People with traumatic brain injury more likely to die from brain cancer than general population
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Daniel Daneshvar, MD, Ph.D., director of the HealthSpan Lab and Chief of the Department of Physical Medicine and Rehabilitation at Mass General Brigham, and Charlotte Luster, of the HealthSpan Lab, are the senior and lead authors of a paper published in Neuroepidemiology, "Brain Cancer Mortality following Traumatic Brain Injury (TBI): A TBI Model Systems Study."
What challenges or unmet needs make this study important?
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 tumors, 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, counseling patients and families, and identifying survivors who may benefit most from monitoring.
What central question(s) were you investigating?
This study examined whether individuals who sustain a TBI are more likely to die from brain cancer than the general population and whether certain factors modify that risk. By focusing on mortality rather than incidence alone, our study addressed a key gap: Even if TBI increases the likelihood of developing a brain tumor, it has been unclear whether it translates into worse survival outcomes at the population level.
What methods or approach did you use?
We analyzed 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 centers—including Spaulding Rehabilitation Hospital—from 1987 to 2024. Brain cancer deaths were identified using death certificates. Our team compared observed deaths in the TBI cohort with 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.
What did you find?
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 more than 14 times as 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.
What are the real-world implications, particularly for patients?
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.
Do you have any follow-up studies planned to validate or build on these findings?
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, behavioral 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 health span, 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.
More information
Charlotte B. Luster et al, Brain Cancer Mortality following Traumatic Brain Injury (TBI): A TBI Model Systems Study, Neuroepidemiology (2026). DOI: 10.1159/000552405
Key medical concepts
Traumatic Brain InjuryBrain CancersBrain TumorsAmyotrophic Lateral Sclerosis
Clinical categories
NeurologyOncologyPhysiatryHealthy aging Provided by Mass General Brigham Who's behind this story?
Gaby Clark
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