Smoking and risk of meningioma: A meta-analysis

Objective: The relationship between smoking and the development of meningioma has been investigated in several epidemiological studies. However, the results of these studies are inconsistent. We conducted a meta-analysis in order to identify any potential association. Methods: PubMed, the Cochrane Library, and EMBASE databases were searched to identify relevant articles that investigated the risk of meningioma following cigarette smoking. Two researchers evaluated study eligibility and extracted the data independently, and disagreements were resolved by discussion. The variables used to estimate the pooled risk of smoking in meningioma development were the multivariate-adjusted risk estimates presented in the literature. Results: Seven case-control and two cohort studies were included in this meta-analysis. The pooled estimated risks associated with ever smoking for meningioma were 1.02 (95% confidence interval (CI): 0.85-1.21) in the case-control studies, 0.93 (95% CI: 0.83-1.04) in the cohort studies and 0.95 (95% CI: 0.87-1.05, P = 0.32) in all studies when the cohort and case-control data were combined. Subgroup analyses suggested that the risk estimates were 1.49 (95% CI: 1.06-2.09, P = 0.02), 0.86 (95% CI: 0.65-1.13), 0.79 (95% CI: 0.50-1.25) and 0.84 (95% CI: 0.69-1.03) for men, women, current and past smoking respectively. Sensitivity analyses restricted to studies with different adjustments for confounders yielded similar results. No evidence of publication bias was observed. Conclusion: Our meta-analysis suggests that there is no association between ever smoking and the risk of meningioma. However, a small but significant risk elevation is present among men smokers. (C) 2012 Elsevier Ltd. All rights reserved.