title: Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act.
abstract: BACKGROUND
  The current analysis follows the implementation of Public Law 107-260, the Benign Brain Tumor Cancer Registries Amendment Act, which mandated the collection of nonmalignant brain tumors.
  
  
  METHODS
  Meningiomas were selected from the Surveillance, Epidemiology, and End Results (SEER) Program database for the years 2004 to 2011. Demographic and clinical characteristics, initial treatment patterns, and survival outcomes were evaluated using surveillance epidemiology statistical methods.
  
  
  RESULTS
  The average annual age-adjusted incidence rate per 100,000 population was 7.62 (95 % confidence interval [CI], 7.55-7.68) for all meningiomas, 7.18 (95% CI, 7.12-7.25) for benign meningiomas, 0.32 (95% CI, 0.31-0.33) for borderline malignant meningiomas, and 0.12 (95% CI, 0.11-0.12) for malignant meningiomas. The annual rates increased for benign and borderline malignant tumors but decreased for malignant tumors. The rates for women exceeded those for men, especially for those with benign meningiomas. Black race was associated with significantly higher rates as was advancing age. Greater than 80% of tumors were located in cerebral meninges. Diagnostic confirmation through pathology occurred for approximately 50% of benign tumors, 90% of borderline malignant tumors, and 80% of malignant tumors. No initial treatment was reported for greater than 60% of benign tumors, 29% of borderline malignant tumors, or 31% of malignant tumors. The 5-year relative survival estimates for benign tumors, borderline malignant tumors, and malignant tumors were 85.6% (95% confidence interval [CI], 85%-86.2%), 82.3% (95% CI, 79.3%-84.8%), and 66% (95% CI, 60.6%-70.9%), respectively. Predictors of poorer survival were advanced age, being male gender, black race, no initial treatment, and malignant tumor behavior.
  
  
  CONCLUSIONS
  The current analysis demonstrates that there is an increasing incidence of nonmalignant meningiomas, probably because of reporting learning curves associated with the implementation of Public Law 107-260. The high proportion of cases who receive no initial treatment is a survival outcome concern, especially for patients with malignant meningiomas.
authors: Division of Epidemiology and Biostatistics and Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors: Therese A
authors: TA
authors: Dolecek
authors: Division of Cancer Biostatistics, University of Kentucky, Lexington, Kentucky.
authors: Emily Van Meter
authors: EV
authors: Dressler
authors: Department of Medicine, University of Kentucky, Lexington, Kentucky.|Department of Neurology, University of Kentucky, Lexington, Kentucky.
authors: Jigisha P
authors: JP
authors: Thakkar
authors: Division of Cancer Biostatistics, University of Kentucky, Lexington, Kentucky.
authors: Meng
authors: M
authors: Liu
authors: Department of Medicine, University of Kentucky, Lexington, Kentucky.|Department of Neurology, University of Kentucky, Lexington, Kentucky.
authors: Abeer
authors: A
authors: Al-Qaisi
authors: Department of Medicine, University of Kentucky, Lexington, Kentucky.|Department of Neurology, University of Kentucky, Lexington, Kentucky.
authors: John L
authors: JL
authors: Villano
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D006801:Humans; D015994:Incidence; D007878:Legislation as Topic; D008577:Meningeal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D008579:Meningioma / Q000453:epidemiology* / Q000473:pathology*; D011159:Population Surveillance; D012042:Registries; D018426:SEER Program / Q000331:legislation & jurisprudence*; D014481:United States / Q000453:epidemiology
keywords: benign tumor; incidence; malignant tumor; meningioma; prognosis; survival; treatment; trend