The purpose of this review is to provide a sufficiently detailed perspective on epidemiologic studies of
primary brain tumors to encourage multidisciplinary etiologic and prognostic studies among surgeons, neuro-oncologists, epidemiologists, and molecular scientists. Molecular
tumor markers that predict survival and treatment response are being identified with hope of even greater gains in this area from emerging array technologies. Regarding risk factors, studies of inherited susceptibility and constitutive polymorphisms in genes pertinent to
carcinogenesis (for example, DNA repair and detoxification genes and
mutagen sensitivity) have revealed provocative findings. Inverse associations of the history of
allergies with
glioma risk observed in 3 large studies and reports of inverse associations of
glioma with common
infections suggest a possible role of
immune factors in
glioma genesis or progression. Studies continue to suggest that
brain tumors might result from workplace, dietary, and other personal and residential exposures, but studies of cell phone use and power frequency electromagnetic fields have found little to support a causal connection with
brain tumors; caveats remain. The only proven causes of
brain tumors (that is, rare hereditary syndromes, therapeutic radiation, and immune suppression giving rise to brain
lymphomas) account for a small proportion of cases. Progress in understanding
primary brain tumors might result from studies of well-defined histologic and molecular
tumor types incorporating assessment of potentially relevant information on subject susceptibility and environmental and noninherited endogenous factors (viruses, radiation, and carcinogenic or protective chemical exposures through diet, workplace, oxidative metabolism, or other sources). Such studies will require the cooperation of researchers from many disciplines.