Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004-2017

July 10, 2021


Background: Given concerns about risks associated with the growing use of mobile phones over recent decades, the authors analyzed temporal trends in incidence rates of nonmalignant meningioma and vestibular schwannoma in the United States.

Methods: The incidence of nonmalignant meningioma and vestibular schwannoma among adults in the Surveillance, Epidemiology, and End Results 18 registries during 2004 through 2017 was evaluated according to the method of diagnosis: microscopically (MC) or radiographically confirmed (RGC). Annual percent changes (APCs) and 95% CIs were estimated using log-linear models.

Results: Overall meningioma rates (n = 108,043) increased significantly from 2004 to 2009 (APC, 5.4%; 95% CI, 4.4%-6.4%) but subsequently rose at a slower pace through 2017 (APC, 1.0%; 95% CI, 0.6%-1.5%). Rates for MC meningiomas changed little from 2004 to 2017 (APC, -0.3%; 95% CI, -0.7%, 0.1%) but rose rapidly for RGC meningiomas until 2009 (APC, 9.5%; 95% CI, 7.8%-11.1%) and rose more modestly thereafter (APC, 2.3%; 95% CI, 1.5%-3.0%). Overall vestibular schwannoma rates (n = 17,475) were stable (APC, 0.4%; 95% CI, -0.2%, 1.0%), but MC vestibular schwannoma rates decreased (APC, -1.9%; 95% CI, -2.7%, -1.1%), whereas RGC vestibular schwannoma rates rose (2006-2017: APC, 1.7%; 95% CI, 0.5%-3.0%). For each tumor, the trends by diagnostic method were similar for each sex and each racial/ethnic group, but RGC diagnosis was more likely in older patients and for smaller tumors. Meningioma trends and the proportion of RGC diagnoses varied notably by registry.

Conclusions: Overall trends obscured differences by diagnostic method in this first large, detailed assessment, but the recent stable rates argue against an association with mobile phone use. Variation among registries requires evaluation to improve the registration of these nonmalignant tumors.

Lay summary: The etiology of most benign meningiomas and vestibular schwannomas is poorly understood, but concerns have been raised about whether mobile phone use contributes to risk of developing these tumors. Descriptive studies examining temporal trends could provide insight; however, globally, few registries collect these nonmalignant cases. In the United States, reporting benign meningiomas and vestibular schwannomas became required by law in 2004. This was the first large, systematic study to quantify and characterize incidence trends for meningioma and vestibular schwannoma according to whether the tumors were diagnosed microscopically or only radiographically. Differential trends across registries and by diagnostic method suggest that caution should be used when interpreting the patterns.


“Etiologic factors for most benign meningiomas and vestibular schwannomas (acoustic neuromas) are poorly understood, but concerns have long been raised about whether mobile phone use may initiate or promote the occurrence of these central nervous system (CNS) tumors. 1, 2  Analytic epidemiologic studies assessing mobile phone use and the risk of meningiomas have shown no association for a duration of use >10 years (see Supporting Table 1). For vestibular schwannomas, long-term mobile phone use has not been consistently linked with risk, but there is heterogeneity among investigations, and elevated risks were observed in a few studies for a duration of use >10 years (see Supporting Table 2). 2”

“The evaluation of a statistical association between mobile phone use and risk of meningioma or vestibular schwannoma was not feasible because of the descriptive epidemiologic study methods used, along with a lack of detailed data on the history, frequency, and hours per day, per week, or per month of mobile phone use from patients with benign brain tumors and from an appropriate comparison group.”

“The potentially large impact of these nonetiologic factors on the incidence trends and the modest increases in meningiomas and stable vestibular schwannoma rates in recent years argue against a substantial effect of the huge increases in mobile phone use on underlying disease risk. This conclusion assumes, however, that the latency period is not many decades in length.”
My comment: Although the case-control research examining the association between mobile phone use and meningioma yields mixed results, this study found that the incidence of meningioma in the U.S. was still increasing from 2009 on, just at a slower pace.

The results from the epidemiologic research examining the association between mobile phone use and acoustic neuroma is more consistent; however, the latency for tumor identification can be 20 or more years.

The smartphone started to become popular in the U.S. in 2007 with the first iPhone and in 2008 with Android phones. In many smartphones the cellular transmission antennas are located in the bottom of the handset so the neck, not the head, is likely to receive the greatest microwave radiation exposure among those who place the phone by their ear.  Two case-control studies found an association between thyroid cancer and mobile phone use, and thyroid cancer incidence has been rapidly increasing in many countries including the U.S.

Diana R Withrow, Susan S Devesa, Dennis Deapen, Valentina Petkov, Alison L Van Dyke, Margaret Adamo, Terri S Armstrong, Mark R Gilbert, Martha S Linet. Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004-2017. Cancer. 2021 Jun 23. doi: 10.1002/cncr.33553.

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