National Brain Tumor Registry of Nepal: A Multi Center Analysis of Brain Tumor Epidemiology and Diagnostic Trends

Abstract

Introduction: Brain tumors are among the leading causes of neurological morbidity and mortality worldwide. In low and middle income countries, including Nepal, limited epidemiological data and delayed diagnosis remain major challenges in improving neuro oncology services. To address this gap, the National Brain Tumor Center (NBTC) established the first nationwide multicenter brain tumor registry to systematically collect demographic, clinical, and pathological information from participating neurosurgical institutions throughout Nepal. Objective was to describe the epidemiological characteristics, pathological trends, and geographic distribution of brain tumors registered in Nepal during 2024-2025 and to identify priorities for improving brain tumor care.

Materials and Methods: A retrospective observational study was performed using data from the National Brain Tumor Registry. The registry included patients diagnosed with intracranial brain tumors at more than 20 neurosurgical centers across Nepal, making it the largest collaborative brain tumor registry currently available in the country. Demographic characteristics, tumor pathology, WHO grade, and provincial distribution were analyzed using descriptive statistics.

Results: Approximately 2,600 patients were registered during  2024(BS 2081), increasing to approximately 3,000 patients during  2025(BS 2082), representing a 15.4% increase in annual patient volume. The mean patient age was 46.32 years, with the highest disease burden occurring among individuals aged 30-50 years. Male and female patients were almost equally represented (50.07% and 49.93%, respectively). Glioma remained the most common primary brain tumor, followed by meningioma. The proportion of high-grade gliomas increased from 43.1% to 55.9%, while high-grade meningiomas increased from 7.4% to 27.1% during the study period. Bagmati Province contributed the highest proportion of registered cases, whereas Karnali and Sudurpashchim Provinces remained underrepresented.

Conclusion: The National Brain Tumor Registry demonstrates an increasing burden of brain tumors in Nepal and reveals a concerning trend toward advanced disease at diagnosis. Expansion of early detection programs, strengthening of referral systems, equitable access to specialist neuro oncology care, and continued development of the national registry are essential for improving patient outcomes.