Sex steroid hormone exposures and risk for meningioma

Jhawar, Balraj S.; Fuchs, Charlie; Colditz, Graham A.; Stampfer, Meir J.

doi:10.3171/jns.2003.99.5.0848

Cited by 141 publications

(146 citation statements)

References 39 publications

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“…In contrast to the Women's Health Study, no association was observed with increasing age at menarche. 13 Similar to findings in breast cancer studies, menopause appeared to be an effect modifier. The pregnancy, OC use and smoking protective effects were stronger in premenopausal women.…”

Section: Discussionsupporting

confidence: 66%

“…11 Studies reporting data on parity or pregnancy and brain tumors are few and not consistent. Several reports 13,24,25 have observed increased risks for meningioma with Ôever having been pregnantÕ: an East German study found no relationship with meningioma among women who are reproductively competent 2 and a recent United States hospital based case-control study saw no associations with number of pregnancies or livebirths. 14,26 Two case-control studies 11,12 have reported reduced odds ratios for parity and meningioma, although these estimates were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…This is in contrast to the other results, where the suggested protective effects of OCs and HRT became more pronounced as the interval of use increased 11 and for which no association with OCs was observed. 13,14 For OCs protection is plausible in that OCs, like pregnancy, suppress pituitary gonadotropin release, inhibit ovulation and lead to decrease of estrogen secretion. Although estrogen receptors are not as common as progesterone receptors in meningiomas, gene transcripts for estrogen receptors may be expressed.…”

Section: Discussionmentioning

confidence: 99%

“…11 The Nurses Health Study Cohort did not observe an association with oral contraceptive use in 125 female cases but did report an increased relative risk among current users of postmenopausal hormones, which was lower than the relative risk among all postmenopausal women. 13 Recently, however, no associations with reproductive and hormonal factors were observed in a case-control study of 151 female meningiomas. 14 Meningiomas are neoplasms that arise from the arachnoidal layer of the meninges.…”

mentioning

confidence: 99%

“…6 A few small epidemiological studies suggested a potential role for both endogenous and exogenous hormonal events with meningioma: lowered risk has been observed with pregnancy, 10,11 a protective effect of surgical menopause has been reported, 12 a significant decreased risk has been reported for premenopausal women and for those spinal meningiomas, 11 and an increasing risk with increasing age at menarche remains unexplained. 13 Protective effects with past use of oral contraceptives (OCs) and current use of estrogen replacement therapy have been suggested. 11 The Nurses Health Study Cohort did not observe an association with oral contraceptive use in 125 female cases but did report an increased relative risk among current users of postmenopausal hormones, which was lower than the relative risk among all postmenopausal women.…”

mentioning

confidence: 99%

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Association of meningioma with reproductive factors

Lee

Grutsch

Persky

et al. 2006

Intl Journal of Cancer

101

104

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Meningiomas occur more commonly in females. The coincidence between meningioma and breast cancer and case reports of tumor growth during pregnancy support a hormonal hypothesis. A case control study was conducted to investigate this. Female subjects treated between 1987 and 1992 were identified from 3 hospitals in the Chicago area. Female spouses of male back pain patients were recruited as controls. A self-administered mail questionnaire focused on exogenous, endogenous and other hormonal factors, personal and family medical history as well as radiation exposures. Odds ratios and 95% confidence intervals were estimated using crude, stratified and multivariable logistic models including 219 cases and 260 controls. Participation rates were 86% among cases and 75% among controls. An increased odds ratio (OR) was observed comparing African Americans to Caucasians [OR 5 2.4, 95% confidence interval (CI) 5 1.0-6.1]. A protective effect was observed for pregnancy, which increased with number and age at first pregnancy. The odds ratio for 3 or more pregnancies compared to none was 0.3 (95% CI 5 0.2-0.6). Age at menarche or total period of hormonal activity was not protective. Ever smokers showed a decreased odds ratio for meningioma (OR 5 0.6, 95% CI 5 0.4-0.9). The increased odds ratios with African Americans was retained in post-menopausal women, while the protective odds ratios for pregnancy, smoking and oral contraceptives (OCs) became stronger in pre-menopausal women. The pattern by duration and timing of use does not suggest an etiologic role for OCs or hormone replacement therapy. These data add to the evidence that factors known to influence endogenous hormones (pregnancy and indirectly smoking) may have protective effects for meningiomas primarily in premenopausal women. ' 2006 Wiley-Liss, Inc.Key words: case-control; meningioma; hormonal; reproductive The hypothesis of a hormonal influence on the occurrence of meningiomas was initially put forth because of the female preponderance in rates, the coincidence between meningioma and breast cancer 1 and case reports of tumor growth during pregnancy. 2 These indirect observations, stimulated studies of sex steroid receptors and a number of receptors and growth factors have been identified in tumor tissue. 3 Progesterone receptors predominate, although estrogen receptors may be present. 4 Although the role of these biologic markers in tumor development has not been established, it appears that the evidence for a role in tumor progression is stronger for progesterone receptors than for estrogen receptors. 5-7 A progesterone antagonist, mifepristone (RU-486), has been used therapeutically in an attempt to slow the growth of unresectable meningiomas, 8 but it has slowed the proliferation of meningioma tumor cells in vitro. 9 The role of hormone replacement therapy (HRT) in symptomatic postmenopausal women with previously treated disease or dormant tumors remains controversial. 6 A few small epidemiological studies suggested a potential role for both endogenous and exo...

