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The biphasic pattern of age-specific malignant brain tumor mortality rates

From the Departments of Neurology, Medicine, and Community Medicine, School of Medicine, West Virginia University at Morgantown.

Address correspondence and reprint requests to Dr. Jack E. Riggs, Department of Neurology, P.O. Box 9180, West Virginia University Health Sciences Center, Morgantown, WV 26506-9180; e-mail: jriggs{at}wvu.edu

Many aging-associated neurologic disorders, including primary malignant brain tumors (MBT), share a common biphasic age-specific mortality rate pattern: initially increasing exponentially with age, and then declining. A modeling study using MBT mortality was conducted to determine if the observed biphasic pattern of MBT age-specific mortality rates emerges if one assumes that there exists a population subset that is inherently susceptible to MBT, and that the risk of mortality from MBT in that susceptible population subset continues to increase exponentially with age. A hypothetical population was subjected to 1988 general mortality risks. A population subset susceptible to MBT was subjected to both exponentially increasing 1988 general and MBT mortality risks. Expected MBT age-specific mortality rates in the total population (both general and MBT susceptible subsets) were determined. Expected MBT age-specific mortality rates in the total population initially increase exponentially with age, and then decline. Moreover, when the size of the MBT-susceptible population subset was set at 1/125 of the size of the general population size, the modeled pattern of age-specific MBT mortality rates closely mimicked the observed pattern of age-specific MBT mortality rates. The observed biphasic pattern of age-specific MBT mortality rates can be explained by the existence of an MBT-susceptible population subset in whom the risk of MBT mortality increases exponentially with age and population subset depletion occurs.