ANTICONVULSANT DRUGS AND CANCER A Cohort Study in Patients with Severe Epilepsy

White, SusanJ.; McLean, A. E. M.; Howland, C.

doi:10.1016/s0140-6736(79)91505-8

Cited by 145 publications

(98 citation statements)

References 9 publications

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“…There are reports in the literature that mortality is higher in men than in women (3,4,11,15,17,24). This finding, however, is not consistent, and many studies show quite the opposite (14,16,20,23). It is therefore questionable whether this determinant is responsible for any part of the variation of the relative risks.…”

Section: Discussionmentioning

confidence: 98%

Survival of Patients with Epilepsy: An Estimate of the Mortality Risk

et al. 2002

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Summary:Purpose: To investigate the extent and causes of the differences in mortality found in studies on mortality in epilepsy based on a quantitative review of the literature.Methods: We used MEDLINE database and Cumulative Index Medicus for 1960-2001, Excerpta Medica for 1948-1965, and relevant journals and bibliographies. We selected comparative studies investigating mortality in epilepsy patients conducted in the last 100 years. The Standardized Mortality Ratio (SMR) was selected as primary outcome. Nineteen studies were included. Pooled estimates were precision weighted and tested for homogeneity. Sources of variability between risk estimates were explored by using multivariate fixed-effects models.Results: SMRs ranged from 1.3 to 9.3. Risk estimates proved heterogeneous ( 2 test statistic: 1,177; df ‫ס‬ 18; p < 0.001). The most important determinant was "source population," explaining half of the variance of the estimates (R 2 , 0.47; p ‫ס‬ 0.006). SMRs in community studies ranged from 1.3 to 3.1, and for institutionalized populations, from 1.9 to 5.1. Conclusions:Our results show that the mortality risk in patients with epilepsy is dependent on source population of patients. Within the different source populations, considerable unexplained variance remains. Hence no uniform summary estimate for the elevated mortality could be determined.

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Section: Discussionmentioning

confidence: 98%

Survival of Patients with Epilepsy: An Estimate of the Mortality Risk

et al. 2002

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“…Among children under 14 years old and adults 70 years old and older, incidence rates for brain malignancies were signi cantly higher from 1991 to 1995 than from 1975to 1979(Legler et al, 1999. In the 15-to 44-year-old age group, there were no meaningful differences in overall rates between the 2 time periods, and for people in the 45-to 64-year-old age group, rates were actually somewhat lower for the more recent time period.…”

Section: Time Trends In Incidence and Mortalitymentioning

confidence: 88%

“…Although more patients with epilepsy develop brain tumors than would normally be expected (Clemmesen and Hjalgrim-Jensen, 1978;Olsen et al, 1989;Shirts et al, 1986;White et al, 1979), determination of causality is problematic because seizures are often a symptom of brain tumors that leads to diagnosis (Lote et al, 1998). Pace et al (1998) showed that 83% of patients with astrocytoma, 46% with anaplastic astrocytoma, and 36% with glioblastoma had seizures preoperatively.…”

Section: Seizuresmentioning

confidence: 99%

Epidemiology of primary brain tumors: Current concepts and review of the literature

Wrensch¹,

Minn²,

Chew³

et al. 2002

Neuro-Oncol

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Neuro-OncologyThe purpose of this review is to provide a suf ciently detailed perspective on epidemiologic studies of primary brain tumors to encourage multidisciplinary etiologic and prognostic studies among surgeons, neuro-oncologists, epidemiologists, and molecular scientists. Molecular tumor markers that predict survival and treatment response are being identi ed with hope of even greater gains in this area from emerging array technologies. Regarding risk factors, studies of inherited susceptibility and constitutive polymorphisms in genes pertinent to carcinogenesis (for example, DNA repair and detoxi cation genes and mutagen sensitivity) have revealed provocative ndings. Inverse associations of the history of allergies with glioma risk observed in 3 large studies and reports of inverse associations of glioma with common infections suggest a possible role of immune factors in glioma genesis or progression. Studies continue to suggest that brain tumors might result from workplace, dietary, and other personal and residential exposures, but studies of cell phone use and power frequency electromagnetic elds have found little to support a causal connection with brain tumors; caveats remain. The only proven causes of brain tumors (that is, rare hereditary syndromes, therapeutic radiation, and immune suppression giving rise to brain lymphomas) account for a small proportion of cases. Progress in understanding primary brain tumors might result from studies of well-de ned histologic and molecular tumor types incorporating assessment of potentially relevant information on subject susceptibility and environmental and noninherited endogenous factors (viruses, radiation, and carcinogenic or protective chemical exposures through diet, workplace, oxidative metabolism, or other sources). Such studies will require the cooperation of researchers from many disciplines. Neuro-Oncology 4, 278-299, 2002 (Posted to Neuro-Oncology [serial online], Doc. 02-011, August 27, 2002 P rimary malignant or benign brain tumors were estimated to be newly diagnosed in about 35,519 Americans in 2001 (CBTRUS, 2000. Epidemiologic studies enhance our understanding of this heterogeneous group of diseases in 2 ways. Descriptive studies characterize the incidence of brain tumors and the mortality and survival rates associated with them with respect to histologic tumor type and demographic characteristics of patients affected, such as their age, sex, and geographic region. Analytic epidemiologic studies either compare the risk of brain tumors in people with and without certain characteristics (cohort studies) or compare the histories of people with and without brain tumors (case-control studies) to provide information on a wide range of possible risk factors, including diet, smoking, alcohol, occupation and industry, exposure to ionizing or nonionizing radiation, infections, allergies, head trauma, family history, and inherited polymorphisms in genes related to carcinogen metabolism, oxidative metabolism, and DNA repair. Because of the relative ra...

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“…7,8 Studies have shown an increased risk of suicide in those with epilepsy compared to the general population. [9][10][11] To our knowledge, there has only been one study examining the association between homicides and epilepsy.…”

mentioning

confidence: 99%