Epidemiological study (observational study)

Mobile phone use and brain tumors in children and adolescents: a multicenter case-control study epidem.

By: Aydin D, Feychting M, Schüz J, Tynes T, Andersen TV, Schmidt LS, Poulsen AH, Johansen C, Prochazka M, Lannering B, Klaeboe L, Eggen T, Jenni D, Grotzer M, Von der Weid N, Kuehni CE, Röösli M

Published in: J Natl Cancer Inst 2011; 103 (16): 1264-1276

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Aim of study (acc. to author)

A multicentric case-control study (CEFALO) was conducted in Denmark, Sweden, Norway, and Switzerland to investigate the relationship between mobile phone use and risk of developing brain tumors in children and adolescents.

Further details

Regular use was defined as use of a mobile phone at least once per week for a period of 6 months or more.

Endpoint/type of risk estimation

brain tumor
childhood brain/CNS tumor: intracranial central nervous system tumor: ependymoma, astrocytoma, primitive neuroectodermal tumor, other glioma, other specified intracranial neoplasms, and unspecified intra-cranial neoplasms

Type of risk estimation:

incidence

(odds ratio (OR))

Exposure

- other domestic appliance
- mobile communications
- digital mobile phone
- cordless phone
- personal

Assessment

list: traffic data from mobile phone network operators including number of calls, duration of calls, subscription start and end dates (in case of consent of the participant)
questionnaire: mobile phone use: more than 20 times during life, ownership of mobile phone, number of subscriptions, start and end, use of hands-free devices, preferred side of head during use, number of calls per day, and duration of calls; use of baby monitors near the head; use of cordless phones (cumulative duration and number of calls)

Exposure groups

Group	Description
Reference group 1	non-regular mobile phone user
Group 2	regular mobile phone user
Reference group 3	time since first use: never regular user
Group 4	time since first use: ≤ 3.3 years
Group 5	time since first use: 3.3 - 5.0 years
Group 6	time since first use: > 5.0 years
Reference group 7	cumulative duration of subscriptions: never regular user
Group 8	cumulative duration of subscriptions: ≤ 2.7 years
Group 9	cumulative duration of subscriptions: 2.8 - 4.0 years
Group 10	cumulative duration of subscriptions: > 4.0 years
Reference group 11	cumulative duration of calls: never regular user
Group 12	cumulative duration of calls: ≤ 35 h
Group 13	cumulative duration of calls: 36 - 144 h
Group 14	cumulative duration of calls: > 144 h
Reference group 15	cumulative number of calls: never regular user
Group 16	cumulative number of calls: ≤ 936
Group 17	cumulative number of calls: 937 - 2638
Group 18	cumulative number of calls: > 2638
Reference group 19	ever use of baby monitors near the head: no
Group 20	ever use of baby monitors near the head: yes
Reference group 21	ever use of cordless phones: no
Group 22	ever use of cordless phones: yes
Reference group 23	cumulative duration of calls with cordless phones: never user
Group 24	cumulative duration of calls with cordless phones: ≤ 23 h
Group 25	cumulative duration of calls with cordless phones: 24 - 70 h
Group 26	cumulative duration of calls with cordless phones: > 70 h
Group 27	cumulative duration of calls with cordless phones: missing data
Reference group 28	cumulative number of calls with cordless phones: never user
Group 29	cumulative number of calls with cordless phones: ≤ 235
Group 30	cumulative number of calls with cordless phones: 236 - 704
Group 31	cumulative number of calls with cordless phones: > 704
Group 32	cumulative number of calls with cordless phones: missing data

Population

Group:
- men
- women
- children
Age: 7–19 years
Observation period: January 2004 - August 2008
Study location: Denmark, Sweden, Norway, and Switzerland

Case group

Characteristics: brain tumor, histologically confirmed or based on unequivocal diagnostic imaging
Data source: cancer registries, pediatric, oncology, and neurosurgery departments
Exclusion criteria: neurofibromatosis or tuberous sclerosis, deafness, severe mental retardation, families with insufficient language skills

Control group

Selection:
- population-based
Matching:
- sex
- age
- area
- case:control = 1:2

Study size

	Cases	Controls
Eligible	423	909
Participants	352	646
Participation rate	83 %	71 %

Statistical analysis method:

conditional logistic regression

Results (acc. to author)

194 (55%) case patients and 329 (51%) control subjects have used regularly mobile phones.
Regular users of mobile phones were not statistically significantly more likely to have been diagnosed with brain tumors compared with nonusers (OR 1.36; CI 0.92-2.02). Children who started to use mobile phones at least 5 years ago were not at increased risk compared with those who had never regularly used mobile phones (OR 1.26; CI 0.70-2.28). In a small subset of study participants for whom operator recorded data were available, brain tumor risk was related to the time elapsed since the mobile phone subscription was started but not to amount of use. No increased risk of brain tumors was observed for brain areas receiving the highest amount of exposure. The results showed no relationship between brain tumor risk and ever use of baby monitors near the head as well as children's use of cordless phones.
The authors conclude that the absence of an exposure-response relationship either in terms of the amount of mobile phone use or by localization of the brain tumor argues against a causal association.

Study funded by

Danish Strategic Research Council, Denmark
Federal Office of Public Health (FOPH; Bundesamt für Gesundheit), Switzerland
Forschungsstiftung Mobilkommunikation (FSM; Research Foundation on Mobile Communication; at the Swiss Federal Institute of Technology Zurich (ETH)), Switzerland
Research Council of Norway
Swedish Cancer Society (Cancerfonden)
Swedish Childhood Cancer Society (Barncancerfonden), Sweden
Swedish Council for Working Life and Social Research (FAS)
Swedish Radiation Protection Authority (SSI)
Swedish Research Council (VR)
Swiss National Science Foundation (SNF)

Comments on this article

Aydin D et al. (2012): Childhood brain tumours and use of mobile phones: comparison of a case-control study with incidence data
Milham S (2012): Re: Mobile phone use and brain tumors in children and adolescents
Aydin D et al. (2012): Response: Re: Mobile Phone Use and Brain Tumors in Children and Adolescents
Morgan LL et al. (2012): Re: Mobile phone use and brain tumors in children and adolescents: a multicenter case-control study
Aydin D et al. (2012): Response: Re: Mobile Phone Use and Brain Tumors in Children and Adolescents: A Multicenter Case-Control Study
Söderqvist F et al. (2011): Childhood brain tumour risk and its association with wireless phones: a commentary

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