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Hormonal therapies and meningioma: is there a link?
Lucía Cea-Soriano1, Tilo Blenk, Mari-Ann Wallander
1Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain. luciaceife@telefonica.net
Background:
The aetiology of meningiomas is largely unknown although hormones have been suggested to play a role.
Methods:
A cohort study was performed to evaluate hormone-related factors associated with meningioma. Patients (12-89 years) with a first diagnosis of meningioma (January 1996-June 2008) were identified from The Health Improvement Network UK primary care database and age- and sex-matched to controls (n=10000) from the same cohort. Odds ratios (ORs) were calculated following a nested case control analysis using unconditional logistic regression.
Results:
In total, 745 patients with meningioma were identified from a study population of 2171287. No significantly increased risk of meningioma was found among female users of oral contraceptives (OR: 1.15; CI: 0.67-1.98), hormone replacement therapy (OR: 0.99; CI: 0.73-1.35) or low-dose cyproterone acetate (CPA; OR: 1.51; CI: 0.33-6.86) compared with non-users. There was a significantly increased risk of meningioma among male users of androgen analogues (OR: 19.09; CI: 2.81-129.74) and among users of high-dose CPA (OR: 6.30; CI: 1.37-28.94) compared with non-users, however there were only three cases currently using these drugs. No significant association was found between meningioma and prostate, breast, or genital cancers.
Conclusions:
Our results do not support a role for exogenous hormone use by females in meningioma development. The risk in males was only observed with high-dose, short-term (<1 year) therapy.
Impact:
While hormonal cancers and therapies are not associated with meningioma in females, the risk in males requires further investigation.
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