Grade-stratified meningioma risk among individuals who are non-Hispanic Black and interactions with male sex.

Background: Meningioma risk factors include older age, female sex, and being Black/African American. Limited data explore how meningioma risk in individuals who are Black varies across the lifespan, interacts with sex, and differs by tumor grade.

Methods: The Central Brain Tumor Registry of the United States is a population-based registry covering the entire US population. Meningioma diagnoses from 2004 to 2019 were used to calculate incidence rate ratios for non-Hispanic Black individuals compared with non-Hispanic White individuals across 10-year age intervals and stratified by sex and World Health Organization tumor grade in this retrospective study.

Results: A total of 53 890 non-Hispanic Black individuals and 322 373 non-Hispanic White individuals with an intracranial meningioma diagnosis were included in analyses. Beginning in young adulthood, the non-Hispanic Black to non-Hispanic White incidence rate ratio was elevated for grade 1 and grades 2-3 tumors. The incidence rate ratio peaked in the seventh decade of life regardless of grade and was higher for grades 2-3 tumors (incidence rate ratio  = 1.57, 95% confidence interval [CI] = 1.46 to 1.69) than grade 1 tumors (incidence rate ratio = 1.27, 95% CI = 1.25 to 1.30) in this age group. The non-Hispanic Black to non-Hispanic White incidence rate ratio was elevated in women (incidence rate ratio = 1.17, 95% CI = 1.16 to 1.18) and was further elevated in men (incidence rate ratio = 1.28, 95% CI = 1.26 to 1.30), revealing synergistic interaction between non-Hispanic Black race and ethnicity and male sex (Pinteraction = .001).

Conclusions: Relative to non-Hispanic White individuals, non-Hispanic Black individuals are at elevated risk of meningioma from young adulthood through old age. Non-Hispanic Black race and ethnicity conferred greater risk of meningioma among men than women and greater risk of grades 2-3 tumors. Population-level differences in meningioma incidence and tumor behavior suggest potential disparities in the geographic, socioeconomic, and racial distribution of meningioma risk factors within the United States.