An international case-control study of adult glioma and meningioma: the role of head trauma.

University of Southern California, Department of Preventive Medicine, USC/Norris Comprehensive Cancer Center, Los Angeles 90033-0800, USA.
International Journal of Epidemiology (Impact Factor: 9.2). 09/1998; 27(4):579-86.
Source: PubMed

ABSTRACT Increased brain tumour risk after head trauma suggested by case reports and clinical series has been previously studied epidemiologically with mixed results. An international multicentre case-control study investigated the role of head trauma from injury or sports participation in adult brain tumour risk.
In all, 1178 glioma and 330 meningioma cases were individually or frequency matched to 2236 controls. Only exposures that occurred at least 5 years before diagnosis and head injuries that received medical attention were considered.
Risk for ever having experienced a head injury was highest for male meningiomas (odds ratio [OR] = 1.5, 95% confidence interval [CI] : 0.9-2.6) but was lower for 'serious' injuries, i.e. those causing loss of consciousness, loss of memory or hospitalization (OR = 1.2, 95% CI: 0.6-2.3). Among male meningiomas, latency of 15 to 24 years significantly increased risk (OR = 5.4, 95% CI: 1.7-16.6), and risk was elevated among those who participated in sports most correlated with head injury (OR = 1.9, 95% CI: 0.7-5.3). Odds ratios were lower for male gliomas (OR = 1.2, 95% CI : 0.9-1.5 for any injury; OR = 1.1, 95% CI: 0.7-1.6 for serious injuries) and in females in general.
Evidence for elevated brain tumour risk after head trauma was strongest for meningiomas in men. Findings related to sports should be interpreted cautiously due to cultural variability in our data and our lack of complete data on physical exercise in general which appeared to be protective.

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    ABSTRACT: Background Head injury has been suggested to correlate with meningioma. However, results of studies investigating the relationship between head injury and meningioma were inconsistent. Therefore, we conducted this study to assess the association between head injury and meningioma, and to determine the possible risk factors. Methods Head injury patients aged 18 years and older, without antecedent diagnosis of brain tumor, and who were followed up for more than 30 days between January 1, 2001, and December 31, 2010, were recruited from the Taiwan National Health Insurance Research Database. Hazard ratios (HRs) of meningioma risk for head injury patients compared with an age- and gender-matched cohort were calculated by Cox proportional regression analysis. The difference in cumulative incidence between head injury patients and the matched cohort was analyzed using the Kaplan–Meier method and tested with the log-rank test. Results Each cohort (i.e., the head injury cohort and the matched cohort) consisted of 75,292 individuals with a mean age of 44.7 years, and 52.3% of these patients were male. The incidence rates of meningioma were 3.99/105 person-years and 3.23/105 person-years in the head injury cohort and the comparison cohort, respectively, with a Charlson Comorbidity Index score-adjusted HR of 1.27 (p = 0.514). There were no associations between head injury and risk of meningioma, neither overall nor in stratified analyses according to severity of head injury, age, and gender of patients. Conclusion Head injury, regardless of severity, patient gender, or age, is unlikely to be a cause of meningioma.
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