Role of medical history in brain tumour development. Results from the international adult brain tumour study

Abstract

In an international population-based case-control study carried out in 8 centres in 6 countries, we investigated the role of specific medical conditions in the aetiology of brain tumours in adults. Recruited were 1,178 glioma and 331 meningioma cases and 2,493 age-and gender-matched population controls. Only medical conditions occurring at least 2 years before brain tumour diagnosis were considered. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a conditional logistic regression model. Heterogeneity between centres was tested. No association between meningioma and previous medical conditions was observed. For glioma, there was an increased risk associated with epilepsy (RR ‫؍‬ 6.55, 95% CI 3.40-12.63), but this was considerably weaker for epilepsy of more than 20 years duration. The risk remained elevated after adjustment for use of anti-epileptic drugs. There was a statistically significant inverse association between glioma and all allergic diseases combined (RR ‫؍‬ 0.59, 95% CI 0.49-0.71); this was also observed for specific allergic conditions, namely, asthma and eczema. Subjects who reported a history of infectious diseases (e.g., colds, flu) showed a 30% reduction in risk (RR ‫؍‬ 0.72, 95% CI 0.61-0.85). The decreased risks for glioma in subjects reporting a history of allergic conditions or infectious diseases may indicate an influence of immunological factors on the development of glioma. The association between glioma and epilepsy has to be interpreted cautiously and needs further investigation. Int. J. Cancer 82:155-160, 1999.1999 Wiley-Liss, Inc.

Association of meningioma with reproductive factors

“…31,32 However, given these observations, interactive effects could be explored and may explain some of the inconsistencies in human studies. 11,29,[33][34][35][36][37][38][39][40][41] It should be noted that smoking was crudely recorded in this study; data on number of cigarettes smoked, type of cigarette and duration of use was not included on the questionnaire. Similarly, alcohol usage was not collected and so could not be controlled for in this analysis.…”

Primary brain tumours and specific serum immunoglobulin E: a case–control study nested in the European Prospective Investigation into Cancer and Nutrition cohort

“…To date, the results from case-control studies have shown an inverse association between glioma and allergies; however, the results have been less consistent for meningioma (5)(6)(7)(8)(9). Cohort studies have also provided conflicting results.…”

“…Most studies of allergies and brain tumours used questionnaire data; hence, allergies were self-reported (5,7,(16)(17)(18) and could therefore be influenced by recall biases or differential misclassification. Only one case-control and one cohort study defined the atopic status of the study participants by measuring total serum IgE levels in glioma cases and controls in addition to the questionnaire data (10,19) and another cohort study used a skin prick test (12).…”

History of allergies and autoimmune diseases and risk of brain tumors in adults

“…The findings regarding infections and brain tumors, while suggestive of a negative association, are mixed. 5,7,8,18,19 Although available data on a broad range of specific medical disorders are inconsistent, immunologically mediated conditions warrant further investigation as factors that might interfere with brain tumor development.Here, we report the associations between history of allergies and autoimmune diseases and risk of glioma, meningioma and acoustic neuroma based on data from a large, case-control study conducted at 3 hospitals in the United States. Associations with prior infections will be addressed in a separate report.…”

“…10 Diabetes also has been negatively associated with risk of glioma in some studies 5,11 but not in others. 7,8,12,13 Several cohort studies of patients with rheumatoid arthritis, 14 pernicious anemia 15 and multiple sclerosis 16,17 failed to demonstrate a decreased risk of brain tumors. The findings regarding infections and brain tumors, while suggestive of a negative association, are mixed.…”