Hormonal therapies and meningioma: Is there a link?

Background: The aetiology of meningiomas is largely unknown although hormones have been suggested to play a role. Methods: A cohort study was performed to evaluate hormone-related factors associated with meningioma. Patients (12–89 years) with a first diagnosis of meningioma (January 1996–June 2008) were identified from The Health Improvement Network UK primary care database and age- and sex-matched to controls (n = 10 000) from the same cohort. Odds ratios (ORs) were calculated following a nested case control analysis using unconditional logistic regression. Results: In total, 745 patients with meningioma were identified from a study population of 2 171 287. No significantly increased risk of meningioma was found among female users of oral contraceptives (OR: 1.15; CI: 0.67–1.98), hormone replacement therapy (OR: 0.99; CI: 0.73–1.35) or low-dose cyproterone acetate (CPA; OR: 1.51; CI: 0.33–6.86) compared with non-users. There was a significantly increased risk of meningioma among male users of androgen analogues (OR: 19.09; CI: 2.81–129.74) and among users of high-dose CPA (OR: 6.30; CI: 1.37–28.94) compared with non-users, however there were only three cases currently using these drugs. No significant association was found between meningioma and prostate, breast, or genital cancers. Conclusions: Our results do not support a role for exogenous hormone use by females in meningioma development. The risk in males was only observed with high-dose, short-term (<1 year) therapy. Impact: While hormonal cancers and therapies are not associated with meningioma in females, the risk in males requires further investigation.