{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:48:32Z","timestamp":1791856112969,"version":"4.3.4"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260628-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Meningioma is a known adverse reaction of high-dose progestogens, but evidence regarding the risk associated with progestogens used as contraception is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether different progestogens used as hormonal contraception are associated with increased risk of meningiomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This nested case-control study conducted over a 25-year study period from January 1, 2000, to December 31, 2024, is a Danish nationwide population-based register study, which included 3 million females aged 15 to 59 years with residence in Denmark. Meningioma cases were dentified, and for each case, 10 controls were matched on age, birthplace, and marital status and randomly selected from the cohort if considered eligible on the day of the case\u2019s meningioma diagnosis. Data were analyzed from July 10, 2025, to May 12, 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Use of progestogens was identified in the registers by date of dispensing or procedural records and grouped by route of administration and active substance. Exposure time was determined by redeemed daily doses or product duration. If a female switched to a different product or became pregnant, her exposure time was changed to the new exposure. The females included were allocated to their most recent use, defined as the exposure closest to the matching date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      The main outcome was incident meningioma and was identified in the Danish National Cancer Register using validated\n                      <jats:italic toggle=\"yes\">International Statistical Classification of Diseases and Related Health Problems, Tenth Revision<\/jats:italic>\n                      diagnoses and\n                      <jats:italic toggle=\"yes\">International Classification of Diseases for Oncology<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Third Edition<\/jats:italic>\n                      codes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1473 cases and 14\u202f717 controls with a median age of 48 years (IQR, 42-53 years) were included in the nested cohort. For combined oral contraceptives, the estimated odds ratios (ORs) for the association between use of progestogens and meningioma were 1.61 (95% CI, 1.00-2.59) with cyproterone, 1.66 (95% CI, 1.31-2.10) with desogestrel, 1.58 (95% CI, 1.05-2.37) with drospirenone, 1.44 (95% CI, 1.17-1.77) with gestodene, 1.40 (95% CI, 1.12-1.76) with levonorgestrel, 1.38 (95% CI, 0.77-2.47) with norethisterone, and 1.04 (95% CI, 0.70-1.54) with norgestimate. For oral progestogen-only contraceptives, the ORs were 1.73 (95% CI, 1.17-2.56) with desogestrel and 0.95 (95% CI, 0.57-1.57) with norethisterone. For injectable medroxyprogesterone, the OR was 4.55 (95% CI, 2.19-9.45). For intrauterine devices (IUDs) with high-dose levonorgestrel, the OR was 1.58 (95% CI, 1.28-1.94), and for IUDs with low-dose levonorgestrel, the OR was 1.14 (95% CI, 0.59-2.22). Exposure within the past year was associated with the highest risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260628-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this case-control study conducted using data from the entire Danish population, recent use of the contraceptive progestogens cyproterone, desogestrel, drospirenone, gestodene, levonorgestrel, injectable medroxyprogesterone, and high-dose IUD was associated with increased risk of meningioma. These findings are considered relevant information for the treated women and the prescribing physicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.22603","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:33:03Z","timestamp":1783006383000},"page":"e2622603","source":"Crossref","is-referenced-by-count":3,"title":["Contraceptive Progestogens and Incident Meningioma"],"prefix":"10.1001","volume":"9","author":[{"given":"Nicklas","family":"Hasselblad Lundstr\u00f8m","sequence":"first","affiliation":[{"name":"Division of Pharmacovigilance and Quality Management, Danish Medicines Agency, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Hjorslev Knudgaard","sequence":"additional","affiliation":[{"name":"Division of Pharmacovigilance and Quality Management, Danish Medicines Agency, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Skaarup Pedersen","sequence":"additional","affiliation":[{"name":"Regulatory and Clinical Assessment, Danish Medicines Agency, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Louise","family":"Schougaard Christiansen","sequence":"additional","affiliation":[{"name":"Division of Pharmacovigilance and Quality Management, Danish Medicines Agency, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Wessel Skovlund","sequence":"additional","affiliation":[{"name":"Data Analytics, Danish Medicines Agency, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"zoi260628r1","doi-asserted-by":"publisher","first-page":"vi1","DOI":"10.1093\/neuonc\/noae145","article-title":"CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2017-2021.","volume":"26","author":"Price","year":"2024","journal-title":"Neuro