Grade-stratified meningioma risk among individuals who are non-Hispanic Black and interactions with male sex.

BACKGROUND: Meningioma risk factors include older age, female sex, and being Black/African American. Limited data explore how meningioma risk in individuals who are Black varies across the lifespan, interacts with sex, and differs by tumor grade. METHODS: The Central Brain Tumor Registry of the United States is a population-based registry covering the entire US population. Meningioma diagnoses from 2004 to 2019 were used to calculate incidence rate ratios for non-Hispanic Black individuals compared with non-Hispanic White individuals across 10-year age intervals and stratified by sex and World Health Organization tumor grade in this retrospective study. RESULTS: A total of 53 890 non-Hispanic Black individuals and 322 373 non-Hispanic White individuals with an intracranial meningioma diagnosis were included in analyses. Beginning in young adulthood, the non-Hispanic Black to non-Hispanic White incidence rate ratio was elevated for grade 1 and grades 2-3 tumors. The incidence rate ratio peaked in the seventh decade of life regardless of grade and was higher for grades 2-3 tumors (incidence rate ratio  = 1.57, 95% confidence interval [CI] = 1.46 to 1.69) than grade 1 tumors (incidence rate ratio = 1.27, 95% CI = 1.25 to 1.30) in this age group. The non-Hispanic Black to non-Hispanic White incidence rate ratio was elevated in women (incidence rate ratio = 1.17, 95% CI = 1.16 to 1.18) and was further elevated in men (incidence rate ratio = 1.28, 95% CI = 1.26 to 1.30), revealing synergistic interaction between non-Hispanic Black race and ethnicity and male sex (Pinteraction = .001). CONCLUSIONS: Relative to non-Hispanic White individuals, non-Hispanic Black individuals are at elevated risk of meningioma from young adulthood through old age. Non-Hispanic Black race and ethnicity conferred greater risk of meningioma among men than women and greater risk of grades 2-3 tumors. Population-level differences in meningioma incidence and tumor behavior suggest potential disparities in the geographic, socioeconomic, and racial distribution of meningioma risk factors within the United States.

Duke Scholars

Author Quinn Ostrom Neurosurgery, Neuro-Oncology

Author Kyle Walsh Neurosurgery

Author Evan Calabrese Radiology, Neuroradiology