Trends in meningioma-related mortality among U.S. adults: A CDC WONDER analysis from 2000 to 2023

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Abstract
Background: Meningiomas are the most common primary intracranial tumors in the United States, comprising nearly 41% of central nervous system tumors. While the majority are benign, atypical (World Health Organization Grade II) and malignant (Grade III) subtypes are clinically significant due to their aggressive biology, higher recurrence, and increased mortality risk. Despite their burden, national mortality trends and demographic disparities in meningioma-related deaths remain underexplored. Methods: We conducted a population-based analysis of meningioma-related mortality among U.S. adults aged ≥65 years from 1999 to 2023 using the centers for disease control and prevention (CDC) wide-ranging online data for epidemiologic research (WONDER) database. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by age, sex, race/ethnicity, region, and urbanization. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) with 95% confidence intervals (CIs). Results: From 2000 to 2023, 28,875 meningioma-related deaths were recorded, with higher mortality in males (65.6%) compared to females (34.4%). The overall AAMR declined from 3.79 in 2000 to 2.44 in 2009 (APC −3.86; 95% CI −5.07 to −2.63; P < 0.001), plateaued through 2017, and subsequently rose to 2.77 in 2023 (APC 3.34; 95% CI 1.13–5.60; P = 0.005). Men experienced an initial decline followed by stabilization, while women showed a late increase after 2014. NonHispanic Whites and Blacks demonstrated biphasic patterns, with recent increases after earlier declines. Geographic variation was also evident, with the highest AAMRs in the District of Columbia and the lowest in Arkansas. Conclusion: Meningioma-related mortality in the United States declined substantially in the early 2000s but has shown an upward trend in recent years, with disparities across sex, race/ethnicity, and region. These findings highlight the need for continued surveillance and targeted public health strategies to address high-risk populations and mitigate the rising mortality associated with aggressive meningioma subtypes.

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