Oncol"},{"issue":"1","key":"zoi260628r2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000338081","article-title":"Epidemiology of meningioma in the United Kingdom.","volume":"39","author":"Cea-Soriano","year":"2012","journal-title":"Neuroepidemiology"},{"issue":"11","key":"zoi260628r3","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1093\/neuonc\/noab150","article-title":"EANO guideline on the diagnosis and management of meningiomas.","volume":"23","author":"Goldbrunner","year":"2021","journal-title":"Neuro Oncol"},{"issue":"3","key":"zoi260628r5","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.jocn.2013.06.008","article-title":"An audit of immunohistochemical marker patterns in meningioma.","volume":"21","author":"Baxter","year":"2014","journal-title":"J Clin Neurosci"},{"issue":"8","key":"zoi260628r6","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1007\/s00701-017-3146-8","article-title":"Meningiomas in pregnancy: timing of surgery and clinical outcomes as observed in 104 cases and establishment of a best management strategy.","volume":"160","author":"Laviv","year":"2018","journal-title":"Acta Neurochir (Wien)"},{"issue":"10","key":"zoi260628r7","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1007\/s00701-015-2532-3","article-title":"Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients.","volume":"157","author":"Bernat","year":"2015","journal-title":"Acta Neurochir (Wien)"},{"issue":"1","key":"zoi260628r8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.3171\/2014.12.JNS142112","article-title":"Hormone-dependent shrinkage of a sphenoid wing meningioma after pregnancy: case report.","volume":"124","author":"Kerschbaumer","year":"2016","journal-title":"J Neurosurg"},{"key":"zoi260628r9","doi-asserted-by":"publisher","first-page":"e1261","DOI":"10.1016\/j.wneu.2018.03.187","article-title":"Houdini tumor: case report and literature review of pregnancy-associated meningioma.","volume":"114","author":"Chakravarthy","year":"2018","journal-title":"World Neurosurg"},{"key":"zoi260628r10","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2649426","article-title":"Postpartum regression of a presumed cavernous meningioma.","volume":"2016","author":"Phang","year":"2016","journal-title":"Case Rep Oncol Med"},{"issue":"1","key":"zoi260628r11","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2024-263529","article-title":"Petroclival meningioma regression after combined oestrogen and nomegestrol acetate interruption.","volume":"18","author":"Lebeau","year":"2025","journal-title":"BMJ Case Rep"},{"issue":"4","key":"zoi260628r12","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1111\/fcp.12878","article-title":"Radiological evolution of progestogen-induced meningioma: A monocentric retrospective study.","volume":"37","author":"Ahmed-Khalifa","year":"2023","journal-title":"Fundam Clin Pharmacol"},{"issue":"4","key":"zoi260628r18","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1093\/neuonc\/noz005","article-title":"Body mass index, comorbidities, and hormonal factors in relation to meningioma in an ethnically diverse population: the multiethnic cohort.","volume":"21","author":"Muskens","year":"2019","journal-title":"Neuro Oncol"},{"issue":"3","key":"zoi260628r19","doi-asserted-by":"publisher","first-page":"649","DOI":"10.3171\/2012.9.JNS12811","article-title":"Exogenous hormone use, reproductive factors, and risk of intracranial meningioma in females.","volume":"118","author":"Claus","year":"2013","journal-title":"J Neurosurg"},{"issue":"10","key":"zoi260628r20","doi-asserted-by":"publisher","first-page":"2562","DOI":"10.1158\/1055-9965.EPI-10-0447","article-title":"Reproductive factors and exogenous hormone use in relation to risk of glioma and meningioma in a large European cohort study.","volume":"19","author":"Michaud","year":"2010","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"2","key":"zoi260628r21","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.canep.2011.08.003","article-title":"Hormonal therapies and meningioma: is there a link?","volume":"36","author":"Cea-Soriano","year":"2012","journal-title":"Cancer Epidemiol"},{"issue":"2","key":"zoi260628r22","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/s11060-014-1427-0","article-title":"Reproductive factors and risk of primary brain tumors in women.","volume":"118","author":"Anic","year":"2014","journal-title":"J Neurooncol"},{"key":"zoi260628r23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-078078","article-title":"Use of progestogens and the risk of intracranial meningioma: national case-control study.","volume":"384","author":"Roland","year":"2024","journal-title":"BMJ"},{"key":"zoi260628r24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-083981","article-title":"Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: national case-control study.","volume":"389","author":"Roland","year":"2025","journal-title":"BMJ"},{"issue":"11","key":"zoi260628r25","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1001\/jamaneurol.2025.3011","article-title":"Depot medroxyprogesterone acetate and risk of meningioma in the