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Wang L, Zhang J, Wang J, Xue H, Deng L, Che F, Heng X, Zheng X, Lu Z, Yang L, Tan Q, Xu Y, Zhang Y, Ji X, Li G, Yang F, Xue F. Postoperative prognostic nomogram for adult grade II/III astrocytoma in the Chinese Han population. Health Inf Sci Syst 2023; 11:23. [PMID: 37151917 PMCID: PMC10160268 DOI: 10.1007/s13755-023-00223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Background Prognostic models of glioma have been the focus of many studies. However, most of them are based on Western populations. Additionally, because of the complexity of healthcare data in China, it is important to select a suitable model based on existing clinical data. This study aimed to develop and independently validate a nomogram for predicting the overall survival (OS) with newly diagnosed grade II/III astrocytoma after surgery. Methods Data of 472 patients with astrocytoma (grades II-III) were collected from Qilu Hospital as training cohort while data of 250 participants from Linyi People's Hospital were collected as validation cohort. Cox proportional hazards model was used to construct the nomogram and individually predicted 1-, 3-, and 5-year survival probabilities. Calibration ability, and discrimination ability were analyzed in both training and validation cohort. Results Overall survival was negatively associated with histopathology, age, subtotal resection, multiple tumors, lower KPS and midline tumors. Internal validation and external validation showed good discrimination (The C-index for 1-, 3-, and 5-year survival were 0.791, 0.748, 0.733 in internal validation and 0.754, 0.735, 0.730 in external validation, respectively). The calibration curves showed good agreement between the predicted and actual 1-, 3-, and 5-year OS rates. Conclusion This is the first nomogram study that integrates common clinicopathological factors to provide an individual probabilistic prognosis prediction for Chinese Han patients with astrocytoma (grades II-III). This model can serve as an easy-to-use tool to advise patients and establish optimized surveillance approaches after surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s13755-023-00223-0.
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Affiliation(s)
- Lijie Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China
- Institute for Medical Dataology, Shandong University, Jinan, China
| | - Jinling Zhang
- Cancer Center & the Research Center of Function Image on Brain Tumor, Linyi People’s Hospital, Shandong University, Linyi, China
| | - Jingtao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China
- Institute for Medical Dataology, Shandong University, Jinan, China
| | - Hao Xue
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Brain and Brain-Inspired Science, Shandong Provincial Key Laboratory of Brain Function Remodeling, Shandong University, Jinan, China
| | - Lin Deng
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Brain and Brain-Inspired Science, Shandong Provincial Key Laboratory of Brain Function Remodeling, Shandong University, Jinan, China
| | - Fengyuan Che
- Neurology Department & the Research Center of Function Image on Brain Tumor, Linyi People’s Hospital, Shandong University, Linyi, China
| | - Xueyuan Heng
- Neurosurgery Department & the Research Center of Function Image on Brain Tumor, Linyi People’s Hospital, Shandong University, Linyi, China
| | - Xuejun Zheng
- Department of Radiology, Linyi People’s Hospital, Shandong University, Linyi, China
| | - Zilong Lu
- The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Liuqing Yang
- The Department for Chronic and Non-Communicable Disease and Endemic Disease Control and Prevention, Linyi Center for Disease Control and Prevention, Linyi, China
| | - Qihua Tan
- Epidemiology and Biostatistics, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Yeping Xu
- Synthesis Electronic Technology Co., Ltd., Jinan, China
| | - Yanchun Zhang
- Institute for Sustainable Industries & Liveable Cities, College of Engineering and Science, Victoria University, Melbourne, VIC Australia
| | - Xiaokang Ji
- Institute for Medical Dataology, Shandong University, Jinan, China
| | - Gang Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Brain and Brain-Inspired Science, Shandong Provincial Key Laboratory of Brain Function Remodeling, Shandong University, Jinan, China
| | - Fan Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China
- Institute for Medical Dataology, Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China
- Institute for Medical Dataology, Shandong University, Jinan, China
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Francis SS, Ostrom QT, Cote DJ, Smith TR, Claus E, Barnholtz-Sloan JS. The Epidemiology of Central Nervous System Tumors. Hematol Oncol Clin North Am 2022; 36:23-42. [PMID: 34801162 DOI: 10.1016/j.hoc.2021.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This article reviews the current epidemiology of central nervous system tumors. Population-level basic epidemiology, nationally and internationally, and current understanding of germline genetic risk are discussed, with a focus on known and well-studied risk factors related to the etiology of central nervous system tumors.
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Affiliation(s)
- Stephen S Francis
- Department of Neurological Surgery, Division of Neuro and Molecular Epidemiology, University of California San Francisco School of Medicine, 1450 3rd Street, HD442, San Francisco, CA 94158, USA.
