Risk of Brain Tumors Associated with Exposure to Exogenous Female Sex Hormones

Wigertz, Annette; Lönn, Stefan; Mathiesen, Tiit; Ahlbom, Anders; Hall, Per; Feychting, Maria

doi:10.1093/aje/kwj254

Cited by 136 publications

(152 citation statements)

References 44 publications

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“…In addition, as in this study, previous studies have found no association between oral contraceptive use and meningioma or glioma risk (Jhawar et al, 2003;Custer et al, 2006;Wigertz et al, 2006).…”

Section: Discussionsupporting

confidence: 65%

Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort

et al. 2008

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Previous studies have reported inconsistent results on the effect of anthropometric and lifestyle factors on the risk of developing glioma or meningioma tumours. A prospective cohort of 1.3 million middle-aged women was used to examine these relationships. During 7.7 million women-years of follow-up, a total of 1563 women were diagnosed with a primary incident central nervous system tumour: 646 tumours were classified as glioma and 390 as meningioma. Our results show that height is related to the incidence of all central nervous system tumours with a risk of about 20% per 10 cm increase in height (relative risk ¼ 1.19, 95% CI ¼ 1.10 -1.30 per 10 cm increase in height, Po0.001): the risks did not differ significantly between specified glioma and meningioma. Body mass index (BMI) was also related to central nervous system tumour incidence, with a risk of about 20% per 10 kg m À2 increase in BMI (relative risk ¼ 1.17, 95% CI ¼ 1.03 -1.34 per 10 kg m À2 increase in BMI, P ¼ 0.02). Smoking status, alcohol intake, socioeconomic level, parity, age at first birth, and oral contraceptive use were not associated with the risk of glioma or meningioma tumours. In conclusion, for women in the United Kingdom, the incidence of glioma or meningioma tumours increases with increasing height and increasing BMI. British Journal of Cancer (2008) Keywords: body mass index; glioma; height; meningioma; women Primary brain and central nervous system cancers are relatively rare and represent approximately 2% of all cancers diagnosed in the United Kingdom. However, due to a poor prognosis, they are responsible for 7% of the years of life lost from cancer before the age of 70 years (Cancer Research UK, 2007). Very little is known about the aetiology of central nervous system tumours, but environmental factors are thought to play a role (McKinney, 2004;Connelly and Malkin, 2007).The two most common types of central nervous system tumour are glioma and meningioma (Claus et al, 2005). Gliomas arise from glial cells, are found predominantly in the brain and to a lesser extent in the spinal cord or other parts of the central nervous system, and represent more than 70% of all brain tumours (Ohgaki and Kleihues, 2005). Gliomas are typically histologically malignant, can be either slow or fast growing, and are more frequently diagnosed in men than in women. Meningiomas arise from the arachnoidal cells of the leptomeninges (the pia mater and arachnoid mater of the meninges) (Sanson and Cornu, 2000), are also more frequently found in the brain than elsewhere in the central nervous system, and represent more than 20% of all brain tumours (Longstreth et al, 1993). Meningiomas are typically benign (490%) and slow growing. The risk of meningioma increases with age (Sanson and Cornu, 2000), and they are more frequently diagnosed in women (Sanson and Cornu, 2000;Perry et al, 2007).There are few well-established risk factors for glioma and meningioma tumours among adults; while exposure to ionizing radiation and rare inherited genetic conditions such as n...

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Section: Discussionsupporting

confidence: 65%

Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort

et al. 2008

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“…A number of different issues were covered by detailed questions, including questions related to reproductive history. Results on exogenous female sex hormones and brain tumor risk have previously been reported for the Swedish data (14). The age range for inclusion differed slightly between the countries: ages 20 to 69 y in the Nordic countries and ages 18 to 59 y in the United Kingdom.…”

Section: Methodsmentioning

confidence: 80%

“…Progesterone, estrogen, and androgen receptors are expressed in meningiomas (7)(8)(9) and gliomas (10,11) in various degrees. Use of exogenous female sex hormones has been reported in relation to meningioma and glioma risk with inconsistent results (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Reproductive Factors and Risk of Meningioma and Glioma

Wigertz¹,

Lönn

Hall

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Female sex hormones have previously been suggested as possible risk factors for brain tumors, but published studies have reported conflicting results. We conducted a population-based case-control study of glioma (n = 626) and meningioma (n = 906) cases and randomly selected controls stratified on age and geographic region (n = 1,774) in Denmark, Finland, Norway, Sweden, and the United Kingdom. Unconditional logistic regression was used to estimate odds ratios (OR) for glioma and meningioma in relation to reproductive factors. A decreased glioma risk was associated with ever-pregnancy compared with neverpregnancy [OR, 0.8; 95% confidence interval (95% CI), 0.6-1.0]. Meningioma risk among women ages <50 years was increased in relation to number of pregnancies leading to a live birth (OR, 1.8; 95% CI: 1.1-2.8 for giving birth to 3 children compared with nulliparous women; P trend among parous women = 0.01). This relation was not found for older women. Breastfeeding among parous women increased the glioma risk (OR, 2.2; 95% CI, 1.3-3.9 for breast-feeding 36 months or more compared with breast-feeding 3 months or less). Menopausal status and age at menopause were not associated with meningioma or glioma risk. Our findings imply that reproductive hormones may influence the occurrence of meningioma and glioma.

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“…6,7 The risk of meningioma is increased among postmenopausal women who have used hormonal treatment replacement therapy and among women who have used longacting contraceptives. 7 The suspicion that high daily doses of cyproterone acetate for long periods could be responsible for the development of meningiomas, and especially multiple meningiomas, was reported in 2008. 1 Froelich et al 1 reported multiple meningiomas in 9 female patients treated with cyproterone acetate.…”

Section: Discussionmentioning

confidence: 99%

Abrupt Regression of a Meningioma after Discontinuation of Cyproterone Treatment: Fig 1.

Goncalves

Pagé²,

Domigo³

et al. 2010

AJNR Am J Neuroradiol

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SUMMARY:The multiplicity of meningiomas or abrupt lesion growth in patients treated with cyproterone acetate suggests that this progestative treatment may promote lesion growth. We report the rapid regression of an incidental meningioma after discontinuation of a 10-year cyproterone acetate treatment. This unique observation suggests that conservative management of meningiomas may be the best option among users of high doses of cyproterone acetate, given that spontaneous regression may occur after hormonal treatment discontinuation.ABBREVIATIONS: FLAIR ϭ fluid-attenuated inversion recovery C yproterone acetate is a synthetic progestin with a powerful antiandrogen property, which is indicated for the treatment of inoperable prostate carcinoma, the reduction of sexual drive in men, or severe signs of androgenization in women. It is occasionally prescribed in male-to-female transsexual patients. It is also found in smaller quantities in combined oral contraceptives and for treating seborrhea, acne, hirsutism, and moderate androgen-related alopecia. Recent observations of meningioma, often multiple, among users of high doses of cyproterone acetate have raised the suspicion that it may promote the rapid growth of pre-existing or new meningioma.

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Risk of Brain Tumors Associated with Exposure to Exogenous Female Sex Hormones

Cited by 136 publications

References 44 publications

Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort

Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort

Reproductive Factors and Risk of Meningioma and Glioma

Abrupt Regression of a Meningioma after Discontinuation of Cyproterone Treatment: Fig 1.

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