Abstract
Pediatric intra-cranial germ cell tumors (iGCTs) occur at an incidence of 0.6–1.2 cases/million/year in Western countries. The incidence is reported up to 5 times higher in the Japan. It is unknown whether this increased incidence is due to tumor biology or environment. The incidence of iGCTs in children ages 0–19 years was evaluated from 12/1/96-12/1/2016 in stable Japanese immigrant populations living abroad compared to current native Japanese registry data. Medulloblastoma incidence was used as a control to account for assumptions in the data. A review of the Brain Tumor Registry of Japan from 1984–2004 revealed an incidence of 2.5 cases/million/year and a lower incidence of medulloblastoma at 1.1 cases/million/year. Sites outside of Japan included Vancouver, Canada, Lima, Peru, and San Paolo, Brazil and together included a population of 853,174 Japanese persons. Within this population, 0 cases of iGCT were identified over a 20-years. The ratio of medulloblastoma to iGCT cases in Japan was identified as 1:2 while the ratio was 2:1, 6.5:1, and 5:1, respectively, in the other three locations. The data suggests increased incidence in the native Japan may not translate to higher incidence in immigrant Japanese populations abroad and a clear genetic component was not found in this preliminary data set. A more precise and comprehensive study is needed to determine the cause of this difference in incidence. This study also emphasizes the importance of national and state registries and is a call to collaborate on state and country level epidemiology studies.