| | - Quinn T Ostrom
- Department of Neurosurgery, Duke University School of Medicine, 571 Research Drive, MSRB-1, Rm 442, Durham, NC 27710, USA
| | - David J Cote
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, 1200 N State Street, Suite 3300, Los Angeles, CA 90033, USA
| | - Timothy R Smith
- Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Avenue, Boston, MA 02115, USA
| | - Elizabeth Claus
- Department of Neurosurgery, Yale University, Yale School of Public Health, Brigham and Women's Hospital, 60 College Street, New Haven, CT 06510, USA
| | - Jill S Barnholtz-Sloan
- Center for Biomedical Informatics and Information Technology, Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), NCI Shady Grove, 9609 Medical Center Dr, Rockville, MD 20850, USA
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Coffee and tea consumption and the risk of glioma: a systematic review and dose-response meta-analysis. Br J Nutr 2021; 127:78-86. [PMID: 33750490 DOI: 10.1017/s0007114521000830] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this systematic review and dose-response meta-analysis, we aimed to assess whether coffee and tea consumption is related to the risk of glioma. We performed a systematic literature search using PubMed, Embase, Scopus and the EuropePMC from the inception of database up until 1 October 2020. Exposures in the present study were coffee and tea consumption, the main outcome was the incidence of glioma. The present study compares the association between the exposure of coffee and tea with the incidence of glioma, and the results are reported in relative risks (RR). There are 12 unique studies comprising of 1 960 731 participants with 2987 glioma cases. Higher coffee consumption was associated with a statistically non-significant trend towards lower risk of glioma (RR 0·77 (95 % CI 0·55, 1·03), P= 0·11; I2:75·27 %). Meta-regression showed that the association between coffee and glioma was reduced by smoking (P= 0·029). Higher tea consumption was associated with a lower risk of glioma (RR 0·84 (95 % CI 0·71, 0·98), P= 0·030; I2:16·42 %). Sensitivity analysis by removal of case-control studies showed that higher coffee consumption (RR 0·85 (95 % CI 0·72, 1·00), P= 0·046; I2:0 %) and higher tea consumption (RR 0·81 (95 % CI 0·70, 0·93), P= 0·004; I2:0 %, Pnon-linearity = 0·140) were associated with lower risk of glioma. Dose-response meta-analysis showed that every one cup of coffee per day decreases the risk of glioma by 3 % (RR 0·97 (95 % CI 0·94, 0·99), P= 0·016, Pnon-linearity = 0·054) and every one cup of tea per day decreases the risk of glioma by 3 % (RR 0·97 (95 % CI 0·94, 1·00), P= 0·048). This meta-analysis showed apparent association between coffee and tea intake and risk of glioma.
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Malueka RG, Dwianingsih EK, Bayuangga HF, Panggabean AS, Argo IW, Donurizki AD, Shaleh S, Wicaksono AS, Dananjoyo K, Asmedi A, Hartanto RA. Clinicopathological Features and Prognosis of Indonesian Patients with Gliomas with IDH Mutation: Insights into Its Significance in a Southeast Asian Population. Asian Pac J Cancer Prev 2020; 21:2287-2295. [PMID: 32856857 PMCID: PMC7771930 DOI: 10.31557/apjcp.2020.21.8.2287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Gliomas remain one of the most common primary brain tumors. Mutations in the isocitrate dehydrogenase (IDH) gene are associated with a distinct set of clinicopathological profiles. However, the distribution and significance of these mutations have never been studied in the Indonesian population. This study aimed to elucidate the association between IDH mutations and clinicopathological as well as prognostic profiles of Indonesian patients with gliomas. Methods: In total, 106 patients with gliomas were recruited from a tertiary academic medical center in Yogyakarta, Indonesia. Formalin-fixed paraffin-embedded and fresh tissue specimens were obtained and sectioned for hematoxylin-eosin staining and immunohistochemical examinations. Genomic DNA was isolated and analyzed for the presence of IDH mutations using standard polymerase chain reaction and nucleotide sequencing methods. Clinicopathological data were collected from medical records. Results: Although no IDH2 mutation was identified, IDH1 mutations were found in 23 (21.7%) of the patients. Patients with IDH1 mutations tended to have a history of smoking and a shorter interval between onset of symptoms and initial surgical interventions. Frontal lobe involvement, oligodendroglial histology, lower Ki67 expression, WHO grades II and III gliomas, and methylated O6-methylguanine-DNA methyltransferase (MGMT) promoters were significantly associated with the presence of IDH1 mutations. Compared with patients with IDH1-wild-type, patients with IDH1 mutation were observed to have a longer overall survival. Conclusions: IDH1 mutations are associated with certain clinicopathological and prognostic profiles in Indonesian patients with gliomas. This finding demonstrates the importance of identifying IDH mutations as part of the management of patients with glioma in Indonesia.
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Affiliation(s)
- Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Halwan Fuad Bayuangga
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Andre Stefanus Panggabean
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Widya Argo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Aditya Dwi Donurizki
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sabillal Shaleh
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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Cigarette Smoking Is Associated with Increased Risk of Malignant Gliomas: A Nationwide Population-Based Cohort Study. Cancers (Basel) 2020; 12:cancers12051343. [PMID: 32466105 PMCID: PMC7280985 DOI: 10.3390/cancers12051343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 01/23/2023] Open
Abstract
The association between cigarette smoking and the risk of developing malignant glioma (MG) remains unclear. We aimed to evaluate this potential association in a large general population, using a well-established and validated longitudinal nationwide database. Using data from the Korean National Health Insurance System cohort, 9,811,768 people over 20 years old without any cancer history in 2009 were followed until the end of 2017. We documented 6100 MG cases (ICD-10 code C71) during the median follow-up period of 7.31 years. Current smokers had a higher risk of developing MG (HR = 1.22, CI: 1.13–1.32) compared with never-smokers, after adjusting for confounders. This association was stronger for those who smoked ≥ 20 cigarettes daily (HR = 1.50, CI: 1.36–1.64). Furthermore, having 30 or more pack-years of smoking over the course of one’s lifetime was associated with an increased risk of developing MG in a dose-dependent manner, compared with never-smokers (HR = 1.31, CI: 1.16–1.48 for 30–39 pack-years of smoking; HR = 1.36, CI: 1.17–1.59 for 40–49 pack-years of smoking; HR = 1.68; CI: 1.44–1.95 for ≥ 50 pack-years of smoking). These results suggest that cigarette smoking may be associated with developing MG. Further prospective studies could help elucidate this association.
