Health
Traumatic brain injury and brain tumor risk in Iraq and Afghanistan war veterans
In a retrospective cohort study reported in JAMA network openStewart et al. found that U.S. veterans of the Iraq and Afghanistan wars with moderate/severe or penetrating traumatic brain injury (TBI) had an increased risk of brain tumors compared to those without traumatic brain injury. discovered.
Research details
The study used data from the Department of Veterans Affairs and the Department of Defense from October 2004 to September 2019 on veterans affiliated with the Military-Related Brain Injury Long-Term Effects Consortium – Chronic Effects of Neurotrauma Consortium. . TBI severity was categorized as mild, moderate/severe, or penetrating.
Main findings
Median follow-up of the cohort was 7.2 years (interquartile range) [IQR] = 4.1 – 10.1) years. After 611,107 veterans were excluded primarily due to missing data, 1,919,740 veterans were included in the analysis. Most were male (80%) and Caucasian (63%). Median age at index date was 31 years (IQR = 25 to 42 years; index date was the date of TBI diagnosis for TBI veterans and for veterans without TBI are simulated dates from the distribution of true index dates within each age group).
Of the 1,919,740 veterans, 449,880 have suffered a TBI, including 385,848 with mild TBI, 46,859 with moderate/severe TBI, and penetrating TBI. There were 17,173 people with sexual brain injury.
318 (0.02%) Veterans without TBI, 80 (0.02%) with mild TBI, 17 (0.04%) with moderate/severe TBI, and penetrating TBI. Brain tumors occurred in ≤10 patients (less than the minimum reportable cell size) (≤0.06%). The crude incidence rates of brain tumors per 100,000 person-years were 3.06 for no TBI, 2.85 for mild TBI, 4.88 for moderate/severe TBI, and 10.34 for penetrating TBI (whole) P < .001).
Moderate/severe traumatic brain injury (adjusted hazard ratio) in analyzes adjusting for age, sex, race/ethnicity, military service, rank, and military status. [HR] = 1.90, 95% confidence interval [CI] = 1.16–3.12, P = .01) and penetrating TBI (adjusted HR = 3.33, 95% CI = 1.71 to 6.49; P < .001), but not mild TBI (adjusted HR = 1.14, 95% CI = 0.88 to 1.47; P = .31) and was significantly associated with subsequent development of brain tumors.
The researchers concluded, “In this cohort study of Iraq and Afghanistan war veterans, moderate/severe TBI and penetrating TBI were associated with subsequent development of brain tumors. “However, it was not associated with mild traumatic brain injury.”
Dr. Ian J. Stewartof, Uniformed Services Bethesda University of Health Sciences Marylandis the corresponding author. JAMA network open article.
Disclosure: This research was supported by the Department of Defense and others. For full research author disclosure, please visit: jamanenetwork.com.
The content of this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas or opinions of ASCO®.
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