Secondary cancer after meningioma diagnosis: an Israeli national study

Background There are limited data on whether primary diagnosis of meningioma may be associated with development of secondary primary cancer (SPC). Methods All meningioma cases (ICD-O-3 morphology codes 9530/0–9539/3) diagnosed in Jewish Israelis ≥ 20 years 1990 through 2015 registered in the Israel National Cancer Registry (INCR) were retrieved. All subsequent cancers occurring more than 6 months after meningioma diagnosis were identified. Risk of secondary cancer (SPC) was compared to cancer risk in the general population through the calculation of standardized incidence ratios (SIRs) and excess absolute risks (EARs). SIRs were stratified by type of second cancer, sex, and age group. Cox regression models were used to estimate hazard ratios of developing SPC. Results Overall, 8044 meningioma cases were identified: mean age at diagnosis was 64.0 ± 14.1 years. Of these, 927 (11.5%) were diagnosed with SPC (SIR 1.6, 95% CI 1.5–1.7). SPC risk was elevated in men (SIR 1.6, 95% CI 1.5–1.9) and women (SIR 1.6, 95% CI 1.5–1.8) diagnosed with meningioma in univariable analyses. Cancers most commonly encountered in the studied population were breast (17.6%), colorectal (13.4%), lung (8.1%), prostate (5%), and bladder (4.6%) cancer. In multivariable analyses, 10+ year increment in age at meningioma diagnosis was significantly associated with higher risk for SPC in individuals diagnosed with meningioma between 20 and 64 years, with an inverse association in the older age group (65+ years). Conclusions Meningioma diagnosis is associated with an increased risk for developing secondary cancers. This risk should be discussed with patients treated for meningioma.