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Association of meningioma with reproductive factors

Lee

Grutsch

Persky

et al. 2006

Intl Journal of Cancer

101

104

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Trends in intracranial meningioma incidence in the United States, 2004‐2015

Lin

Deng

et al. 2019

Cancer Medicine

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BackgroundMeningioma incidence was reported to have risen substantially in the United States during the first decade of the 21st century. There are few reports about subsequent incidence trends. This study provides updated data to investigate trends in meningioma incidence by demographic and tumor characteristics at diagnosis in the United states from 2004 to 2015.MethodsTrends in meningioma incidence were analyzed using data from the Surveillance, Epidemiology, and End Results‐18 (SEER‐18) registry database of the National Cancer Institute. The joinpoint program was used to calculate annual percent change (APC) in incidence rates.ResultsThe overall incidence of meningioma increased by 4.6% (95% CI, 3.4‐5.9) annually in 2004‐2009, but remained stable from 2009 to 2015 (APC, 0; 95% CI, −0.8 to 0.8). Females (10.66 per 100 000 person‐years) and blacks (9.52 per 100 000 person‐years) had significant predominance in meningioma incidence. Incidence in many subgroups increased significantly up to 2009 and then remained stable until 2015. However, meningioma incidence in young and middle‐aged people increased significantly throughout the entire time period from 2004 to 2015 (APC: 3.6% for <20‐year‐olds; 2.5% for 20‐39‐year‐olds; 1.8% for 40‐59‐year‐olds). The incidence of WHO II meningioma increased during 2011‐2015 (APC = 5.4%), while the incidence of WHO III meningioma decreased during 2004‐2015 (APC = −5.6%).ConclusionIn this study, the incidence of meningioma was found to be stable in recent years. Possible reasons for this finding include changes in population characteristics, the widespread use of diagnostic techniques, and changes in tumor classification and risk factors in the US population.

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Exogenous hormone use and meningioma risk

Claus

Black

Bondy

et al. 2007

Cancer

109

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The decision to commence or continue use of hormone replacement therapy or oral contraceptives in women presumed or known to be diagnosed with intracranial meningioma is a common clinical question in neurosurgery. A review of the English-language literature was undertaken to examine the association between the use of exogenous hormones and meningioma risk. Seven publications were identified, 6 of which met criteria for inclusion. No randomized clinical trial data were available, hence, results were collected from 2 population-based case-control studies, 2 hospital-based case-control studies, 1 nested case-control study drawn from a large national cohort, and 1 retrospective cohort study. At present, there is no statistical evidence of an increased risk of meningioma among users of oral contraceptives. Although not definitive, available data suggest an association between the use of hormone replacement therapy and increased meningioma risk. Further evaluation of exogenous hormone use in women with meningioma is needed with particular attention to stratification by hormone (ie, estrogen and/or progesterone) composition, duration of and age at use as well as tumor receptor subtype.

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Sex steroid hormone exposures and risk for meningioma

Abstract: The risk for meningiomas was increased among women exposed to either endogenous or exogenous sex hormones. An unexpected relationship with increasing age at menarche was also noted; this remains unexplained.

Cited by 141 publications

References 39 publications

Association of meningioma with reproductive factors

Association of meningioma with reproductive factors

Trends in intracranial meningioma incidence in the United States, 2004‐2015

Exogenous hormone use and meningioma risk

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