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: 9.18). 09/1998; 27(4):579-86.
Source: PubMed


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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    • "There are also several case reports between previous trauma and subsequent development of meningioma (Sakai et al. 1981; Rodrigues et al. 2006; Francois et al. 2010; Kizilay et al. 2010), which is another of the primary brain tumor types observed by (Pearce et al. 2012). There is epidemiological evidence of this relationship as well, (Preston-Martin et al. 1998), including dose response relationships (Phillips et al. 2002). Past epidemiological evidence in large part shows an association between radiation exposure and brain tumors only after high doses characteristic of radiotherapy (UNSCEAR 2006; Mettler and Upton 2008). "
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    • "In fact, evidence of a possible causal role of previous brain traumatic injury in the oncogenesis of intracranial gliomas is lacking in epidemiological studies [2, 13]. Some evidence has been found only for intracranial meningiomas [14]. This would mean that, concerning gliomas, there is not enough evidence for possible medico-legal implications between previous trauma and tumorigenesis [15]. "
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    • "Limited evidence suggests that gliomas are associated with traumatic brain injury, cigarette smoking, use of hair dyes, and exposure to certain chemicals and viruses. For instance, studies suggest associations between prior head injury and meningioma in men,9 between smoking unfiltered cigarettes and an increased risk of adult glioma,10,11 and a null or inverse association between glioma and alcohol consumption.12 An international case-control study showed an inverse association between allergic diseases and glioma, but not with meningioma.13 "
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