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. Cancer82:155–160, 1999. © 1999 Wiley‐Liss, Inc.

A pooled multisite analysis of the effects of atopic medical conditions in glioma risk in different ethnic groups

“…However, this inverse association did not hold true across all ethnicities. This study adds to the evidence that atopic conditions may be protective for glioma but suggests that the inverse association may be influenced by additional factors such as ethnicity [4–6, 26–29]. Specifically, in this study, the inverse association was seen with Whites and Asians, but not with Blacks.…”

Approaching a Scientific Consensus on the Association between Allergies and Glioma Risk: A Report from the Glioma International Case-Control Study

“…Previously, McCarthy et al reported an OR of 0.76 for the association between any oral antihistamine use versus none (95% CI: 0.59–0.99), but they did not adjust for allergy status and their result could, therefore, be confounded by the effect of allergies (17). In our prior studies, we have observed an increased risk for glioma associated with antihistamine use, particularly among individuals with allergic conditions (38–40); however, other studies have found either no association or a protective effect (18, 41). More detailed analyses on antihistamine use (accounting for frequency, duration, and type) are planned, and may help clarify this relationship.…”

Reproductive factors and risk of primary brain tumors in women

“…The observed excess risk associated with menopause is at variance with the concept that estrogen promotes meningioma given that post-menopausal women have lower cumulative exposure to estrogen as compared to age-similar pre-menopausal women. Post-menopausal status was associated with an elevated risk of meningioma in some [43, 46], though not all [42, 44, 45] prior case-control studies; whereas cohort studies observed either no association [41] or a significantly lower risk [37] among post-menopausal women. Similar to our finding, most studies [32, 33, 41, 42, 45–49], including three cohort studies [32, 33, 41] observed no association between menopause status and risk of glioma.…”