To evaluate and compare the global incidence and mortality of Brain and Central Nerve System (CNS) cancer, from 1993 to 2023, based on Socio-Demographic Index (SDI) categories. 

Brain and CNS tumors constitute a significant global health challenge due to their aggressive nature. Although diagnostic and treatment advances in high-income nations are seen, marked disparities in access to specialized services, timely diagnosis, and clinical outcomes persist. Analyzing epidemiological trends along with socioeconomic development is essential for equitable public health strategies and initiatives to reduce these disparities.

This retrospective, ecological study analyzed mortality and incidence rate per 100,000 population for brain and CNS cancers from the Global Burden of Disease Study (GBD 2023). Data were stratified in low, middle, and high-middle SDI groups for all ages and both sexes. Linear regression was used to evaluate overall temporal trends.

In Low SDI countries, a clear trend of underdiagnosis was observed: incidence and mortality remained statistically unchanged over the years analyzed (p >0.05). Middle SDI countries showed the most significant increase. Incidence increased from 2.52 to 3.74 (+48.4%) and mortality from 1.86 to 2.75 (+47.8%) (p<0.001). High-middle SDI countries showed both incidence growth from 3.78 to 4.98 (+31.8%) and mortality from 2.72 to 3.48 (+27.9%) (p<0.001), with a noticeable increase after 2016.