Mayo Clinic Proceedings Home

Factors Associated With Meningioma Detected in a Population-Based Sample



      To determine the frequency of incidental meningioma and identify associated factors in a population-based sample of participants who systematically underwent brain imaging.

      Patients and Methods

      We searched the Mayo Clinic Study of Aging, a population-based sample of Olmsted County, Minnesota, residents who underwent longitudinal magnetic resonance imaging of the brain. Using a text search of radiologists’ notes for 2402 individuals (median age, 75.0 years) who underwent imaging between August 10, 2005, and July 31, 2014, we identified 52 patients (2.2%) who had at least one meningioma. We estimated the association of selected risk factors with the presence of meningioma using odds ratios and 95% CIs from logistic regression models adjusted for age and sex. Based on these results, we moved the most significant variables forward to a multivariable model.


      Controlling for age and sex, significant associations with the presence of meningioma included higher body mass index (odds ratio [OR], 1.06; 95% CI, 1.01-1.12; P=.03), nonsteroidal anti-inflammatory drugs (OR, 2.11; 95% CI, 1.13-3.95; P=.02), aspirin (OR, 1.90; 95% CI, 1.05-3.46; P=.04), and blood pressure–lowering medication (OR, 2.06; 95% CI, 1.06-3.99; P=.03). Lower risk was associated with male sex (OR, 0.51; 95% CI, 0.29-0.90; P=.02), coronary artery disease (OR, 0.46; 95% CI, 0.22-0.97; P=.04), and higher self-reported anxiety (OR, 0.88; 95% CI, 0.78-0.98; P=.02). Simultaneous adjustment for all of these factors except aspirin in a multivariable model did not attenuate these associations (concordance, 0.71).


      In a population-based sample of 2402 participants, 52 (2.2%) had an incidental meningioma. They were more likely to be female and have higher body mass index. Meningioma was also associated with certain medications (nonsteroidal anti-inflammatory drugs and blood pressure–lowering medications) and inversely with anxiety and coronary artery disease.

      Abbreviations and Acronyms:

