Geographic Trends and Disparities in Meningioma Mortality: A National Observational Study from 1999 to 2020 Utilizing the CDC Wonder Database.

BACKGROUND

Meningiomas are benign tumors that surround the brain and spinal cord. While studies have examined disparities in meningioma outcomes nationally, the meningioma mortality rate based on urbanization level is unclear. This study utilized the Centers for Disease Control Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database to investigate meningioma mortality rates and disparities between urbanization categories.

METHODS

Patients whose underlying cause of death was meningioma from 1999 to 2020 were included. Chi-squared testing determined mortality differences across urbanization groups (large central metro, large fringe metro, and medium metro). Multivariable logistic regression and adjusted odds ratios (OR) evaluated associations between death location and age, sex, race, and ethnicity. Age-adjusted meningioma mortality rates per 100,000 people with 95% confidence intervals (CIs) were reported.

RESULTS

We analyzed a cohort of 12,274 patients. All older age groups demonstrated significantly lower odds of mortality in large central metros compared with other regions (OR: 0.54-0.69; p  < 0.05). Men had higher odds of dying in large central metro areas compared with women (OR: 1.09; p  = 0.047). Asian and African American patients had significantly higher odds of meningioma mortality in large central metros compared with their counterparts (OR: 7.53 vs. 3.42; p  < 0.001). Similarly, Hispanic/Latino ethnicity was associated with an increased likelihood of death in large central metros (OR: 6.97; p  < 0.001), but a lower likelihood in medium metros (OR: 0.77; p  = 0.029). No significant changes in mortality rates were observed based on urbanization.

CONCLUSION

We report that urbanization plays a significant role in meningioma mortality, with varying effects by sex, race, ethnicity, and age.