Abstract
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.
Keywords
meningioma - urbanization - geographic - centers for disease control and prevention