      BP (blood pressure), BMI (body mass index), CAD (coronary artery disease), HRT (hormone replacement therapy), MCSA (Mayo Clinic Study of Aging), NSAID (nonsteroidal anti-inflammatory drug), OR (odds ratio)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ostrom Q.T.
        • Gittleman H.
        • Fulop J.
        • et al.
        CBTRUS Statistical Report: Primary brain and central nervous system tumors diagnosed in the United States in 2008-2012.
        Neuro Oncol. 2015; 17: iv1-iv62
        • Nakasu S.
        • Hirano A.
        • Shimura T.
        • Llena J.F.
        Incidental meningiomas in autopsy study.
        Surg Neurol. 1987; 27: 319-322
        • Dolecek T.A.
        • Dressler E.V.
        • Thakkar J.P.
        • Liu M.
        • Al-Qaisi A.
        • Villano J.L.
        Epidemiology of meningiomas post-Public Law 107-206: the Benign Brain Tumor Cancer Registries Amendment Act.
        Cancer. 2015; 121: 2400-2410
        • Rogers L.
        • Barani I.
        • Chamberlain M.
        • et al.
        Meningiomas: knowledge base, treatment outcomes, and uncertainties: a RANO review.
        J Neurosurg. 2015; 122: 4-23
        • Krampla W.
        • Newrkla S.
        • Pfisterer W.
        • et al.
        Frequency and risk factors for meningioma in clinically healthy 75-year-old patients: results of the Transdanube Ageing Study (VITA).
        Cancer. 2004; 100: 1208-1212
        • Roberts R.O.
        • Geda Y.E.
        • Knopman D.S.
        • et al.
        The Mayo Clinic Study of Aging: design and sampling, participation, baseline measures and sample characteristics.
        Neuroepidemiology. 2008; 30: 58-69
        • Brastianos P.K.
        • Carter S.L.
        • Santagata S.
        • et al.
        Genomic characterization of brain metastases reveals branched evolution and potential therapeutic targets.
        Cancer Discov. 2015; 5: 1164-1177
        • Knopman D.S.
        • Jack Jr., C.R.
        • Wiste H.J.
        • et al.
        Short-term clinical outcomes for stages of NIA-AA preclinical Alzheimer disease.
        Neurology. 2012; 78 ([published correction appears in Neurology. 2017;89(9):980]): 1576-1582
        • Butts A.M.
        • Weigand S.
        • Brown P.D.
        • et al.
        Neurocognition in individuals with incidentally-identified meningioma.
        J Neurooncol. 2017; 134: 125-132
        • Blessed G.
        • Tomlinson B.E.
        • Roth M.
        The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects.
        Br J Psychiatry. 1968; 114: 797-811
        • Kokmen E.
        • Smith G.E.
        • Petersen R.C.
        • Tangalos E.
        • Ivnik R.C.
        The short test of mental status: correlations with standardized psychometric testing.
        Arch Neurol. 1991; 48: 725-728
        • Beck A.T.
        • Steer R.A.
        • Brown G.K.
        Manual for the Beck Depression Inventory-II.
        Psychological Corporation, San Antonio, TX1996
        • Beck A.T.
        • Steer R.A.
        Beck Anxiety Inventory Manual.
        Psychological Corporation, San Antonio, TX1993
        • Vernooij M.W.
        • Ikram M.A.
        • Tanghe H.L.
        • et al.
        Incidental findings on brain MRI in the general population.
        N Engl J Med. 2007; 357: 1821-1828
        • Niedermaier T.
        • Behrens G.
        • Schmid D.
        • Schlecht I.
        • Fischer B.
        • Leitzmann M.F.
        Body mass index, physical activity, and risk of adult meningioma and glioma: a meta-analysis.
        Neurology. 2015; 85: 1342-1350
        • Johnson D.R.
        • Olson J.E.
        • Vierkant R.A.
        • et al.
        Risk factors for meningioma in postmenopausal women: results from the Iowa Women's Health Study.
        Neuro Oncol. 2011; 13: 1011-1019
        • Wiedmann M.K.H.
        • Brunborg C.
        • Di Ieva A.
        • et al.
        Overweight, obesity and height as risk factors for meningioma, glioma, pituitary adenoma and nerve sheath tumor: a large population-based prospective cohort study.
        Acta Oncol. 2017; 56: 1302-1309
        • Michaud D.S.
        • Gallo V.
        • Schlehofer B.
        • et al.
        Reproductive factors and exogenous hormone use in relation to risk of glioma and meningioma in a large European cohort study.
        Cancer Epidemiol Biomarkers Prev. 2010; 19: 2562-2569
        • Benson V.S.
        • Kirichek O.
        • Beral V.
        • Green J.
        Menopausal hormone therapy and central nervous system tumor risk: large UK prospective study and meta-analysis.
        Int J Cancer. 2015; 136: 2369-2377
        • Seliger C.
        • Meier C.R.
        • Becker C.
        • et al.
        Diabetes, use of metformin, and the risk of meningioma.
        PLoS One. 2017; 12: e0181089
        • Bernardo B.M.
        • Orellana R.C.
        • Weisband Y.L.
        • et al.
        Association between prediagnostic glucose, triglycerides, cholesterol and meningioma, and reverse causality.
        Br J Cancer. 2016; 115: 108-114
        • Lauby-Secretan B.
        • Scoccianti C.
        • Loomis D.
        • Grosse Y.
        • Bianchini F.
        • Straif K.
        • International Agency for Research on Cancer Handbook Working Group
        Body fatness and cancer—viewpoint of the IARC Working Group.
        N Engl J Med. 2016; 375: 794-798
        • Shibuya M.
        Pathology and molecular genetics of meningioma: recent advances.
        Neurol Med Chir (Tokyo). 2015; 55: 14-27
        • Maile E.J.
        • Barnes I.
        • Finlayson A.E.
        • Sayeed S.
        • Ali R.
        Nervous system and intracranial tumour incidence by ethnicity in England, 2001-2007: a descriptive epidemiological study.
        PLoS One. 2016; 11: e0154347
        • Gittleman H.
        • Cote D.J.
        • Ostrom Q.T.
        • et al.
        Do race and age vary in non-malignant central nervous system tumor incidences in the United States?.
        J Neurooncol. 2017; 134: 269-277