b'studys authors postulated that glioblastoma may arisereally need to have a better understanding of brain as a response to injury, such as TBI, in patients with acancerand TBIand,frankly,otherdiagnosesafter mutated genomic background. 3 TBI that we have also looked at. If we can build better models and get better risk prediction, then potentially Scientifically Plausible we can begin to talk about things like screening.The idea is that TBI is going to cause inflammationThe study is one of manyand there are more on that is going to turn on repair mechanisms, so poten- the way, Stewart addedshowing patients with TBI tially in someone at high risk, TBI can be the thingare at risk for a wide variety of chronic medical condi-that tips [them] over into getting the diagnosis, saidtions. I think the most important thing to take away Stewart. That is very speculativejust a theory, byfrom this is that the trajectory of these peoples lives no means proven, but it is scientifically plausible.hasforeverbeenchanged,hesaid.Theyareat Although the risk of brain cancer was almost dou- increased for a wide variety of things and now brain bledwithmoderate/severeTBIinthenewstudy,cancer is another one of those things we can add to Stewartofferedtheassurancethattheriskisstillthe list.small. The issue is that brain cancer is a very rare1Stewart, I. J., Howard, J. T., Poltavskiy, E., Dore, M., et al. (2024). diagnosis. If you take very small number and doubleTraumatic Brain Injury and Subsequent Risk of Brain Cancer in US it, you still have a very small number, he said. EvenVeterans of the Iraq and Afghanistan Wars. JAMA Network Open, for a patient with more severe TBIs, brain cancer is7(2), e2354588. https://doi.org/10.1001/jamanetworkopen.2023.54588still not a likely outcome. 2Morantz, R. A., & Shain, W. (1978). Trauma and brain tumors: Right now, the studys message is one of awareness,an experimental study. Neurosurgery, 3(2), 181-186. https://doi.Stewart said. Unfortunately we dont have any rec- org/10.1227/00006123-197809000-00009ommendations with regard to screening or something3Richards, L. M., Whitley, O. K. N., MacLeod, G., Cavalli, F. M. G., et al. (2021). Gradient of Developmental and Injury Response like that. It wouldnt be effective to screen all of thesetranscriptional states defines functional vulnerabilities underpinning people over a period of time, given how rare this diag- glioblastoma heterogeneity. Nature Cancer, 2(2), 157-173. https://doi.nosis is. But what I think this underscores is [that] weorg/10.1038/s43018-020-00154-9Cumulative Incidence Functions for the Outcome of Malignant Brain Cancer Stratified by Traumatic Brain Injury SeveritySource: Traumatic Brain Injury and Subsequent Risk of Brain Cancer in US Veterans of the Iraq and Afghanistan Wars. JAMA Network Open, 7(2), e2354588. https://doi.org/10.1001/jamanetworkopen.2023.5458849'