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Ostrom QT, Fahmideh MA, Cote DJ, Muskens IS, Schraw JM, Scheurer ME, Bondy ML. Risk factors for childhood and adult primary brain tumors. Neuro Oncol 2019; 21:1357-1375. [PMID: 31301133 PMCID: PMC6827837 DOI: 10.1093/neuonc/noz123] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Primary brain tumors account for ~1% of new cancer cases and ~2% of cancer deaths in the United States; however, they are the most commonly occurring solid tumors in children. These tumors are very heterogeneous and can be broadly classified into malignant and benign (or non-malignant), and specific histologies vary in frequency by age, sex, and race/ethnicity. Epidemiological studies have explored numerous potential risk factors, and thus far the only validated associations for brain tumors are ionizing radiation (which increases risk in both adults and children) and history of allergies (which decreases risk in adults). Studies of genetic risk factors have identified 32 germline variants associated with increased risk for these tumors in adults (25 in glioma, 2 in meningioma, 3 in pituitary adenoma, and 2 in primary CNS lymphoma), and further studies are currently under way for other histologic subtypes, as well as for various childhood brain tumors. While identifying risk factors for these tumors is difficult due to their rarity, many existing datasets can be leveraged for future discoveries in multi-institutional collaborations. Many institutions are continuing to develop large clinical databases including pre-diagnostic risk factor data, and developments in molecular characterization of tumor subtypes continue to allow for investigation of more refined phenotypes. Key Point 1. Brain tumors are a heterogeneous group of tumors that vary significantly in incidence by age, sex, and race/ethnicity.2. The only well-validated risk factors for brain tumors are ionizing radiation (which increases risk in adults and children) and history of allergies (which decreases risk).3. Genome-wide association studies have identified 32 histology-specific inherited genetic variants associated with increased risk of these tumors.
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Affiliation(s)
- Quinn T Ostrom
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Maral Adel Fahmideh
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Solna, Karolinska Institutet, and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - David J Cote
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Computational Neuroscience Outcomes Center, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Ivo S Muskens
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jeremy M Schraw
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Melissa L Bondy
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
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McConnell DD, Carr SB, Litofsky NS. Potential effects of nicotine on glioblastoma and chemoradiotherapy: a review. Expert Rev Neurother 2019; 19:545-555. [PMID: 31092064 DOI: 10.1080/14737175.2019.1617701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: Glioblastoma multiforme (GBM) has a poor prognosis despite maximal surgical resection with subsequent multi-modal radiation and chemotherapy. Use of tobacco products following diagnosis and during the period of treatment for non-neural tumors detrimentally affects treatment and prognosis. Approximately, 16-28% of patients with glioblastoma continue to smoke after diagnosis and during treatment. The literature is sparse for information-pertaining effects of smoking and nicotine on GBM treatment and prognosis. Areas covered: This review discusses cellular pathways involved in GBM progression that might be affected by nicotine, as well as how nicotine may contribute to resistance to treatment. Similarities of GBM pathways to those in non-neural tumors are investigated for potential effects by nicotine. English language papers were identified using PubMed, Medline and Scopus databases using a combination of keywords including but not limited to the following: nicotine, vaping, tobacco, e-cigarettes, smoking, vaping AND glioblastoma or brain cancer OR/AND temozolomide, carmustine, methotrexate, procarbazine, lomustine, vincristine, and neural tumor cell lines. Expert opinion: Understanding the impact of nicotine on treatment and resistance to chemotherapeutics should allow physicians to educate their patients with GBM with evidence-based recommendations about the effects of continuing to use nicotine-containing products after diagnosis and during treatment.
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Affiliation(s)
- Diane D McConnell
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
| | - Steven B Carr
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
| | - N Scott Litofsky
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
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Persaud-Sharma D, Burns J, Trangle J, Castro G, Barengo N, Moulik S, Manuel Lozano J. Demographic Variation in the Frequency of Gliomas in Florida. ACTA ACUST UNITED AC 2019; 55:medicina55010005. [PMID: 30621205 PMCID: PMC6358829 DOI: 10.3390/medicina55010005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/26/2018] [Accepted: 12/26/2018] [Indexed: 11/16/2022]
Abstract
Background and objectives: Glial brain cancers affect nearly 20,000 individuals in the United States (USA) annually. SEER database data exploring the relationship between race and gliomas is now available and have shown that cerebral gliomas occur at a higher frequency in Caucasian men. However, such analyses did not include demographic data specific to the state of Florida. This study assessed the association between race and glial vs. non-glial Central Nervous System (CNS) cancers in Florida, USA. Materials and Methods: This case-control study utilized the Florida Cancer Data Registry (FCDS), in which race was considered the exposure and development of glioma as the measured outcome. The sample was comprised of patients in Florida diagnosed with brain tumors from 1981 to 2013. Relative racial frequencies were compared between patients with glial brain tumors and those with other CNS tumors. Data was analyzed using logistic regression in order to determine any associations between race and frequency of diagnosis adjusting for several confounders (age, sex, smoking status, year of diagnosis, and insurance status). Results: Between 1981 and 2013 a total of 14,092 patients meeting the inclusion and exclusion criteria were diagnosed in Florida with a primary brain tumor. Being of non-white race was associated with 60% decreased odds of glioma diagnosis compared to the reference white population (adjusted OR 0.4, 95% CI 0.34⁻0.47). Secondary findings include associations between increasing age and male sex with increased odds of glioma diagnosis. Decreased adjusted odds of glioma diagnosis were found with former smoking status (reference non-smokers), diagnosis between 2001 and 2010 (reference 1981⁻1990), and Medicaid or Medicare insurance (reference private insurance). Hispanic ethnicity, current smoking status, no insurance/self-pay, and geographical location (urban vs. rural) all had no association with glioma diagnosis. Conclusions: These findings are consistent with and help reinforce previous studies utilizing national databases (SEER) which also showed increasing odds of glioma diagnosis in older white males. Various potential explanations for these findings include genetic predisposition, lifestyle and behavioral factors, and socioeconomic status, including access to healthcare. Future research aims at identifying potential genetic etiologies.
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Affiliation(s)
- Dharam Persaud-Sharma
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Joseph Burns
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Jeran Trangle
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Grettel Castro
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Noel Barengo
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Sabyasachi Moulik
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
| | - Juan Manuel Lozano
- Herbert Wertheim College of Medicine Miami, Florida International University, Miami, FL 33199, USA.
