Burden of pediatric CNS malignancies across 204 countries from 1990 to 2021.

e14032 Background: Central nervous system (CNS) tumors are a leading cause of cancer-related morbidity and mortality among children. Understanding the global trends and distribution of pediatric CNS cancer-related deaths is critical to inform healthcare policies and optimize resource allocation. Methods: This study analyzed mortality and morbidity indicators, including death rates, disability-adjusted life years (DALYs), years of life lost (YLL), and years lived with disability (YLD) per 100,000 population, from the Global Burden of Disease 2021 database. Data were collected for individuals under 20 years old across 204 countries from 1990 to 2021. A linear regression model was used to calculate the average annual percent change (AAPC) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05. Results: Between 1990 and 2021, pediatric CNS malignancies accounted for 736,560 deaths globally. Overall, a significant decline was observed in death rates, DALYs, and YLL, accompanied by a slight increase in YLD. Death rates decreased globally with an AAPC of -1.42 (95% CI: -1.42 to -1.23; p < 0.0001), while DALYs and YLL followed a similar downward trend, with AAPCs of -1.35 (95% CI: -1.46 to -1.25; p < 0.0001) and -1.36 (95% CI: -1.47 to -1.26; p < 0.0001), respectively. In contrast, YLD rates increased modestly, with an AAPC of 0.11 (95% CI: 0.01 to 0.21; p = 0.04). Turkmenistan experienced the steepest increases across several indicators, including death rates (AAPC: 5.14; 95% CI: 4.36 to 5.93), DALYs (AAPC: 5.04; 95% CI: 4.28 to 5.82), and YLL (AAPC: 5.04; 95% CI: 4.27 to 5.82). Serbia showed the largest reductions, with death rates (AAPC: -3.29; 95% CI: -3.60 to -3.00), DALYs (AAPC: -3.37; 95% CI: -3.67 to -3.07), and YLL (AAPC: -3.39; 95% CI: -3.69 to -3.09) significantly declining. YLD trends varied, with Ecuador reporting the highest increase (AAPC: 6.17; 95% CI: 4.22 to 8.15) and Greenland the largest decrease (AAPC: -1.72; 95% CI: -2.10 to -1.33). Conclusions: Between 1990 and 2021, the global impact of pediatric CNS malignancies improved significantly, with reductions in deaths, YLL, DALYs. However, YLD increased slightly, indicating that more children are surviving but with long-term health problems. Most regions made progress, but some, like Ecuador and Turkmenistan, saw their trends worsen, while Serbia and Greenland saw the biggest improvements. Future research is needed to explore these gaps.