Traumatic brain injury (TBI) affects millions of people each year, yet its long-term consequences, including potential links to brain cancer mortality, remain poorly understood.

While some studies have suggested that moderate-to-severe TBI may increase the risk of brain tumours, no prior research has systematically examined whether TBI increases the risk of dying from brain cancer.

Determining whether specific injury types carry heightened mortality risk is critical for informing follow-up care, counselling patients and families, and identifying survivors who may benefit most from monitoring.

A study examined whether individuals who sustain a TBI are more likely to die from brain cancer compared to the general population, and whether certain factors modify that risk.

Daniel Daneshvar, MD, PhD, director of the HealthSpan Lab and Chief of the Department of Physical Medicine and Rehabilitation at Mass General Brigham, and Charlotte Lustre, of the HealthSpan Lab, are the senior and lead authors of this paper published in Neuroepidemiology, “Brain Cancer Mortality following Traumatic Brain Injury (TBI): A TBI Model Systems Study.”

By focusing on mortality rather than incidence alone, our study addressed a key gap: even if TBI increases the likelihood of developing a brain tumour, it has been unclear whether it translates into worse survival outcomes at the population level.

The researchers analysed data from the TBI Model Systems National Database, a large, longitudinal cohort of more than 20,000 civilians with TBI who received inpatient rehabilitation across 20 centres—including Spaulding Rehabilitation Hospital—between 1987 and 2024.

Brain cancer deaths were identified using death certificates. Our team compared observed deaths in the TBI cohort to expected deaths in a demographically matched general population, adjusting for age, sex, race and calendar year.

Subgroup analyses assessed differences by injury severity (mild, moderate or severe), injury mechanism and cancer risk factors such as smoking and alcohol use.

The study found that people with TBI were 1.75 times more likely to die from brain cancer than the general population.

The elevated risk was particularly striking among those whose injuries resulted from gunshot wounds, who were over 14 times more likely to die from brain cancer.

Individuals with mild but complicated TBI also had nearly four times the brain cancer mortality risk. 

Moderate-to-severe TBI showed elevated but statistically nonsignificant risk, likely due to smaller sample sizes.

These findings suggest that certain groups of TBI survivors may benefit from closer long-term monitoring for brain cancer.

For clinicians, the results reinforce that TBI should not be viewed solely as an acute event, but as a condition with potential long-term neurological consequences, including malignancy.

For patients and families, the study highlights the importance of ongoing follow-up care after serious brain injury.

More broadly, the findings add to growing evidence that inflammation triggered by TBI may have lasting biological effects.

While not yet sufficient to change clinical guidelines, this work supports further research into cancer surveillance among TBI survivors and underscores the value of linking injury registries with cancer databases to better track long-term outcomes.

The researchers say that "We are continuing to investigate the long-term impacts of TBI across a range of outcomes, including neurodegenerative conditions such as amyotrophic lateral sclerosis (ALS).

Building on these findings, our future work will explore how biological, behavioural and environmental factors interact to shape long-term risk after TBI.

In particular, we aim to identify markers of resilience and vulnerability, as well as opportunities for early intervention to improve healthspan, the period of life spent in good health."

A key focus will be identifying practical ways to reduce risk and improve long-term outcomes, with an emphasis on maintaining function and quality of life over time.

Article: Brain Cancer Mortality following Traumatic Brain Injury (TBI): A TBI Model Systems Study

Source: Mass General Brigham