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Andersson U, Degerman S, Dahlin AM, Wibom C, Johansson G, Bondy ML, Melin BS. The association between longer relative leukocyte telomere length and risk of glioma is independent of the potentially confounding factors allergy, BMI, and smoking. Cancer Causes Control 2018; 30:177-185. [PMID: 30560391 DOI: 10.1007/s10552-018-1120-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/06/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Previous studies have suggested an association between relative leukocyte telomere length (rLTL) and glioma risk. This association may be influenced by several factors, including allergies, BMI, and smoking. Previous studies have shown that individuals with asthma and allergy have shortened relative telomere length, and decreased risk of glioma. Though, the details and the interplay between rLTL, asthma and allergies, and glioma molecular phenotype is largely unknown. METHODS rLTL was measured by qPCR in a Swedish population-based glioma case-control cohort (421 cases and 671 controls). rLTL was related to glioma risk and health parameters associated with asthma and allergy, as well as molecular events in glioma including IDH1 mutation, 1p/19q co-deletion, and EGFR amplification. RESULTS Longer rLTL was associated with increased risk of glioma (OR = 1.16; 95% CI 1.02-1.31). Similar to previous reports, there was an inverse association between allergy and glioma risk. Specific, allergy symptoms including watery eyes was most strongly associated with glioma risk. High body mass index (BMI) a year prior diagnosis was significantly protective against glioma in our population. Adjusting for allergy, asthma, BMI, and smoking did not markedly change the association between longer rLTL and glioma risk. rLTL among cases was not associated with IDH1 mutation, 1p/19q co-deletion, or EGFR amplification, after adjusting for age at diagnosis and sex. CONCLUSIONS In this Swedish glioma case-control cohort, we identified that long rLTL increases the risk of glioma, an association not confounded by allergy, BMI, or smoking. This highlights the complex interplay of the immune system, rLTL and cancer risk.
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Affiliation(s)
- Ulrika Andersson
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden.
| | - Sofie Degerman
- Department of Medical Biosciences, Pathology, Umea University, Umea, Sweden
| | - Anna M Dahlin
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Carl Wibom
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Gunnar Johansson
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Melissa L Bondy
- Department of Medicine, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Beatrice S Melin
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
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Li HX, Peng XX, Zong Q, Zhang K, Wang MX, Liu YZ, Han GL. Cigarette smoking and risk of adult glioma: a meta-analysis of 24 observational studies involving more than 2.3 million individuals. Onco Targets Ther 2016; 9:3511-23. [PMID: 27366088 PMCID: PMC4913539 DOI: 10.2147/ott.s99713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Cigarette smoking has been shown to be a risk factor for adult glioma by some but not all studies. We conducted a meta-analysis to systematically assess the potential association. Methods PubMed and EMBASE were searched from the date of their inception to October 1, 2015, to identify relevant articles. Reference lists from these articles were reviewed to identify additional studies. Both cohort and case–control studies were included. Fixed-effects models were used to calculate the overall relative risk (RR) with corresponding 95% confidence intervals (CIs). Results The final analysis included 24 studies (seven cohort and 17 case–control studies), involving more than 2.3 million individuals. The combined RR was 1.04 (95% CI: 1.00, 1.09; P=0.073) for ever-smokers, 0.97 (95% CI: 0.88, 1.07; P=0.574) for current-smokers, and 1.07 (95% CI: 0.98, 1.16; P=0.130) for past smokers, with little evidence of heterogeneity. Omission of any single study from the analysis had little effect on the result. No evidence of publication bias was found. A small but statistically significant increase was found in past smokers in females (RR: 1.13, 95% CI: 1.00, 1.28; P=0.046) but not in males. Conclusion In general, there was no association between cigarette smoking and adult glioma. The small but statistically significant association in females requires further investigation.
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Affiliation(s)
- Hong-Xing Li
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Xiao-Xiao Peng
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China; Department of Intensive Care Unit, Dongying, Shandong, People's Republic of China
| | - Qiang Zong
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Kai Zhang
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Ming-Xin Wang
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Yi-Zhe Liu
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Guang-Liang Han
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
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Abstract
To systematically assess the relationship between smoking and glioma risk.A dose-response meta-analysis of case-control and cohort studies was performed. Pertinent studies were identified by searching database and reference lists. Random-effects model was employed to pool the estimates of the relative risks (RRs) with corresponding 95% confidence intervals (CIs).A total of 19 case-control and 6 cohort studies were included. Overall, compared with those who never smoked, the pooled RR and 95% CI was 0.98 (0.92-1.05) for ever smoker. The subgroups were not significantly different regarding risk of glioma except the group of age at start smoking (RR = 1.17, 95% CI: 0.93-1.48 for age < 20; RR = 1.25, 95% CI: 1.02-1.52 for age ≥ 20). Dose-response analysis also suggested no significant association between smoking and the risk of glioma, although some evidence for a linear relationship between smoking and glioma risk was observed.In conclusion, this meta-analysis provides little support for a causal relationship between smoking and risk of glioma.
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Affiliation(s)
- Chuan Shao
- From the Department of Neurosurgery, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan, China (CS, WZ, JH); and Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (ZQ)
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12
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Pouchieu C, Baldi I, Gruber A, Berteaud E, Carles C, Loiseau H. Descriptive epidemiology and risk factors of primary central nervous system tumors: Current knowledge. Rev Neurol (Paris) 2015; 172:46-55. [PMID: 26708326 DOI: 10.1016/j.neurol.2015.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 11/16/2022]
Abstract
Although comparisons are difficult due to differences in methodologies, the annual incidence rates of central nervous system (CNS) tumors range from 8.5 to 21.4/100,000 population according to cancer registries, with a predominance of neuroepithelial tumors in men and meningiomas in women. An increase in the incidence of CNS tumors has been observed during the past decades in several countries. It has been suggested that this trend could be due to aging of the population, and improvements in diagnostic imaging and healthcare access, but these factors do not explain differences in incidence by gender and histological subtypes. Several etiological hypotheses related to intrinsic (sociodemographic, anthropometric, hormonal, immunological, genetic) and exogenous (ionizing radiation, electromagnetic fields, diet, infections, pesticides, drugs) risk factors have led to analytical epidemiological studies to establish relationships with CNS tumors. The only established environmental risk factor for CNS tumors is ionizing radiation exposure. However, for other risk factors, studies have been inconsistent and inconclusive due to systematic differences in study design and difficulties in accurately measuring exposures. Thus, the etiology of CNS tumors is complex and may involve several genetic and/or environmental factors that may act differently according to histological subtype.
