Central Nervous System Cancers in South Asia (SAARC Region): Current Burden in 2024 and Projections for 2050

Abstract Background Cancer is the second leading cause of death in low- and middle-income countries (LMICs). Primary tumors of the brain and central nervous system (CNS) represent key drivers of global cancer burden, and the South Asian Association for Regional Cooperation (SAARC) countries make up a significant proportion of this cancer burden. Understanding tumor incidence and mortality at the regional level is necessary, given potential differences in healthcare infrastructure across regions. Methods We conducted a cross-sectional descriptive epidemiological analysis of malignant central nervous system (CNS) tumors in the eight SAARC member states, using the GLOBOCAN 2022 dataset to present data on national-level estimates of age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) per 100,000. In addition, 2050 estimates of CNS burden across the eight countries were also presented. Results 42,293 new cases of primary brain and other CNS tumors were estimated across SAARC countries, with 34,764 deaths. ASIR among males ranged from 1.0 Bangladesh to 4.5 in Afghanistan; female ASIRs ranged from 0.29 in Maldives to 3.2 in Afghanistan. Mortality patterns broadly mirrored incidence, with higher rates in Afghanistan, Pakistan, and India. In the pediatric only population, ASIR among males ranged from 0.0 in Maldives to 1.1 in Afghanistan, and from 0.0 in Maldives to 2.0 in Bhutan. MIRs were ≥0.80 in all SAARC countries. Conclusion Our findings reveal a heterogeneity in CNS cancer burden across SAARC, with varying incidences per country. The SAARC countries are limited by poorer infrastructure that limit possibilities for earlier diagnosis and access to multimodal, gold-standard management pathways. National and regional efforts are necessary in bridging existing gaps in physical infrastructure, and personnel.