Nationwide study of trends in meningioma incidence, treatment, and imaging surveillance in Denmark

Meningioma incidence is rising globally, yet many tumors follow an indolent course. Despite low intervention rates, surveillance imaging is extensive, and it is unclear whether current practices meaningfully influence treatment decisions. A nationwide study in Denmark investigated trends in incidence, treatment and imaging surveillance among patients with meningioma from 2010 through 2023. A total of 8134 patients were included (median age 66 years; range 18-102; 73.7% women). The age- and sex-standardized incidence rate increased from 6.4 to 12.6 per 100 000 person-years between 2010 and 2023, yet yearly treatment rates remained stable. A total of 5307 patients (65.2%) received no treatment, while 2665 (32.8%) underwent surgery and 439 (5.4%) received radiotherapy. Surveillance imaging was common, with 7143 patients (87.8%) receiving one or more follow-up MRI scan. Of 28 736 MRI scans, 23 992 (83.5%) were not followed by treatment. Imaging beyond 5 years after diagnosis rarely led to changes in treatment but accounted for a substantial proportion of total scans. Only 1.4% of patients underwent surgery after year 5. The authors conclude that between 2010 and 2023, meningioma incidence increased substantially, while treatment rates remained stable. Most imaging did not result in intervention.