Moderate to Severe TBI Linked With Development of Malignant Brain Tumors
A history of moderate to severe traumatic brain injury (TBI) in US adult civilians was associated with an increased risk of developing a malignant brain tumor over follow-up, according to results from a cohort study published online in JAMA Network Open.
“This association was confirmed in a meta-analysis with geographically diverse sites across the US. This analysis leveraged, to our knowledge, the largest cohort of nonveterans with TBI, and identified an association between TBI and malignant brain tumor development in adults that may have gone undetected in previous smaller studies,” wrote corresponding authors Saef Izzy, MD, of Harvard Medical School, Boston, Massachusetts, and Ross Zafonte, DO, of the University of Missouri School of Medicine, Columbia, Missouri, and study coauthors.
A previous study reported an increased risk of brain tumors in US veterans of the Iraq and Afghanistan wars who had a TBI, but studies of civilians have produced conflicting results. To further investigate the link in nonveterans, researchers conducted a retrospective study of patients at Mass General Brigham, Boston, Massachusetts between 2000 and 2023. The cohort included 75,679 patients with a history of TBI and 75,679 control participants without TBI.
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Over a median follow-up of 7.2 years, the prevalence of malignant brain tumors was 0.6% in adults with a history of moderate to severe TBI compared with 0.4% in the control and mild TBI groups, according to the study. Hazard ratios for developing malignant brain tumors were 1.67 in the moderate to severe TBI group and 0.99 in the mild TBI group compared with the control group.
When researchers combined the Mass General Bringham data with data from other trauma sites affiliated with Northwestern Medicine in Chicago, Illinois, and the UC Health in California, they identified a 1.57 hazard ratio for developing a malignant brain tumor in patients with moderate to severe TBI compared with controls.
“I see these results as alarming,” said Dr Izzy in a news release. “Our work over the past 5 years has shown that TBI is a chronic condition with lasting effects. Now, evidence of a potential increased risk of malignant brain tumors adds urgency to shift the focus from short-term recovery to lifelong vigilance.”
While additional research is necessary to better understand the mechanisms behind the TBI-brain tumor link, the current findings may warrant additional evaluation and monitoring of patients with TBI to detect brain tumor development.
“While there is an increased risk of tumor from TBI, the overall risk remains low. Still, brain tumor is a devasting disease and often gets detected in later stages,” said lead author Sandro Marini, MD, a neurologist at Mass General Brigham. “Now, we’ve opened the door to monitor TBI patients more closely.”
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