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Affiliation(s)
- C Pouchieu
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France
| | - I Baldi
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France.
| | - A Gruber
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France
| | - E Berteaud
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France
| | - C Carles
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France
| | - H Loiseau
- Service de neurochirurgie, CHU de Bordeaux, 33000 Bordeaux, France
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13
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Hou L, Jiang J, Liu B, Han W, Wu Y, Zou X, Nasca PC, Xue F, Chen Y, Zhang B, Pang H, Wang Y, Wang Z, Li J. Smoking and adult glioma: a population-based case-control study in China. Neuro Oncol 2015; 18:105-13. [PMID: 26409568 DOI: 10.1093/neuonc/nov146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/24/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Smoking increases the risk of numerous cancers; however, an association of smoking with adult gliomas has not been found in a population. METHODS This case-control study included 4556 glioma cases (ICD-9 code 191.0-191.9) aged ≥ 30 years and 9112 controls from a national survey of smoking and mortality in China in 1989-1991. Controls from 325 255 surviving spouses of all-cause deaths were randomly assigned to cases in each of 103 areas according to sex and age groups at a ratio of 2:1. Smoking information was ascertained retrospectively by interviewing surviving spouses. RESULTS After adjustment for confounders, smoking increased the risk of glioma deaths by 11% (odds ratio [OR] = 1.11; 95% confidence interval [CI]: 1.03-1.21). Compared with non-smokers; the increased risk was 9% (OR = 1.09; 95% CI: 0.99-1.20) in men and 16% (OR = 1.16; 95% CI: 1.00-1.36) in women. The risk increased with age and doses. For individuals aged ≥ 50 years, smoking was associated with higher risk of glioma death by 25% (OR = 1.25; 95% CI: 1.15-1.38); this increased risk for smokers who smoked ≥ 20 cigarettes daily for ≥ 30 years was 53% (OR = 1.53; 95% CI: 1.34-1.74). There were similar findings in both men and women and with either pathology-based or non-pathology-based comparisons. CONCLUSIONS This study indicates that smoking is associated with glioma deaths in the Chinese population. Long-term heavy smoking could be a factor for risk stratification in individuals attending brain tumor clinics.
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Affiliation(s)
- Lei Hou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Boqi Liu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yanping Wu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Xiaonong Zou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Philip C Nasca
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yuanli Chen
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Haiyu Pang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Junyao Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
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Vida S, Richardson L, Cardis E, Krewski D, McBride M, Parent ME, Abrahamowicz M, Leffondré K, Siemiatycki J. Brain tumours and cigarette smoking: analysis of the INTERPHONE Canada case-control study. Environ Health 2014; 13:55. [PMID: 24972852 PMCID: PMC4088305 DOI: 10.1186/1476-069x-13-55] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/23/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND There is conflicting evidence regarding the associations between cigarette smoking and glioma or meningioma. Our purpose is to provide further evidence on these possible associations. METHODS We conducted a set of case-control studies in three Canadian cities, Montreal, Ottawa and Vancouver. The study included 166 subjects with glioma, 93 subjects with meningioma, and 648 population-based controls. A lifetime history of cigarette smoking was collected and various smoking indices were computed. Multivariable logistic regression was used to estimate odds ratios (ORs) between smoking and each of the two types of brain tumours. RESULTS Adjusted ORs between smoking and each type of brain tumour were not significantly elevated for all smokers combined or for smokers with over 15 pack-years ((packs / day) x years) accumulated. We tested for interactions between smoking and several sociodemographic variables; the interaction between smoking and education on glioma risk was significant, with smoking showing an elevated OR among subjects with lower education and an OR below unity among subjects with higher education. CONCLUSION Except for an unexplained and possibly artefactual excess risk in one population subgroup, we found little or no evidence of an association between smoking and either glioma or meningioma.
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Affiliation(s)
- Stephen Vida
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
- McGill University, Montréal, Québec, Canada
| | - Lesley Richardson
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Elisabeth Cardis
- Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM), CIBERESP, Barcelona, Spain
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Mary McBride
- British Columbia Cancer Agency, Vancouver, Canada
| | - Marie-Elise Parent
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | - Michal Abrahamowicz
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
- McGill University, Montréal, Québec, Canada
| | - Karen Leffondré
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - Jack Siemiatycki
- Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
- Guzzo-SRC Research Chair in Environment and Cancer, Centre de Recherche, Centre hospitalier de l’Université de Montréal (CHUM), 850, rue St-Denis, room S02-458, Montreal, Quebec H2X 0A9, Canada
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Cigarette smoking, alcohol intake, and risk of glioma in the NIH-AARP Diet and Health Study. Br J Cancer 2013; 110:242-8. [PMID: 24335921 PMCID: PMC3887282 DOI: 10.1038/bjc.2013.611] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/10/2013] [Accepted: 09/12/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Although cigarette smoking and alcohol drinking increase the risk of several cancers and certain components of cigarette smoke and alcohol can penetrate the blood-brain barrier, it remains unclear whether these exposures influence the risk of glioma. METHODS We examined the associations between cigarette smoking, alcohol intake, and risk of glioma in the National Institutes of Health-AARP Diet and Health Study, a prospective study of 477,095 US men and women ages 50-71 years at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using models with age as the time metric and adjusted for sex, race/ethnicity, education, and marital status. RESULTS During a median 10.5 person-years of follow-up, 492 men and 212 women were diagnosed with first primary glioma. Among men, current, heavier smoking was associated with a reduced risk of glioma compared with never smoking, but this was based on only nine cases. No associations were observed between smoking behaviours and glioma risk in women. Greater alcohol consumption was associated with a decreased risk of glioma, particularly among men (>2 drinks per day vs <1 drink per week: HR=0.67, 95% CI=0.51-0.90). CONCLUSION Smoking and alcohol drinking do not appear to increase the risk of glioma.
