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


CONCLUSIONS
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.
Custer
Brian
B
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA. bcuster@u.washington.edu
Longstreth
W T
WT
Phillips
Leslie E
LE
Koepsell
Thomas D
TD
Van Belle
Gerald
G
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016001:Confidence Intervals; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000139:chemically induced* / Q000737:chemistry; D008579:Meningioma / Q000139:chemically induced* / Q000737:chemistry; D008875:Middle Aged; D016017:Odds Ratio; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012307:Risk Factors; D012959:Socioeconomic Factors
D003278:Contraceptives, Oral, Hormonal; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone