Long-term psychological and neurological outcomes among people with a history of non-malignant meningioma in the UK Biobank cohort

TL;DR

This study finds that people with non-malignant meningiomas face increased long-term risks of neurological and psychological issues.

Contribution

The study is the first to comprehensively assess long-term outcomes in non-malignant meningioma survivors using a large population cohort.

Findings

Meningioma survivors had significantly increased risks of 9 out of 10 neurological and psychological sequelae.

The highest risk was for epilepsy (SIR 18.9) and visual disturbances (SIR 6.6).

Risks for depression, anxiety, and cognitive issues ranged from 2.3 to 4.4.

Abstract

Meningiomas are among the most common brain tumours in the United Kingdom and incidence is increasing. Up to 90% of meningiomas are Grade 1 (non-malignant) and have high survival. Brain tumour survivors are at risk of psychological and neurological late effects but risks in persons with non-malignant meningioma are not well characterized.

We used UK Biobank, a cohort of approximately 500 000 adults recruited ages 40-69 during 2006-2010. Non-malignant meningioma patients were identified through linked cancer registry data. Follow-up for 10 outcomes was based on linkage to Hospital Episode Statistics. Standardized incidence ratios (SIRs) compared risks in meningioma patients to rates from UK Biobank overall, adjusted for age, sex, and calendar time.

Four hundred and sixty-seven individuals were diagnosed with non-malignant meningioma after joining UK Biobank (77% female). Median age at diagnosis was 65 and median follow-up was 5 years. Persons with meningioma had significantly increased risks of 9 of 10 sequelae studied. The lowest SIR was for stroke (1.3, 95% confidence interval [CI] 0.6-2.9) and the highest SIRs were for epilepsy (18.9, 95%CI: 13.3-26.9) and visual disturbances (6.6, 95%CI: 3.3-13.1). SIRs for depression, anxiety, headache, fatigue, hearing loss, limb weakness, and cognitive issues (in ascending order) ranged from 2.3 (95%CI: 1.6-3.4) to 4.4 (95%CI: 2.8-6.9).

By providing preliminary evidence of excess risk of a range of long-term sequelae, this research can provide insight into future risks and validate survivor experience for people diagnosed with non-malignant meningioma and build momentum for future research using larger population-based databases and primary care records.

Figures