e14045 Background: Pediatric central nervous system (CNS) tumors are a leading cause of childhood cancer mortality globally, yet epidemiologic data from low- and middle-income countries (LMICs) remain scarce. Understanding long-term tumor patterns is essential to inform equitable childhood cancer control. We describe the histologic spectrum and temporal trends of pediatric CNS tumors over 15 years at Kenya’s largest referral hospital. Methods: We conducted a retrospective review of children ≤18 years with histologically confirmed CNS tumors treated surgically at Kenyatta National Hospital between 2010 and 2024. Demographic, histologic, tumor grade, location, and year of diagnosis data were extracted from pathology records. Tumors were classified according to WHO CNS5 criteria; cases requiring molecular confirmation were designated as not otherwise specified due to absence of molecular testing. Temporal trends were analyzed by year and 5-year periods. Results: A total of 404 pediatric CNS tumors were identified. Gliomas were the most common tumors (41.1%), followed by embryonal tumors (32.2%), with medulloblastoma representing nearly one-quarter of all cases. Low-grade tumors accounted for 58.4% overall and increased over time (55.0% in 2010–2014 vs 61.7% in 2020–2024; p<0.001). Annual surgical case volumes rose steadily, peaking in 2021, likely reflecting backlog after COVID-19–related service disruptions. The proportion of tumors diagnosed in children aged 0–4 years increased markedly from 22.6% to 35.1% across the study period. Supratentorial and infratentorial tumors were nearly equally represented. Conclusions: This 15-year analysis provides the most comprehensive characterization of pediatric CNS tumors in Kenya to date and highlights evolving tumor patterns in an LMIC setting. Rising detection of low-grade tumors and increasing diagnoses in very young children suggest improving access to care, while persistent reliance on histology alone underscores critical diagnostic gaps. These findings emphasize the need for expanded molecular pathology, multidisciplinary neuro-oncology services, and population-based registries to advance global childhood cancer equity.
Mwachaka et al. (Thu,) studied this question.