Journal of Neuro-Oncology

, Volume 68, Issue 1, pp 57–69 | Cite as

The Risk for Malignant Primary Adult-Onset Glioma in a Large, Multiethnic, Managed-Care Cohort: Cigarette Smoking and Other Lifestyle Behaviors

  • Jimmy T. Efird
  • Gary D. Friedman
  • Stephen Sidney
  • Arthur Klatsky
  • Laurel A. Habel
  • Natalia V. Udaltsova
  • Stephen Van Den Eeden
  • Lorene M. Nelson


Purpose: To determine the risk for malignant primary adult-onset glioma (MPAG) associated with cigarette smoking and other lifestyle behaviors in a large, multiethnic, managed-care cohort.

Methods: The study population included a cohort of 133,811 subscribers to the Kaiser Permanente Medical Care Program of Northern California who had received a multiphasic health checkup and questionnaire between 1977 and 1985, were at least 25 years old at their start of follow-up, and had no prior history of benign or malignant brain tumors. In this cohort, patients were followed for up to 21 years for the development of MPAG.

Results: Risk for MPAG among women increased with increasing packs of cigarettes smoked per day (p-for-trend = 0.04), adjusting for cigar and pipe smoking, patient age, sex, race, education, alcohol use and coffee consumption. A similar pattern was not observed for men. Individuals who smoked marijuana at least once a month, adjusting for cigarette smoking (packs smoked per day) and for the factors noted above, had a 2.8-fold (CI = 1.3–6.2) increased risk for MPAG. Relative risk for MPAG increased with increasing consumption of coffee (p-for-trend = 0.05).

Conclusions: Cigarette smoking was associated with an increased risk for MPAG among women but not among men. Individuals who smoked marijuana at least once a month had an increased risk for MPAG, although no dose-response relation was observed. Drinkers of >7 cups of coffee per day had a 70% increased risk for MPAG and smaller risk elevation for lower consumption. Alcohol usage was not associated with an increased risk for MPAG.

alcohol cigarettes coffee gliomas marijuana 


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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Jimmy T. Efird
    • 1
  • Gary D. Friedman
    • 2
    • 3
  • Stephen Sidney
    • 3
  • Arthur Klatsky
    • 3
  • Laurel A. Habel
    • 2
    • 3
  • Natalia V. Udaltsova
    • 3
  • Stephen Van Den Eeden
    • 2
    • 3
  • Lorene M. Nelson
    • 2
  1. 1.John A. Burns School of MedicineUniversity of HawaiiHonolulu
  2. 2.Division of Epidemiology, Department of Health Research and PolicyStanford School of MedicineStanford
  3. 3.Division of ResearchKaiser Permanente Medical Care ProgramOaklandUSA

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