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Prior hospitalization for epilepsy, diabetes, and stroke
and subsequent glioma and meningioma risk
Schwartzbaum J, Jonsson F, Ahlbom A, Preston-Martin S, Malmer B, Lonn S,
Soderberg K, Feychting M
Division of Epidemiology and Biometrics, School of Public Health, Ohio State
University, Columbus, OH 43210, USA. schwartzbaum.1@osu.edu
We conducted a case-control study to evaluate the preclinical association
between epilepsy, diabetes, and stroke and primary adult brain tumors.
We
first identified all 1,501 low-grade glioma, 4,587 high-grade glioma (HGG),
and 4,193 meningioma cases reported to the Swedish Cancer Registry from 1987
to 1999.
Next, controls (137,485) were randomly selected from the
continuously updated Swedish Population Registry and matched to cases
diagnosed that year on age and sex.
Finally, cases and controls were linked
to the Swedish Hospital Discharge Registry (1969-1999).
We found that >
or =8 years before HGG diagnosis (or control reference year) there was an
elevated risk of HGG among people discharged with epilepsy [odds ratio (OR),
3.01; 95% confidence interval (95% CI), 1.73-5.22].
Two to 3 years before
HGG diagnosis, this risk increased (OR, 5.33; 95% CI, 3.58-7.93) and was
especially strong among people ages <55 years (OR, 13.49; 95% CI,
6.99-25.94).
During this 2- to 3-year prediagnostic period, we also found an
increased risk of HGG among people discharged with meningitis (OR, 3.02; 95%
CI, 1.06-8.59) or viral encephalitis (OR, 12.64; 95% CI, 2.24-71.24).
Results are similar for glioblastoma multiforme, low-grade glioma, and
meningioma.
In contrast, risk of HGG among people discharged with diabetes
or stroke does not increase until year of brain tumor diagnosis.
The
occurrence of excess epilepsy > or =8 years before HGG diagnosis suggests
a relatively long preclinical phase, but excess diabetes or stroke appear
late in HGG development.
PMID: 15767344 [PubMed - in process]
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