title: Subsequent brain tumors in patients with autoimmune disease.
abstract: BACKGROUND
  Previous studies have reported increased risk of brain tumors after allergic conditions, but no systematic analyses of these tumors in patients with autoimmune disease (AId) have been performed. No data are available on survival among patients with AId from brain tumors. We analyzed systematically risks and survival in histological types of brain tumors among patients who received a diagnosis of 33 different AIds.
  
  
  METHODS
  Standardized incidence ratios (SIRs) for brain tumors or hazard ratios (HRs) of deaths after brain tumors were calculated up to 2008 in 402 462 patients hospitalized for AId after 1964 and were compared with data on the population not hospitalized for AIds.
  
  
  RESULTS
  Brain tumors were diagnosed in 880 patients with AId. No increased or decreased risks (SIRs) were noted for glioma, whereas the increased SIRs for meningioma after many AIds were likely to be attributable to surveillance bias. The data on survival showed overall decreases for glioma (HR, 1.15) and meningioma (HR, 1.26). The survival in both was decreased in patients with chronic rheumatic heart disease, multiple sclerosis, and rheumatoid arthritis. Overall, HRs were increased for glioma after 6 AIds and for meningioma after 7 AIds.
  
  
  CONCLUSIONS
  The present data showed that none of the 33 AIds influenced the risk of glioma. However, many AIds negatively influence survival in glioma and meningioma, probably through added physical burden or therapeutic limitations. Information of an existing AId in patients with newly diagnosed brain tumors should help the prognostic assessment and the design of treatment.
authors.affiliation: Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany. k.hemminki@dkfz.de
authors.forename: Kari
authors.initials: K
authors.lastname: Hemminki
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Liu
authors.forename: Asta
authors.initials: A
authors.lastname: Försti
authors.forename: Jianguang
authors.initials: J
authors.lastname: Ji
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications*; D001932:Brain Neoplasms / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
keywords: comorbidity; glioma; hazard ratio; meningioma; standardized incidence ratio