Presentation (CTI)

OBJECTIVES: Meningiomas are the most common intracranial tumours in adults, typically slow growing. This review aims to identify and evaluate risk factors associated with meningioma development in adults.
METHODS: A systematic search was conducted in Embase^® and MEDLINE^® via Embase.com for English-language articles reporting risk factors in patients with meningioma.
RESULTS: Of 1,216 records screened, 58 studies were included. Older age (≥ 65 years) increased risk (odds ratio [OR] = 1.65; 95% confidence interval [CI]: 1.03, 2.65). Female sex was strongly associated with higher incidence, up to 3.4 times greater than in males. Obesity (BMI ≥ 30) increased risk, relative risk [RR] of 1.40 (95% CI: 1.08, 1.87), and each 5 kg/m² increase raised risk by 5% (hazard ration [HR] = 1.05; 95% CI: 1.00, 1.10). Height per 10 cm increase was associated with higher risk in both women, HR = 1.38 (95% CI: 1.08, 1.77) and men HR = 1.67 (95% CI: 0.93, 2.97). Occupational exposure to iron was associated with a borderline significant increase in meningioma risk (OR = 1.26; 95% CI: 1.00, 1.58), with a stronger and statistically significant association in women (OR = 1.70; 95% CI: 1.00, 2.89). Additionally, higher occupational exposures to chromium and nickel were linked to an increase in risk, with ORs ranging from 1.2-1.7. Hormonal exposures including chlormadinone acetate (RR = 3.1), cyproterone acetate (RR = 11.4) and fertility treatments (OR = 4.97) were significantly increased risk. Analgesic use was also implicated: aspirin (OR = 1.41) and acetaminophen (OR = 1.85). Brain radiation exposure showed a clear dose-dependent risk increase (excess RR/1 Gy = 1.82), suggesting a strong linear relationship.
CONCLUSIONS: Meningioma risk is influenced by age, gender, BMI, height, hormonal therapies, analgesics, and occupational exposure to metals and radiation, highlighting the complex interplay of biological, environmental, and lifestyle factors.