US.","volume":"82","author":"Xiao","year":"2025","journal-title":"JAMA Neurol"},{"issue":"2","key":"zoi260628r26","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1093\/neuonc\/noaf228","article-title":"Hormonal contraceptives and the risk of meningioma: a Swedish register-based case-control study.","volume":"28","author":"Tettamanti","year":"2026","journal-title":"Neuro Oncol"},{"issue":"19","key":"zoi260628r27","doi-asserted-by":"publisher","first-page":"3362","DOI":"10.3390\/cancers16193362","article-title":"The Association between medroxyprogesterone acetate exposure and meningioma.","volume":"16","author":"Griffin","year":"2024","journal-title":"Cancers (Basel)"},{"issue":"8","key":"zoi260628r28","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1002\/pds.5482","article-title":"Core concepts in pharmacoepidemiology: fundamentals of the cohort and case-control study designs.","volume":"31","author":"Potteg\u00e5rd","year":"2022","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"7","key":"zoi260628r29","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1177\/1403494810393562","article-title":"The Danish Cancer Registry.","volume":"39","author":"Gjerstorff","year":"2011","journal-title":"Scand J Public Health"},{"issue":"15","key":"zoi260628r30","doi-asserted-by":"publisher","first-page":"3303","DOI":"10.1016\/j.ejca.2013.05.026","article-title":"Hormone replacement therapy increases the risk of cranial meningioma.","volume":"49","author":"Andersen","year":"2013","journal-title":"Eur J Cancer"},{"issue":"12","key":"zoi260628r31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004321","article-title":"Menopausal hormone therapy and central nervous system tumors: Danish nested case-control study.","volume":"20","author":"Pourhadi","year":"2023","journal-title":"PLoS Med"},{"issue":"6","key":"zoi260628r32","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1097\/AOG.0b013e3181c2bde8","article-title":"Pregnancy and laboratory studies: a reference table for clinicians.","volume":"114","author":"Abbassi-Ghanavati","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"2","key":"zoi260628r33","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1136\/jnnp.21.2.89","article-title":"The relapsing course of certain meningiomas in relation to pregnancy and menstruation.","volume":"21","author":"Bickerstaff","year":"1958","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"5","key":"zoi260628r34","doi-asserted-by":"publisher","first-page":"440","DOI":"10.2176\/nmc.29.440","article-title":"Rapid growth of a meningioma during pregnancy: relationship with estrogen and progesterone receptors\u2014case report.","volume":"29","author":"Saitoh","year":"1989","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"1","key":"zoi260628r35","doi-asserted-by":"publisher","first-page":"9153","DOI":"10.1038\/s41598-021-88742-2","article-title":"The risk of developing a meningioma during and after pregnancy.","volume":"11","author":"Pettersson-Segerlind","year":"2021","journal-title":"Sci Rep"},{"key":"zoi260628r4","unstructured":"Meningiom i Danmark, 2010-2023. Danish Neuro-Oncology Registry (DNOR). Accessed September 29, 2025. https:\/\/dnog.dk\/assets\/files\/dnor-%C3%A5rsrapporter\/Meningeomer_OFFICIEL_270625.pdf"},{"key":"zoi260628r13","unstructured":"Monthly report. Pharmacovigilance Working Party (PhVWP). November 2009 Plenary Meeting. PhVWP Discussions on safety concerns. European Medicines Agency. Accessed September 24, 2025. https:\/\/www.ema.europa.eu\/en\/documents\/report\/monthly-report-pharmacovigilance-working-party-phvwp-november-2009-plenary-meeting_en.pdf"},{"key":"zoi260628r14","unstructured":"Pharmacovigilance Risk Assessment Committee (PRAC): assessment report for referral regarding cyproterone acetate. February 13, 2020. European Medicines Agency. Accessed September 24, 2025. https:\/\/www.ema.europa.eu\/en\/documents\/referral\/cyproterone-article-31-referral-prac-assessment-report_en.pdf"},{"key":"zoi260628r15","unstructured":"Pharmacovigilance Risk Assessment Committee (PRAC): assessment report for referral regarding nomegestrol and chlormadinone. European Medicines Agency. July 13, 2022. Accessed September 24, 2025. https:\/\/www.ema.europa.eu\/en\/documents\/referral\/nomegestrol-and-chlormadinone-article-31-referral-assessment-report_en.pdf"},{"key":"zoi260628r16","unstructured":"Medroxyprogesterone acetate: Direct Healthcare Professional Communication (DHPC). European Medicines Agency (EMA). Accessed September 29, 2025. https:\/\/www.ema.europa.eu\/en\/medicines\/dhpc\/medroxyprogesterone-acetate"},{"key":"zoi260628r17","unstructured":"Pharmacovigilance Risk Assessment Committee (PRAC): minutes of PRAC meeting on 10-12 May 2023. European Medicines Agency. August 18, 2023. Accessed September 24, 2025. https:\/\/www.ema.europa.eu\/en\/documents\/minutes\/minutes-prac-meeting-10-12-may-2023_en.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2851077\/hasselblad_lundstrm_2026_oi_260628_1782415878.8083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:33:17Z","timestamp":1783006397000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2851077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.22603","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}