The relationship between asthma and glioma: a case-control study in a universal access healthcare system

TL;DR

People with asthma are less likely to later be diagnosed with high-grade gliomas, but this link may be influenced by detection biases.

Contribution

A case-control study in a military healthcare system found an inverse association between asthma and high-grade gliomas.

Findings

Asthma was associated with a lower odds of high-grade glioma diagnosis.

The inverse association was strongest for large tumors and when asthma was diagnosed more than 12 months before glioma.

No association was found for small tumors or recent asthma diagnoses, suggesting detection bias may play a role.

Abstract

Multiple studies have found an inverse relationship between asthma and malignant gliomas, possibly due to increased immune response from asthma. This study assessed the relationship between asthma and subsequent glioma diagnosis while reducing potential effects of recall and detection bias.

Data were extracted from the Military Cancer Epidemiology database which includes cancer registry and medical claims data from military and retired servicemembers and their dependents. Cases were individuals with a pathology-confirmed glioma diagnosis between 1998 and 2014. Cancer free-controls were matched to cases by sex, race, age, and active-duty military status. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals for the relationship between asthma and subsequent glioma diagnosis.

Cases were less likely to have been diagnosed with asthma than controls [OR = 0.72 (0.57, 0.92)], specifically among high-grade gliomas [OR = 0.71 (0.52, 0.98)] and large (> 37 mm) tumors [OR = 0.60 (0.39, 0.93)]. Cases were less likely to have been diagnosed with asthma 13–36 months [OR = 0.53 (0.33, 0.87)] and > 36 months [OR = 0.75 (0.56, 0.99)] before a glioma diagnosis.

We found an inverse association between asthma and subsequently diagnosed malignant glioma, notably among high-grade gliomas and large tumors. However, no association was observed for small tumors or with asthma diagnosed within 12 months prior to glioma diagnosis, suggesting that greater surveillance after asthma might increase the detection of a glioma. These findings suggest that potential detection bias might have obscured the inverse association between asthma and glioma, particularly among low-grade gliomas and circumscribed gliomas and glioneuronal tumors.

The online version contains supplementary material available at 10.1007/s11060-026-05498-3.