Hormonal exposures and the risk of intracranial meningioma in women: a population-based case-control study

Brian Custer¹^,2 , WT Longstreth Jr¹^,3 , Leslie E Phillips¹ , Thomas D Koepsell¹^,4 and Gerald Van Belle⁵^,6

¹Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA

²Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, WA, USA

³Department of Neurology, School of Medicine, University of Washington, Seattle, WA, USA

⁴Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA

⁵Department of Environmental Health, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA

⁶Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA

author email corresponding author email

BMC Cancer 2006, 6:152doi:10.1186/1471-2407-6-152


Published:	7 June 2006

Abstract

Background

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.

Methods

The 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.

Results

Although 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.

Conclusion

This 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.