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Lachance DH, Yang P, Johnson DR, Decker PA, Kollmeyer TM, McCoy LS, Rice T, Xiao Y, Ali-Osman F, Wang F, Stoddard SM, Sprau DJ, Kosel ML, Wiencke JK, Wiemels JL, Patoka JS, Davis F, McCarthy B, Rynearson AL, Worra JB, Fridley BL, O'Neill BP, Buckner JC, Il'yasova D, Jenkins RB, Wrensch MR. Associations of high-grade glioma with glioma risk alleles and histories of allergy and smoking. Am J Epidemiol 2011; 174:574-81. [PMID: 21742680 DOI: 10.1093/aje/kwr124] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Glioma risk has consistently been inversely associated with allergy history but not with smoking history despite putative biologic plausibility. Data from 855 high-grade glioma cases and 1,160 controls from 4 geographic regions of the United States during 1997-2008 were analyzed for interactions between allergy and smoking histories and inherited variants in 5 established glioma risk regions: 5p15.3 (TERT), 8q24.21 (CCDC26/MLZE), 9p21.3 (CDKN2B), 11q23.3 (PHLDB1/DDX6), and 20q13.3 (RTEL1). The inverse relation between allergy and glioma was stronger among those who did not (odds ratio(allergy-glioma) = 0.40, 95% confidence interval: 0.28, 0.58) versus those who did (odds ratio(allergy-glioma) = 0.76, 95% confidence interval: 0.59, 0.97; P(interaction) = 0.02) carry the 9p21.3 risk allele. However, the inverse association with allergy was stronger among those who carried (odds ratio(allergy-glioma) = 0.44, 95% confidence interval: 0.29, 0.68) versus those who did not carry (odds ratio(allergy-glioma) = 0.68, 95% confidence interval: 0.54, 0.86) the 20q13.3 glioma risk allele, but this interaction was not statistically significant (P = 0.14). No relation was observed between glioma risk and smoking (odds ratio = 0.92, 95% confidence interval: 0.77, 1.10; P = 0.37), and there were no interactions for glioma risk of smoking history with any of the risk alleles. The authors' observations are consistent with a recent report that the inherited glioma risk variants in chromosome regions 9p21.3 and 20q13.3 may modify the inverse association of allergy and glioma.
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Affiliation(s)
- Daniel H Lachance
- Department of Neurology, Mayo Clinic, 200 First Street SW,Rochester, MN 55905, USA.
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Bao G, Wang M, Guo S, Han Y, Xu G. Association between epidermal growth factor +61 G/A polymorphism and glioma risk in a Chinese Han population. J Int Med Res 2011; 38:1645-52. [PMID: 21309478 DOI: 10.1177/147323001003800509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The association between the +61 G/A polymorphism of the epidermal growth factor (EGF) gene and glioma risk remains controversial and unclear. The objective of this study was to investigate the association between the EGF +61 G/A polymorphism and glioma risk in a Chinese Han population. Peripheral blood samples were extracted from 160 glioma patients and 320 control subjects. Genotyping was performed using a polymerase chain reaction-restriction fragment length polymorphism method. Glioma patients had a significantly higher frequency of the AA genotype (odds ratio [OR] 1.93, 95% confidence intervals [CI] 1.08, 3.44) than control subjects and the frequency of the AA genotype was significantly higher in glioblastoma patients than in patients with other gliomas (OR 2.19, 95% CI 1.05, 4.57). Patients with grade IV gliomas had a significantly higher frequency of the AA genotype (OR 2.25, 95% CI 1.08, 4.71) than patients with lower grade gliomas. This study demonstrated that the EGF +61 AA genotype is associated with an increased risk of glioma in a Chinese Han population.
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Affiliation(s)
- G Bao
- Department of Neurosurgery, The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, China.
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Bao G, Wang M, Guo S, Han Y, Xu G. Vascular Endothelial Growth Factor +936 C/T Gene Polymorphism and Glioma Risk in a Chinese Han Population. Genet Test Mol Biomarkers 2011; 15:103-6. [PMID: 21117958 DOI: 10.1089/gtmb.2010.0141] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gang Bao
- Department of Neurosurgery, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Maode Wang
- Department of Neurosurgery, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Shiwen Guo
- Department of Neurosurgery, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Yuliang Han
- Department of Neurosurgery, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Gaofeng Xu
- Department of Neurosurgery, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
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Kyritsis AP, Bondy ML, Levin VA. Modulation of glioma risk and progression by dietary nutrients and antiinflammatory agents. Nutr Cancer 2011; 63:174-84. [PMID: 21302177 PMCID: PMC3047463 DOI: 10.1080/01635581.2011.523807] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gliomas are tumors of glial origin formed in the central nervous system and exhibit profound morphological and genetic heterogeneity. The etiology of this heterogeneity involves an interaction between genetic alterations and environmental risk factors. Scientific evidence suggests that certain natural dietary components, such as phytoestrogens, flavonoids, polyunsaturated fatty acids, and vitamins, may exert a protective effect against gliomas by changing the nature of the interaction between genetics and environment. Similarly, certain antiinflammatory drugs and dietary modifications, such as methionine restriction and the adoption of low-calorie or ketogenic diets, may take advantage of glioma and normal glial cells' differential requirements for glucose, methionine, and ketone bodies and may, therefore, be effective as part of preventive or treatment strategies for gliomas. Treatment trials of glioma patients and chemoprevention trials of individuals with a known genetic predisposition to glioma using the most promising of these agents, such as the antiinflammatory drugs curcumin and gamma-linolenic acid, are needed to validate or refute these agents' putative role in gliomas.
