PEOPLE who survive a traumatic brain injury (TBI) face a markedly higher risk of dying from brain cancer than the general population, according to a large US cohort study, with gunshot-wound and mild injuries carrying the steepest TBI brain cancer risk.
Tracking Deaths Across Nearly Four Decades
The investigators ran a retrospective cohort study using the TBI Model Systems National Database, which enrols people admitted for inpatient rehabilitation after acute hospitalisation for traumatic brain injury. A total of 20,211 individuals enrolled between 1987 and 2024 were included. As the study was observational, participants were grouped by injury type rather than treatment arms, spanning gunshot-wound-related, mild, and moderate-to-severe TBI. Brain cancer deaths were drawn from death certificates. The primary outcome was brain cancer mortality, expressed as standardised mortality ratios (SMRs) against a population matched for age, sex, race, and calendar year; secondary analyses examined risk factors. Of the cohort, 4,297 had died at analysis.
Sharpest TBI Brain Cancer Signal After Gunshot Wounds
Among the 4,297 decedents, 18 died of brain cancer, a significantly elevated rate versus the matched general population (SMR=1.75; 95% CI: 1.04–2.77). The signal was strongest for gunshot-wound-related injury (SMR=14.29; 95% CI: 2.95–41.75) and was also significant for mild TBI (SMR=3.88; 95% CI: 1.06–9.94). By contrast, moderate-to-severe TBI showed no statistically significant excess (SMR=1.52; 95% CI: 0.83–2.54).
Weighing the Risk in Survivor Care
The authors concluded that surviving a TBI carries a 1.75-fold higher likelihood of brain cancer death, with gunshot-wound and mild injuries emerging as particularly high-risk groups. They suggested the findings could inform early prevention and flag survivors warranting closer surveillance. Given the small number of cancer deaths, the team cautioned that larger studies are needed before firm causal conclusions can be drawn about the biology linking trauma to tumour formation.
Reference
Luster CB et al. Brain cancer mortality following traumatic brain injury (TBI): a TBI model systems study. Neuroepidemiology. 2026;DOI:10.1159/000552405.
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