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A number of reports have indicated an increasing incidence of primary brain tumors over the past few decades. The purpose of this study was to describe incidence rate trends in a population-based series of newly diagnosed primary nonmalignant and malignant brain and other CNS tumors, contributing five additional years to previously published incidence trends. Data for the years 1985 through 1999 from six collaborating state cancer registries of the Central Brain Tumor Registry of the United States were used to determine incidence trends in the broad age groups 0-19, 20-64, and ≥65 years, overall and for selected histologies. Multiplicative Poisson regression was used to express trends as average annual percent change (AAPC). Joinpoint regression was used to identify sharp changes in incidence occurring over this period. Overall, incidence increased modestly (AAPC, 1.1; 95% CI, 0.8-1.4). When brain lymphomas were excluded, this increase remained statistically significant. A sharp change in incidence of brain lymphomas from increasing to decreasing over time was identified. Specific histologies that were increasing included anaplastic astrocytomas in individuals aged ≥65 years, microscopically confirmed gliomas in both adult age groups, and microscopically confirmed glioma, not otherwise specified (NOS), in children. Increases that were not specific to any population subgroup were seen for oligodendrogliomas, ependymomas, meningiomas, and nerve sheath tumors. Decreases were noted for astrocytoma, NOS, nonmicroscopically confirmed gliomas, and pituitary tumors. Improvements in diagnosis and classification are likely reflected in the decreasing trends in unspecified glioma subgroups and the accompanying increasing trends in more specific glioma subgroups. However, increases in meningiomas and nerve sheath tumors deserve further attention. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test a brief orientation program for reducing anxiety, depressive symptoms, and overall distress in cancer patients at their initial clinic visit. One hundred and fifty consecutively referred patients seen in an oncology outpatient clinic were randomly assigned to an intervention or usual care control group. The intervention group received a clinic tour, general information about clinic operations, and a question and answer session with an oncology counselor. Outcome measures included the State-Trait Anxiety Inventory (STAI), the Brief Profile of Mood States (POMS), the Center for Epidemiologic Studies-Depression (CES-D) Scale, and an oncology clinic questionnaire which were administered at the initial clinic visit and follow-up. There were no statistically significant clinical or demographic differences between groups at initial assessment. At follow-up, the intervention group had lower state anxiety, lower overall distress, and fewer patients reporting depressive symptoms. Patients in the intervention group demonstrated significantly more knowledge about clinic operations and greater satisfaction with care. These data provide evidence that anxiety, distress and depressive symptoms can be reduced with an orientation program. This finding has particular relevance in the early stages of diagnosis where patients may suffer symptoms of anxiety and depression. © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]