Exogenous hormone use, reproductive factors, and risk of intracranial meningioma in females

Clinical article

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  • 1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut;
  • | 2 Department of Epidemiology, Baylor College of Medicine, Houston, Texas;
  • | 3 Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina;
  • | 4 Departments of Epidemiology and Biostatistics and Neurological Surgery, University of California at San Francisco School of Medicine, San Francisco, California; and
  • | 5 Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts
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Object

The 2-fold higher incidence of meningioma in women compared with men has long suggested a role for hormonally mediated risk factors, but specific mechanisms remain elusive.

Methods

The study included data obtained in 1127 women 29–79 years of age with intracranial meningioma diagnosed among residents of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Texas counties between May 1, 2006, and October 6, 2011, and data obtained in 1092 control individuals who were frequency matched for age group and geography with meningioma patients.

Results

No association was observed for age at menarche, age at menopause, or parity and meningioma risk. Women who reported breastfeeding for at least 6 months were at reduced risk of meningioma (OR 0.78, 95% CI 0.63–0.96). A significant positive association existed between meningioma risk and increased body mass index (p < 0.01) while a significant negative association existed between meningioma risk and current smoking (p < 0.01). Among premenopausal women, current use of oral contraceptives was associated with an increased risk of meningiomas (OR 1.8, 95% CI 1.1–2.9), while current use of hormone replacement therapy among postmenopausal women was not associated with a significant elevation in risk (OR 1.1, 95% CI 0.74–1.67). There was no association between use of fertility medications and meningioma risk.

Conclusions

The authors' study confirms associations for body mass index, breastfeeding, and cigarette smoking but provides little evidence for associations of reproductive and menstrual factors with meningioma risk. The relationship between current use of exogenous hormones and meningioma remains unclear, limited by the small numbers of patients currently on oral hormone medications and a lack of hormone receptor data for meningioma tumors.

Abbreviations used in this paper:

BMI = body mass index; EPIC = European Prospective Investigation into Cancer and Nutrition; HRT = hormone replacement therapy; OC = oral contraceptive.

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Contributor Notes

Address correspondence to: Elizabeth B. Claus, M.D., Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, P.O. Box 208034, New Haven, Connecticut 06520-8034. email: elizabeth.claus@yale.edu.

Please include this information when citing this paper: published online October 26, 2012; DOI: 10.3171/2012.9.JNS12811.

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