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American Journal of Epidemiology Advance Access published online on July 11, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj254
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received October 14, 2005
Accepted March 20, 2006

ORIGINAL CONTRIBUTIONS

Risk of Brain Tumors Associated with Exposure to Exogenous Female Sex Hormones

Annette Wigertz 1 *, Stefan Lönn 1, Tiit Mathiesen 2, Anders Ahlbom 1, Per Hall 3, and Maria Feychting 1, and the Swedish INTERPHONE Study Group

1 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
2 Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
3 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden

* To whom correspondence should be addressed.
Annette Wigertz, E-mail: annette.wigertz{at}ki.se


  Abstract

The etiology of brain tumors is largely unknown. Prior observations have implicated gender-specific hormones in the pathogenesis of these tumors. In a population-based case-control study, the authors identified all women aged 20-69 years who had been diagnosed with meningioma or glioma during 2000-2002 in four regions of Sweden. Controls were randomly selected from the study base. Detailed information on hormone usage, including use of hormonal contraceptives, hormonal treatment for gynecologic problems, and hormone replacement therapy, was collected from 178 meningioma cases, 115 glioma cases, and 323 controls. Data were analyzed using unconditional logistic regression, adjusting for age, residential area, education, and parity. An increased relative risk of meningioma was found among postmenopausal women for ever use of hormone replacement therapy, with an odds ratio of 1.7 (95% confidence interval: 1.0, 2.8). Women who had used long-acting hormonal contraceptives (subdermal implants, injections, or hormonal intrauterine devices) had an increased risk of meningioma; the odds ratio for at least 10 years of use was 2.7 (95% confidence interval: 0.9, 7.5). Hormone usage was not associated with glioma risk in this study. The findings suggest that the use of female sex steroids may increase the risk of meningioma.

Keywords: case-control studies; contraceptives, oral; estrogens; glioma; hormone replacement therapy; meningioma; progesterone.
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