracranial tumors (PICT). Most (69%) were younger than 50 years, with 16% children and adolescents and 4% elderly (≥70 years); meningioma (28%), pituitary adenoma (19%), glioblastoma (15%), astrocytoma (13%), and medulloblastoma (5%) were the most common. In childhood and adolescence, astrocytoma (35.34%) and medulloblastoma (22.56%) predominated. The mean age-adjusted incidence rate/100,000 was: PICT: 3.02; astrocytic tumors: 0.93; meningioma: 0.96; pituitary adenoma: 0.44; and medulloblastoma: 0.13. All showed a declining trend which was only statistically significant for medulloblastoma (P = 0.007). A modest correlation between the percentage of elderly in the general population and incidence rates was found (r = 0.411). Tumors with significant male preponderance were high-grade astrocytic tumors, silent pituitary adenoma (SA), and nerve sheath tumor. Meningioma had a female to male ratio of 2.24. The peak frequency for functional pituitary adenoma and females was in the age range of 20-29 years, while for SA and males it was 40-49 years. About 5% of ICT were metastatic, with cancers of breast (26%), lung (17%) and gastrointestinal (11%) origin as the most common. In conclusion, the epidemiology of PICT in Kuwait is characterized by low incidence rates and a distinct age distribution.