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Epidemiological Study (case-control study, pooled analysis)

Pooled analysis of two case-control studies on the use of cellular and cordless telephones and the risk of benign brain tumours diagnosed during 1997-2003. epidemiol.

By: Hardell L, Carlberg M, Hansson Mild K
Published in: Int J Oncol 2006; 28 (2): 509 - 518 ( open external web page

PubMed Entry , open external web page

Journal web site )

Aim of study (according to author)
A pooled analysis of two previous case-control studies on the use of cellular and cordless telephones and the risk of benign brain tumors was conducted in Sweden.
Background/further details:
The first case-control study regarding the period 1997-2000 was published in the publications 9105 and 9520. The second study regarding the period 2000-2003 was published in publication 12068 concerning benign brain tumors and in publication 12259 concerning malignant brain tumors.

Endpoint/type of risk estimation

brain tumor: benign brain tumors: meningioma, acoustic neuroma and other types

Estimate of incidence by odds ratio (OR)

Exposure

mobile communication system, analog mobile phone, digital mobile phone, cordless phone, personal exposure
type of exposure: personal
assessment by questionnaire (first year of use, type of phone, mean minutes of daily use over the years, use in a car with external antenna or a hands-free, ear most frequently used)
assessment by interview (supplementing data)

groups of exposure:

Reference group 1:	unexposed
group 2:	analog > 1- to 5-year latency period
group 3:	analog > 5- to 10-year latency period
group 4:	analog > 10-year latency period
group 5:	analog > 15-year latency period
group 6:	analog total, > 1-year latency period
group 7:	analog ≤ 85 h, > 1- to 5-year latency period
group 8:	analog ≤ 85 h, > 5- to 10-year latency period
group 9:	analog ≤ 85 h, > 10-year latency period
group 10:	analog ≤ 85 h, total, > 1-year latency period
group 11:	analog > 85 h, > 1- to 5-year latency period
group 12:	analog > 85 h, > 5- to 10-year latency period
group 13:	analog > 85 h, > 10-year latency period
group 14:	analog > 85 h, total, > 1-year latency period
group 15:	digital > 1- to 5-year latency period
group 16:	digital > 5- to 10-year latency period
group 17:	digital > 10-year latency period
group 18:	digital total, > 1-year latency period
group 19:	digital ≤ 64 h, > 1- to 5-year latency period
group 20:	digital ≤ 64 h, > 5- to 10-year latency period
group 21:	digital ≤ 64 h, > 10-year latency period
group 22:	digital ≤ 64 h, total, > 1-year latency period
group 23:	digital > 64 h, > 1- to 5-year latency period
group 24:	digital > 64 h, > 5- to 10-year latency period
group 25:	digital > 64 h, > 10-year latency period
group 26:	digital > 64 h, total, > 1-year latency period
group 27:	cordless > 1- to 5-year latency period
group 28:	cordless > 5- to 10-year latency period
group 29:	cordless > 10-year latency period
group 30:	cordless total, > 1-year latency period
group 31:	cordless ≤ 195 h, > 1- to 5-year latency period
group 32:	cordless ≤ 195 h, > 5- to 10-year latency period
group 33:	cordless ≤ 195 h, > 10-year latency period
group 34:	cordless ≤ 195 h, total, > 1-year latency period
group 35:	cordless > 195 h, > 1- to 5-year latency period
group 36:	cordless > 195 h, > 5- to 10-year latency period
group 37:	cordless > 195 h, > 10-year latency period
group 38:	cordless > 195 h, total, > 1-year latency period

Population

case group
men and women, aged from 20 to 80 years
diagnosis: brain tumor, histopathologically verified
observation period: January 1997 - December 2003
study location: Sweden (Uppsala/Örebro and Linköping medical regions 1997-2003, Stockholm and Gothenburg regions 1997-2000)
source of data: Cancer registry
exclusion criteria: deceased, medical conditions
control group

matching: sex, age, area

Further parameters acquired by questionnaire (working history, exposure to different agents, smoking habits)

