Epidemiological study (observational study)

Acoustic neuroma risk in relation to mobile telephone use: Results of the INTERPHONE international case-control study epidem.

By: INTERPHONE Study Group, Cardis E, Deltour I, Vrijheid M, Evrard AS, Moissonnier M, Armstrong B, Brown J, Nadon L, Giles G, Siemiatycki J, Parent ME, Krewski D, McBride MM, Johansen C, Christensen HC, Auvinen A, Kurttio P, Salminen T, Lahkola A, Hours M, Bernard M, Montestruq L, Schüz J, Blettner M, Berg-Beckhoff G, Schlehofer B, Sadetzki S, Chetrit A, Jarus-Hakak A, Lagorio S, Iavarone I, Takebayashi T, Yamaguchi N, Woodward A, Cook A, Pearce N, Tynes T, Klaeboe L, Blaasaas KG, Feychting M, Lönn S, Ahlbom A, McKinney PA, Hepworth SJ, Muir KR, Swerdlow AJ, Schoemaker MJ

Published in: Cancer Epidemiol 2011; 35 (5): 453-464

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Aim of study (acc. to author)

An international case-control study (INTERPHONE) was conducted in 13 countries to determine whether mobile phone use increases the risk of brain tumors.

Further details

The INTERPHONE study was initiated as an international set of case-control studies conducted in 13 countries (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden and the UK) focussing on four types of tumors (glioma, meningioma, acoustic neurinoma, and parotid gland tumor) in tissues that most absorb radiofrequency energy emitted by mobile phones. In the present publication the results of the analysis of the acoustic neuroma risk are presented, an earlier publication 18215 covers the results for the risk of glioma and meningioma.
Sensitivity analyses were performed to detect potential sources for bias.
Regular use of a mobile phone was defined as at least once a week for at least six months.

Endpoint/type of risk estimation

brain tumor: acoustic neuroma

Type of risk estimation:

incidence

(odds ratio (OR))

Exposure

- mobile communications
- mobile phone
- personal

Assessment

questionnaire: mobile phone use, including start and end dates of use, frequency and laterality of use, type of phone, use of hands-free devices, and other factors, such as type of telephone network
interview: face-to-face interview with the study subject or a proxy or telephone interview
calculation: lifetime cumulative numbers of hours of phone use and numbers of calls

Exposure groups

Group	Description
Reference group 1	regular use: no
Group 2	regular use: yes
Reference group 3	never regular use
Group 4	time since start of use: 1-1.9 years
Group 5	time since start of use: 2-4 years
Group 6	time since start of use: 5-9 years
Group 7	time since start of use: ≥ 10 years
Reference group 8	never regular use
Group 9	cumulative call time: < 5 h
Group 10	cumulative call time: 5-12.9 h
Group 11	cumulative call time: 13-30.9 h
Group 12	cumulative call time: 31-60.9 h
Group 13	cumulative call time: 61-114.9 h
Group 14	cumulative call time: 115-199.9 h
Group 15	cumulative call time: 200-359.9 h
Group 16	cumulative call time: 360-734.9 h
Group 17	cumulative call time: 735-1639.9 h
Group 18	cumulative call time: ≥ 1640 h
Reference group 19	never regular use
Group 20	cumulative number of calls: < 150
Group 21	cumulative number of calls: 150-349
Group 22	cumulative number of calls: 350-749
Group 23	cumulative number of calls: 750-1.399
Group 24	cumulative number of calls: 1,400-2,549
Group 25	cumulative number of calls: 2,550-4,149
Group 26	cumulative number of calls: 4,150-6,799
Group 27	umulative number of calls: 6,800-12,799
Group 28	cumulative number of calls: 12,800-26,999
Group 29	cumulative number of calls: ≥ 27,000
Reference group 30	no ipsilateral mobile phone use
Group 31	ipsilateral mobile phone use
Reference group 32	never regular use
Group 33	ipsilateral use, time since start of use: 1-1.9 years
Group 34	ipsilateral use, time since start of use: 2-4 years
Group 35	ipsilateral use, time since start of use: 5-9 years
Group 36	ipsilateral use, time since start of use: ≥ 10 years
Reference group 37	no regular use
Group 38	ipsilateral use, cumulative call time: < 5 h
Group 39	ipsilateral use, cumulative call time: 5-114.9 h
Group 40	ipsilateral use, cumulative call time: 115-359.9 h
Group 41	ipsilateral use, cumulative call time: 360-1639.9 h
Group 42	ipsilateral use, cumulative call time: ≥ 1640 h
Reference group 43	no regular use
Group 44	ipsilateral use, cumulative number of calls: 150
Group 45	ipsilateral use, cumulative number of calls: 150-2,549
Group 46	ipsilateral use, cumulative number of calls: 2,550-6,799
Group 47	ipsilateral use, cumulative number of calls: 6,800-26,999
Group 48	ipsilateral use, cumulative number of calls: ≥ 27,000
Reference group 49	no regular use
Group 50	contralateral use, time since start of use: 1-1.9 years
Group 51	contralateral use, time since start of use: 2-4 years
Group 52	contralateral use, time since start of use: 5-9 years
Group 53	contralateral use, time since start of use: ≥ 10 years
Reference group 54	no regular use
Group 55	contralateral use, cumulative call time: < 5 h
Group 56	contralateral use, cumulative call time: 5-114.9 h
Group 57	contralateral use, cumulative call time: 115-359.9 h
Group 58	contralateral use, cumulative call time: 360-1639.9 h
Group 59	contralateral use, cumulative call time: ≥ 1640 h
Reference group 60	no regular use
Group 61	contralateral use, cumulative number of calls: 150
Group 62	contralateral use, cumulative number of calls: 150-2,549
Group 63	contralateral use, cumulative number of calls: 2,550-6,799
Group 64	contralateral use, cumulative number of calls: 6,800-26,999
Group 65	contralateral use, cumulative number of calls: ≥ 27,000

