Non-malignant and malignant meningioma incidence and survival in the elderly from 2005-2015 using the Central Brain Tumor Registry of the United States.

Background: Meningioma incidence increases significantly with age. In the expanding elderly population, we lack complete understanding of population-based trends in meningioma incidence/survival. We provide an updated, comprehensive analysis of meningioma incidence and survival for individuals aged over 65.

Methods: Data were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) from 2005-2015 for non-malignant and malignant meningioma. Age-adjusted incidence rates per 100,000 person-years were analyzed by age, sex, race, ethnicity, location, and treatment modalities. Survival was analyzed using Kaplan-Meier and multivariable Cox proportional hazards models for a subset of CBTRUS data.

Results: Non-malignant meningioma incidence doubled from adults age 65-69 years to adults over age 85 years and was significantly greater in females than males for all ages. Malignant meningioma incidence did not differ by sex for any age grouping. Non-malignant and malignant meningioma incidence was significantly greater in Black populations versus others. Non-malignant meningioma survival was worse with age, in Black populations, and in males, including when analyzed by five-year age groups. Surgical resection and radiation did not improve survival compared to resection alone in non-malignant meningioma.

Conclusions: This study reports increasing non-malignant meningioma incidence in the elderly, increased incidence in Black populations, and in females. In contrast, malignant meningioma incidence did not differ between sexes. Risk of death was higher for Black individuals and males. Additionally, radiation did not confer a survival advantage when combined with resection for non-malignant meningioma. Thus, we identify clinically relevant discrepancies in meningioma incidence/survival that require further study.