Study size	cases	controls
number eligible	1,429	2,437
number participating	1,254	2162
rate of participating	88%	89%

Other: benign and malignant brain tumors total: 2437, controls for malignant and benign cases

Statistically significant results

group	exposure	endpoint	cases	controls	parameter (OR)	confidence interval
5	analog > 15-year latency period	acoustic neuroma	6	22	3.8	1.4-10
6	analog total, > 1-year latency period	acoustic neuroma	68	297	2.9	2.0-4.3
18	digital total, > 1-year latency period	acoustic neuroma	105	775	1.5	1.1-2.1
30	cordless total, > 1-year latency period	acoustic neuroma	96	701	1.5	1.04-2.0

Statistical analysis using unconditional logistic regression (adjusted for age, 5-year age group, socioeconomic status, year of diagnosis)

Results/conclusion (according to author)
The results showed an increased risk of benign brain tumors, especially acoustic neuroma. The highest risk for acoustic neuroma was found for a latency period of more than 15 years for use of analog cellular phones. No convincing pattern of association was observed for other types of benign brain tumors.

Limitations (according to author): Several calculations were based on low numbers.

(Study character: epidemiological study, case-control study, pooled analysis)

Study funded by

Cancer och Allergifonden (Cancer and Allergy Foundation), Sweden
Cancerhjälpen (Cancerhelp), Sweden
Nyckelfonden, Sweden
Örebro Cancer Fund, Sweden

Published comment on this article:

by Morgan LL

Carlberg M et al. (2012): On the association between glioma, wireless phones, heredity and ionising...
Hardell L et al. (2011): Pooled analysis of case-control studies on malignant brain tumours and the use...
Hardell L et al. (2010): Mobile Phone Use and the Risk for Malignant Brain Tumors: A Case-Control Study...
Hardell L et al. (2009): Epidemiological evidence for an association between use of wireless phones and...
Hardell L et al. (2008): Meta-analysis of long-term mobile phone use and the association with brain...
Klaeboe L et al. (2007): Use of mobile phones in Norway and risk of intracranial tumours.
Lahkola A et al. (2007): Mobile phone use and risk of glioma in 5 North European countries.
Hardell L et al. (2006): Case-control study of the association between the use of cellular and cordless...
Takebayashi T et al. (2006): Mobile phone use and acoustic neuroma risk in Japan.
Schüz J et al. (2006): Cellular phones, cordless phones, and the risks of glioma and meningioma...
Schoemaker MJ et al. (2005): Mobile phone use and risk of acoustic neuroma: results of the Interphone...
Christensen HC et al. (2005): Cellular telephones and risk for brain tumors: a population-based, incident...
Hardell L et al. (2005): Case-Control Study on Cellular and Cordless Telephones and the Risk for...
Hardell L et al. (2005): Use of cellular telephones and brain tumour risk in urban and rural areas.
Christensen HC et al. (2004): Cellular telephone use and risk of acoustic neuroma.
Hardell L et al. (2004): Cellular and cordless telephone use and the association with brain tumors in...
Lönn S et al. (2004): Mobile Phone Use and the Risk of Acoustic Neuroma.
Kundi M et al. (2004): Mobile telephones and cancer--a review of epidemiological evidence.
Hardell L et al. (2003): Further aspects on cellular and cordless telephones and brain tumours.
Hardell L et al. (2002): Case-control study on the use of cellular and cordless phones and the risk for...
Auvinen A et al. (2002): Brain tumors and salivary gland cancers among cellular telephone users.
Hardell L et al. (2002): Cellular and cordless telephones and the risk for brain tumours.

Glossary: acoustic neuroma, analog, antenna, benign, brain tumors, cancer registry, case-control study, cellular, cellular phones, confidence interval, cordless phone, diagnosis, digital, ear, endpoint, epidemiological, exposure, histopathologically, incidence, latency, malignant, matching, mean, meningioma, mobile communication, OR, pooled analysis, questionnaire, risk, socioeconomic status, statistical, unconditional logistic regression

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