Abstract
BackgroundThe role of exogenous hormone exposures in the development of meningioma is unclear, but these exposures have been proposed as one hypothesis to explain the over-abundance of such tumors in women.MethodsThe association between oral contraception (OC) or hormone replacement therapy (HRT) and intracranial meningioma in women was investigated using a population-based, matched case-control study. Exposures for 143 cases and 286 controls matched on age within five years were obtained by interview. Diagnoses were confirmed histopathologically and estrogen and progesterone receptor assays conducted.ResultsAlthough risk of meningioma appeared modestly elevated in past OC users (OR = 1.5, 95% CI 0.8 – 2.7), and in current users (OR = 2.5, 95% CI 0.5 – 12.6), the confidence intervals were wide. No significant association between meningioma risk and duration of OC use was found. Likewise, risk of meningioma was only weakly associated with past use of HRT (OR = 0.7, 95% CI 0.4 – 1.3), and not at all with current use of HRT (OR = 1.0, 95% CI 0.5 – 2.2). Of 142 available specimens, 2 (1%) expressed estrogen receptors, whereas 130 (92%) expressed progesterone receptors (PR). OC use was associated with increased risk of a meningioma expressing less rather than more PR (OR = 3.2, 95% CI 1.3 – 8.0). Overall, in post menopausal women, HRT use appeared to confer a non-significant protective effect, and was not associated with low or high PR expressing meningiomas.ConclusionThis study found little evidence of associations between meningioma and exogenous hormone exposures in women but did suggest that some hormonal exposures may influence tumor biology in those women who develop meningioma.
Highlights
The role of exogenous hormone exposures in the development of meningioma is unclear, but these exposures have been proposed as one hypothesis to explain the over-abundance of such tumors in women
Consistent with data from other studies in North America and Europe, we have previously reported the incidence of intracranial meningioma in western Washington State to be 3.2 per 100,000 personyears, with women comprising 69% of the meningioma diagnoses and the highest age- and gender-specific incidence of over 7 per 100,000 person-years in women 60 years or older[3]
As part of a case-control study designed to investigate putative risk factors for intracranial meningioma, we evaluated the association between intracranial meningioma and sex hormone exposures, and in relation to hormone receptor expression in the tumors
Summary
The role of exogenous hormone exposures in the development of meningioma is unclear, but these exposures have been proposed as one hypothesis to explain the over-abundance of such tumors in women. The Women's Health Initiative (WHI) study, a large randomized trial, found an increased risk for breast carcinoma in post-menopausal women using opposed hormone replacement therapy (estrogen and progestin)[7]. In a separate WHI analysis, results of unopposed estrogen exposure suggest a non-significant reduction in the risk of breast carcinoma[8]. A recent report from a case-control study found few significant associations between reproductive or hormonal factors and the risk of meningioma[17]. Results from the Nurses' Health Study cohort, suggest the risk of meningioma is increased among women exposed to either endogenous or exogenous sex hormones[18]. As part of a case-control study designed to investigate putative risk factors for intracranial meningioma, we evaluated the association between intracranial meningioma and sex hormone exposures, and in relation to hormone receptor expression in the tumors
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