{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:25:39Z","timestamp":1792808739533,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n While brain cancer is rare, it has a very poor prognosis and few established risk factors. To date, epidemiologic work examining the potential association of traumatic brain injury (TBI) with the subsequent risk of brain cancer is conflicting. Further data may be useful.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine whether a history of TBI exposure is associated with the subsequent development of brain cancer.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A retrospective cohort study was conducted from October 1, 2004, to September 20, 2019, and data analysis was performed between January 1 and June 26, 2023. The median follow-up for the cohort was 7.2 (IQR, 4.1-10.1) years. Veterans Affairs (VA) and Department of Defense (DoD) administrative data on 1\u202f919\u202f740 veterans from the Long-Term Impact of Military-Relevant Brain Injury Consortium\u2013Chronic Effects of Neurotrauma Consortium were included.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n The main exposure of interest was TBI severity (categorized as mild, moderate or severe [moderate\/severe], and penetrating).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The outcome of interest was the development of brain cancer based on\n International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)<\/jats:italic>\n or\n International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)<\/jats:italic>\n diagnostic codes in either the DoD\/VA medical records or from the National Death Index.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n After 611\u202f107 exclusions (predominately for no encounter during the study period), a cohort including 1\u202f919\u202f740 veterans was included, most of whom were male (80.25%) and non-Hispanic White (63.11%). Median age at index date was 31 (IQR, 25-42) years. The cohort included 449\u202f880 individuals with TBI (mild, 385\u202f848; moderate\/severe, 46\u202f859; and penetrating, 17\u202f173). Brain cancer occurred in 318 individuals without TBI (0.02%), 80 with mild TBI (0.02%), 17 with moderate\/severe TBI (0.04%), and 10 or fewer with penetrating TBI (\u22640.06%). After adjustment, moderate\/severe TBI (adjusted hazard ratio [AHR], 1.90; 95% CI, 1.16-3.12) and penetrating TBI (AHR, 3.33; 95% CI, 1.71-6.49), but not mild TBI (AHR, 1.14; 95% CI, 0.88-1.47), were associated with the subsequent development of brain cancer.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of veterans of the Iraq and Afghanistan wars, moderate\/severe TBI and penetrating TBI, but not mild TBI, were associated with the subsequent development of brain cancer.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.54588","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T11:00:58Z","timestamp":1707994858000},"page":"e2354588","source":"Crossref","is-referenced-by-count":23,"title":["Traumatic Brain Injury and Subsequent Risk of Brain Cancer in US Veterans of the Iraq and Afghanistan Wars"],"prefix":"10.1001","volume":"7","author":[{"given":"Ian J.","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland"},{"name":"Military Cardiovascular Outcomes Research Program, Uniformed Services University of Health Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Howard","sequence":"additional","affiliation":[{"name":"Miltary & Health Research Foundation, Laurel, Maryland"},{"name":"Department of Public Health, University of Texas, San Antonio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Poltavskiy","sequence":"additional","affiliation":[{"name":"Miltary & Health Research Foundation, Laurel, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dore","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Amuan","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement, and Analytic Sciences Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah"},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Ocier","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement, and Analytic Sciences Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah"},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland"},{"name":"The Henry M. 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