1. Among United States veterans of the Iraq and Afghanistan wars, the experience of a moderate, severe, or penetrating traumatic brain injury was associated with a greater risk of developing brain cancer. 

Evidence Rating Level: 2 (Good)

Primary brain cancer is uncommon, affecting 7.02 per 100,000 persons in the United States. Little is known about the risk factors for primary brain cancer. In this retrospective cohort study, researchers aimed to determine whether traumatic brain injury (TBI) is associated with the development of primary brain cancer. Data were collected from United States veterans of the Iraq and Afghanistan wars via the Long-Term Impact of Military-Relevant Brain Injury Consortium–Chronic Effects of Neurotrauma Consortium. 1,919,740 participants were included in the study, 80.25% male, 63.11% non-Hispanic White, median age 31 (IQR, 25-42 years). 449,880 of the participants had suffered from a TBI. 385 848 were mild, 46 859 were moderate to severe, and 17,173 were penetrating TBIs. There was an increased risk of developing brain cancer for those with moderate to severe TBIs (adjusted hazard ratio [AHR], 1.90; 95% CI, 1.16-3.12) and penetrating TBIs (AHR, 3.33; 95% CI, 1.71-6.49). Mild TBIs were not associated with brain cancer. A strength of this study is the large cohort size. A limitation is that only veterans were included, therefore the results may not be generalizable to the average population with traumatic brain injuries. Further research is needed to assess whether there is an association between TBIs and brain cancer in other populations. Overall, this study demonstrates that among United States veterans, the experience of a moderate, severe, or penetrating traumatic brain injury was associated with a greater risk of developing primary brain cancer. 

Click to read the study in JAMA Network Open

Image: PD

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