Global, regional, and national burden of older adults peripheral nervous system tumors (1990-2021): a systematic analysis of incidence, DALYs, and deaths with projections to 2050.

BACKGROUND

Peripheral nervous system tumors are abnormal proliferations originating from neural tissues (such as the nerve sheath and nerve fibers), classified as either benign or malignant. Common subtypes encompass schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors. Notably, malignant peripheral nerve sheath tumors are characterized by their high malignancy potential and have demonstrated a concerning rise in both incidence and mortality rates in recent epidemiological studies.

METHODS

Based on the Global Burden of Disease 2021 database, we conducted a statistical analysis of the trends of incidence, disability-adjusted life years (DALYs) per 100 100 population along with 95% uncertainty intervals, as well as deaths among adults aged 70 years and older from 1990 to 2021 in peripheral nervous system tumors. The data were subjected to stratified analyses across age, sex, sociodemographic index (SDI), 21 regions, and 204 countries. A Bayesian age-period-cohort (BAPC) model incorporating integrated nested Laplace approximations was applied to forecast the disease burden up to 2050. On a global scale, all stratified analyses demonstrated a consistent trajectory trend in incidence, DALYs, and deaths among older adults, with projections indicating this trend is likely to persist until 2050.

RESULTS

Over the past three decades (1990-2021), the incidence rates of peripheral nervous system tumors have risen by 185%, with DALY rates increasing by 164% and death rates climbing by 167%. Notably, high SDI regions exhibited declining trends in incidence rates (-10.1%), DALY rates (-14.3%), and mortality rates (-11.6%) after 2003, low- and middle SDI regions maintained annual increases. A significant gender reversal occurred in 2021, where male incidence numbers, DALYs, and death numbers surpassed female rates. BAPC modeling predicts a 2.0-fold increase in ASIR by 2050 relative to 2021 levels, with DALY and mortality burdens projected to rise 2.2-fold and 1.8-fold respectively under current trajectories.

CONCLUSION

The analysis results revealed that there were pronounced disparities across SDI regions, with high-middle SDI regions shouldering the greatest burden. These findings underscore the urgent need for region-specific prevention and control strategies to address the growing epidemiological and socioeconomic impacts of these malignancies in aging populations.