Published: May 19, 2020
DOI: 10.7759/cureus.8195
Grech N, Dalli T, Mizzi S, et al. (May 19, 2020) Rising Incidence of Glioblastoma Multiforme in a Well-Defined Population. Cureus 12(5): e8195. doi:10.7759/cureus.8195
Abstract
Background and Objectives
The incidence of glioblastoma multiforme (GBM) ranges from 0.59 to 5 per 100,000 persons, and it is on the rise in many countries. The reason for this rise is multifactorial, and possible contributing factors include an aging population, overdiagnosis, ionizing radiation, air pollution and others. The aim of this study is to conduct an epidemiological study of GBM in a well-defined population over a 10-year period and determine its significance, while comparing results with international standards.
Materials and Methods
All histological diagnoses of GBM in Malta from 2008 to 2017 were identified. Poisson regression was used to determine significance in incidence variation. Log-rank tests were used to compare the survival distributions of each variable. Cox regression for survival analysis with the Breslow method for ties was then performed to consider the overall model.
Results
A total of 100 patients (61 males; mean age 60.29±10.09 years) were diagnosed with GBM over the period 2008 to 2017. There was a significant increase in incidence from 0.73 to 4.49 per 100,000 over the 10-year period (p≤0.001). The most common presenting complaint was limb paresis (29%). Approximately 65% of patients were treated with maximum safe resection (MSR). Using Cox regression analysis, younger age at presentation and treatment with MSR significantly improved survival (p=0.026 and p≤0.001, respectively). The median survival was 10 months.
Conclusions
An increasing incidence of GBM is becoming evident, while the median survival remains low. This troubling trend emphasizes the importance of further research into GBM etiology and treatment.
Extract
Another possible risk factor is RF-EMF, a type of non-ionizing radiation. Natural sources include the sun and the Earth itself, while artificial sources include satellite devices, broadcasting devices and mobile phones. A Working Group met in 2011 at the International Agency for Research on Cancer to assess the carcinogenicity of RF-EMF. They concluded that there may be an association between RF-EMF (level 2B evidence) and glioma predisposition [16]. Hardell and Calberg in 2015 found an association between mobile phone use and glioma risk with an odds ratio of 1.3 (95% CI=1.1-1.6 overall) to 3.0 (95% CI=1.7-5.2) [17]. According to the Malta Communications Authority reports, 385,636 active mobile phone internet subscriptions in 2008 had increased drastically to 604,759 subscriptions in 2017 [24]. There has also been an introduction of 4G in Malta in 2013, with coverage of the entire Maltese islands by 2015 [25]. Taking all this into consideration, there are clear indications of increasing public RF-EMF radiation levels throughout Malta. Currently, national risk assessments are being carried out to assess the introduction of 5G in Malta and other countries [26].
Added note by EMFSA
GBM Rising in Denmark, Much as in England. True Increases or Artifacts? https://microwavenews.com/news-center/fact-or-artifact