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Cabaniols C, Giorgi R, Chinot O, Ferahta N, Spinelli V, Alla P, Barrie M, Lehucher-Michel MP. Links between private habits, psychological stress and brain cancer: a case-control pilot study in France. J Neurooncol 2010; 103:307-16. [PMID: 20835749 DOI: 10.1007/s11060-010-0388-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 08/26/2010] [Indexed: 12/31/2022]
Abstract
Numerous studies have increasingly suggested that medical history and lifestyle factors could be involved in the increase of cancer risk in adults. The issue whether psychological factors can influence the development of cancer has been discussed for many years. In the field of brain cancer, psychological stress has not so far been investigated. We conducted a French case-control pilot study with 122 adult incident cases and 122 controls free of any cancer diagnosis, matched for age and gender, to investigate links between malignant primitive brain tumours (MPBT) and medical history, private habits and psychological stress. Data were collected through self-administered questionnaires, and person-to-person interviews. To complete the psychological stress assessment, 100-mm visual analog scales were used. After adjustment for confounders, we found no significant effect of head trauma, aspartame, tobacco or alcohol consumption, place (rural or urban) of residence, sociodemographic data, and experience of psychological stress at work/home. Our results showed a significant association between MPBT risk and major life events over the past 5 years before diagnosis (OR = 1.90, 95% CI 1.13-3.20), family histories of cancer (OR = 1.90, 95% CI 1.12-3.22), fresh vegetable and fruit intake (OR = 0.29, 95% CI 0.09-0.95), and skipped meals several times per week (OR = 0.35, 95% CI 0.16-0.77). The present study suggests the role of genetic factors in glioma risk, and also suggests that an acute and sudden psychological stress might influence MPBT appearance. Additional large clinical studies are needed to confirm these findings.
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Affiliation(s)
- Cécilia Cabaniols
- EA3279, Evaluation Hospitalière et Santé Perçue, Université de la Méditerranée, et Unité de Consultation de Pathologie Professionnelle, Hôpital Timone Adultes, 264, rue Saint Pierre, 13385, Marseille Cedex 05, France
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Dubrow R, Darefsky AS, Park Y, Mayne ST, Moore SC, Kilfoy B, Cross AJ, Sinha R, Hollenbeck AR, Schatzkin A, Ward MH. Dietary components related to N-nitroso compound formation: a prospective study of adult glioma. Cancer Epidemiol Biomarkers Prev 2010; 19:1709-22. [PMID: 20570910 PMCID: PMC2901412 DOI: 10.1158/1055-9965.epi-10-0225] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND N-nitroso compounds (NOC) are found in processed meat and are formed endogenously from intake of nitrite and nitrate. Endogenous NOC formation is antagonized by nitrosation inhibitors in fruit and vegetables (e.g., vitamin C) and promoted by heme in red meat. It has been hypothesized that a diet resulting in high exposure to NOCs increases adult glioma risk. METHODS Using proportional hazards models, we tested this hypothesis among 545,770 participants in the prospective NIH-AARP Diet and Health Study, which assessed dietary intake at baseline (1995-1996) with a comprehensive food frequency questionnaire, and at ages 12 to 13 years with an abbreviated food frequency questionnaire. RESULTS During follow-up through 2003, 585 participants were diagnosed with glioma. We found no significant trends in glioma risk for consumption of processed or red meat, nitrate, or vitamin C or E. We found significant positive trends for nitrite intake from plant sources (hazard ratio for quintile 5 versus quintile 1, 1.59; 95% confidence interval, 1.20-2.10; P for trend = 0.028) and, unexpectedly, for fruit and vegetable intake (hazard ratio, 1.42; 95% confidence interval, 1.08-1.86; P for trend = 0.0081). Examination of interactions between dietary intakes (e.g., nitrite and vitamin C) and a limited analysis of diet at ages 12 to 13 years provided no support for the NOC hypothesis. CONCLUSIONS Our results suggest that consumption of processed or red meat, nitrite, or nitrate does not increase adult glioma risk, and that consumption of fruit and vegetables, vitamin C, or vitamin E does not reduce risk. IMPACT Our results, in agreement with the only previous prospective analysis, cast doubt on the NOC hypothesis in relation to dietary intake and adult glioma risk.
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Affiliation(s)
- Robert Dubrow
- Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06520-8034, USA.
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Moustakas A, Kreisl TN. New treatment options in the management of glioblastoma multiforme: a focus on bevacizumab. Onco Targets Ther 2010; 3:27-38. [PMID: 20616955 PMCID: PMC2895775 DOI: 10.2147/ott.s5307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Indexed: 12/21/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults and carries the poorest prognosis. Despite recent progress in molecular biology, neuro-imaging and neuro-surgical care, the management of patients with GBM continues to harbor significant challenges. Survival after diagnosis is poor even with the most aggressive approach using multimodality therapy. Although the etiology of malignant gliomas is not known, the dependency of tumor growth on angiogenesis has identified this pathway as a promising therapeutic target. Bevacizumab was the first antiangiogenic therapy approved for use in cancer and received accelerated Food and Drug Administration approval for the treatment of recurrent GBM in 2009, the first new drug for this disease in over a decade. This review describes the rationale behind the treatment of GBM with bevacizumab. The pharmacology, efficacy, safety and tolerability of bevacizumab will also be reviewed.