Population

Group:
- men
- women
Age: 30–59 years
Observation period: 2000 - 2004
Study location: Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK

Case group

Characteristics: acoustic neuroma, histologically confirmed or based on unequivocal diagnostic imaging
Data source: neurological and neurosurgical facilities in the study regions

Control group

Selection:
- population-based
Matching:
- sex
- age
- ethnic origin (only in Israel)
- case:control = 1:2

Study size

	Cases	Controls
Eligible	1,361	14,354
Participants	1,121	7,658
Evaluable	1,105	2,145

Statistical analysis method:

conditional logistic regression
sensitivity analyses

(adjustment:

age
sex
education
study centre, ethnicity in Israel

)

Results (acc. to author)

Overall, no increased risk for acoustic neuroma was observed with ever having been a regular mobile phone user (group 2) and for persons with 10 years and longer mobile phone use (group 7). No trend of increasing ORs with increasing cumulative call time or cumulative number of calls was observed, with the lowest OR (0.48; CI 0.30-0.78) observed in the second highest group of cumulative call time (735 -1639.9 h). In the highest group (≥ 1640 h) of cumulative call time, the OR was 1.32 (CI 0.88-1.97); but there were implausible values reported in this group (e.g., mobile phone use more than 5 h/day). Similar results were observed when restricting the analysis at 5 years before the reference date (to exclude possible effects of prodomal symptoms on mobile phone use).
In general, odds ratios were not greater in subjects who reported usual phone use on the same side of the head as their tumor (ipsilateral) than in persons with contralateral use, but it was greater in those with 1640 and more cumulative hours of use.
The authors concluded that there was no increase in risk of acoustic neuroma with ever regular use of a mobile phone or for users who began regular use 10 years or more before the reference date. Elevated odds ratios observed at the highest level of cumulative call time could be due to chance, reporting bias or a causal effect. As acoustic neuroma is usually a slowly growing tumour, the interval between introduction of mobile phones and occurrence of the tumor might have been too short to observe an effect, if there is one.

Study funded by

3
Academy of Finland
Association pour la Recherche sur le Cancer (ARC), France
Australian Research Council (ARC)
Bouygues Telecom, France
Canada Research Chairs (Chaires de Recherche du Canada), Ottawa, Ontario, Canada
Canadian Institutes of Health Research (CIHR)
Canadian Wireless Telecommunications Association (CWTA; Association canadienne des télécommunications sans fil (ACTS)), Canada
Cancer Society of New Zealand
Department of Health, UK
Deutsches Mobilfunk Forschungsprogramm (DMF; German Mobile Phone Research Programme) at Federal Office for Radiation Protection (BfS)
Emil Aaltonen Foundation, Finland
European Union (EU)/European Commission
GSM Association, UK/Ireland
Guzzo Environment-Cancer Chair (University of Montréal) in partnership with Cancer Research Society (CRS) undertaken by the Environment-Cancer Fund, Canada
Hawkes Bay Medical Research Foundation (HBMR), New Zealand
Health and Safety Executive, UK
Health Research Council of New Zealand
International Union against Cancer (UICC; Union Internationale Contre le Cancer), Switzerland
MAIFOR Program (Mainzer Forschungsförderungsprogramm) of the University of Mainz, Germany
Ministerium für Umwelt und Naturschutz, Landwirtschaft und Verbraucherschutz, Nordrhein-Westfalen (Ministry for the Environment of the state of North Rhine-Westphalia), Germany
Ministerium für Umwelt und Verkehr, Baden-Württemberg (Ministry for the Environment and Traffic of the state of Baden-Württemberg), Germany
Ministry of Internal Affairs and Communications, Japan
Mobile Manufacturers Forum (MMF), Belgium
Mobile Telecommunications and Health Research (MTHR), UK
O2
Orange
Quality of Life and Management of Living Resources program of European Union
Scottish Executive/Scottish Ministers, UK
SFR, France
Swedish Cancer Society (Cancerfonden)
Swedish Research Council (VR)
T-Mobile
Vodafone
Waikato Medical Research Foundation (WMRF), New Zealand
Wellington Medical Research Foundation (WMRF), New Zealand

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