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

Background: Meningiomas are among the most common brain tumours in the UK 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. Methods: 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. Results: 467 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). Conclusions: 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.