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Affiliation(s)
- Argirios Moustakas
- National Cancer Institute, Neuro-Oncology Branch, National Institutes of Health, Bethesda, Maryland, USA
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Wang S, Zhao Y, Ruan Z, Chen H, Fan W, Chen J, Wu Q, Qian J, Zhang T, Huang Y, Lu D. Association between EGF +61 G/A and glioma risk in a Chinese population. BMC Cancer 2010; 10:221. [PMID: 20487573 PMCID: PMC2885363 DOI: 10.1186/1471-2407-10-221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 05/21/2010] [Indexed: 01/01/2023] Open
Abstract
Background Epidermal growth factor (EGF) is critical in cancer process. EGF and EGF receptor (EGFR) interaction plays a pivotal role in cell proliferation, differentiation, and tumorigenesis of epithelial tissues. Variations of the EGF +61G/A (rs4444903) may lead to an alteration in EGF production and/or activity, which can result in individual susceptibility to brain glioma. The purpose of this study was to investigate the potential association between EGF +61G/A and brain glioma in a Chinese population. Methods In this study, we analyzed single nucleotide polymorphism of EGF +61G/A in 677 patients with glioma and 698 gender- and age-matched controls. Genotyping was performed by polymerase chain reaction-ligation detection reaction (PCR-LDR) method. Results The A allele (minor Allele) was 33.0% in cases and 27.3% in controls. The additive model was more powerful to reveal the association in our study than that of recessive and dominant model. Our data showed the genotype G/A and A/A was associated with increased risk for glioma (adjusted OR = 1.48, 95%CI: 1.17-1.87, p = 0.001 for G/A, adjusted OR = 1.81, 95%CI: 1.20-2.72, p = 0.005 for A/A, respectively), and for glioblastoma (adjusted OR = 1.51, 95%CI: 1.06-2.17, p = 0.024 and adjusted OR = 2.35, 95%CI: 1.34-4.15, p = 0.003, respectively). The A allele significantly increased glioma risk (OR = 1.31, 95%CI: 1.11-1.55, p = 0.001). The additive model (G/G vs G/A vs A/A) showed that both G/A and A/A genotype increased glioma risk (adjusted OR = 1.40, 95% CI: 1.17-1.66, p = 0.0002).G/A and A/A genotypes or EGF +61 A allele increased risk in both low and high WHO grade glioma. Non-smokers with G/A and A/A genotype showed increased glioma risk compared with G/G genotype (adjusted OR = 1.72, 95%CI: 1.29-2.30, p = 0.0002 and adjusted OR = 1.81, 95%CI: 1.10-2.99, p = 0.020, respectively). This association was not found in ever- or current-smokers. Conclusions Our study indicated that G/A and A/A genotypes or EGF +61 A allele were associated with higher glioma risk in Chinese. This is in contrast with previous studies which reported G allele as a risk factor of glioma in Caucasian. The role of EGF +61 A/G polymorphism in glioma susceptibility needs further investigation.
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Affiliation(s)
- Shujie Wang
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Sciences, Fudan University, Shanghai 200433, China
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Michaud DS, Holick CN, Batchelor TT, Giovannucci E, Hunter DJ. Prospective study of meat intake and dietary nitrates, nitrites, and nitrosamines and risk of adult glioma. Am J Clin Nutr 2009; 90:570-7. [PMID: 19587083 PMCID: PMC2728643 DOI: 10.3945/ajcn.2008.27199] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The hypothesis that nitrosamine exposure may increase the risk of glioma has been circulating for several decades, but testing it has been difficult because of the ubiquitous nature of nitrosamine exposure. Diet has been the focus of many studies because it can substantially influence nitrosamine exposure, mostly from the endogenous formation of nitrosamines based on intake of nitrite and nitrate. OBJECTIVE The objective was to examine the relation between intakes of meats, nitrate, nitrite, and 2 nitrosamines [nitrosodimethylamine (NDMA) and nitrosopyrolidine (NPYR)] and glioma risk in a prospective analysis. METHODS Data from 3 US prospective cohort studies were combined for this analysis; 335 glioma cases were diagnosed during < or =24 y of follow-up. Dietary intake was assessed with food-frequency questionnaires. Nitrate, nitrite, and nitrosamine values were calculated based on published values of these nutrients in various foods over different periods in time. Cox proportional hazards models were used to estimate incidence rate ratios (RRs) and 95% CIs. Estimates from each cohort were pooled by using a random-effects model. RESULTS Risk of glioma was not elevated among individuals in the highest intake category of total processed meats (RR: 0.92; 95% CI: 0.48, 1.77), nitrate (RR: 1.02; 95% CI: 0.66, 1.58), nitrites (RR: 1.26; 95% CI: 0.89, 1.79), or NDMA (RR: 0.88; 95% CI: 0.57, 1.36) compared with the lowest category. No effect modification was observed by intake of vitamins C or E or other antioxidant measures. CONCLUSION We found no suggestion that intake of meat, nitrate, nitrite, or nitrosamines is related to the risk of glioma.
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Affiliation(s)
- Dominique S Michaud
- Department of Epidemiology and Public Health, Imperial College London, United Kingdom.
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Mandelzweig L, Novikov I, Sadetzki S. Smoking and risk of glioma: a meta-analysis. Cancer Causes Control 2009; 20:1927-38. [DOI: 10.1007/s10552-009-9386-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 06/10/2009] [Indexed: 11/29/2022]
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[Epidemiology of primary brain tumor]. Rev Neurol (Paris) 2009; 165:650-70. [PMID: 19446856 DOI: 10.1016/j.neurol.2009.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 04/01/2009] [Accepted: 04/03/2009] [Indexed: 01/13/2023]
Abstract
Two main approaches are generally used to study the epidemiology of primary brain tumors. The first approach is to identify risk factors, which may be intrinsic or related to external causes. The second main approach is descriptive. Intrinsic factors potentially affecting risk include genetic predisposition and susceptibility, gender, race, birth weight and allergy. Radiation exposure is the main extrinsic factor affecting risk. A large body of work devoted, among others, to electromagnetic fields and especially cellular phones, substitutive hormonal therapy, pesticides, and diet have been published. To date, results have been discordant. Descriptive epidemiological studies have reported an increasing annual incidence of primary brain tumors in industrialized countries. The main reasons are the increasing age of the population and better access to diagnostic imaging. Comparing incidences from one registry to another is difficult. Spatial and temporal variations constitute one explanation and evolutions in coding methods another. In all registries, weak incidence of primary brain tumors constitute a very important limiting factor. Renewed interest from the neuro-oncological community is needed to obtain pertinent and essential data which could facilitate improved knowledge on this topic.
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Schrot RJ. Response to Letter by Hassan et al. J Neurooncol 2008. [DOI: 10.1007/s11060-008-9628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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