Epidemiological study (observational study)

Use of mobile and cordless phones and survival of patients with glioma epidem.

By: Hardell L, Carlberg M

Published in: Neuroepidemiology 2013; 40 (2): 101-108

Aim of study (acc. to author)

Survival of patients after glioma diagnosis in relation to the use of mobile phones and cordless phones was investigated in a case-control study in Sweden. The present study is based on the study population of the case-control studies of Hardell et al (2006), Hardell et al (2011) and Hardell et al (2010).

Endpoint/type of risk estimation

brain tumor: glioma
survival

Exposure

- mobile communications
- analog mobile phone
- digital mobile phone
- cordless phone
- personal

Assessment

questionnaire: type of mobile phone (analog or digital), average minutes of daily use over the years, use in a car with external antenna or a hands-free device; years of use and mean number of minutes per day of cordless phone us

Exposure groups

Group	Description
Reference group 1	unexposed: no mobile or cordless phone use or less than 1 year
Group 2	mobile + cordless phone use > 1 to 5 years
Group 3	mobile + cordless phone use > 5 to 10 years
Group 4	mobile + cordless phone use >10 years
Group 5	mobile phone (analog and digital) use > 1 to 5 years
Group 6	mobile phone use > 5 to 10 years
Group 7	mobile phone use >10 years
Group 8	cordless phone use > 1 to 5 years
Group 9	cordless phone use > 5 to 10 years
Group 10	cordless phone use >10 years
Group 11	mobile + cordless phone, cumulative lifetime use: 1 - 1,000 h
Group 12	mobile + cordless phone, cumulative lifetime use: 1,001 - 2,000 h
Group 13	mobile + cordless phone, cumulative lifetime use: > 2,000 h
Group 14	mobile phone, cumulative lifetime use: 1 - 1,000 h
Group 15	mobile phone, cumulative lifetime use: 1,001 - 2,000 h
Group 16	mobile phone, cumulative lifetime use: > 2,000 h
Group 17	cordless phone, cumulative lifetime use: 1 - 1,000 h
Group 18	cordless phone, cumulative lifetime use: 1,001 - 2,000 h
Group 19	cordless phone, cumulative lifetime use: > 2,000 h
Group 20	mobile + cordless phone use: first terzile
Group 21	mobile + cordless phone use: second terzile
Group 22	mobile + cordless phone use: third terzile
Group 23	mobile phone use: first terzile
Group 24	mobile phone use: second terzile
Group 25	mobile phone use: third terzile
Group 26	cordless phone use: first terzile
Group 27	cordless phone use: second terzile
Group 28	cordless phone use: third terzile

Population

Group:
- men
- women
Age: 20–80 years
Characteristics: brain tumor, histopathologically verified
Observation period: 1997 - 2003
Study location: Sweden (Uppsala/Örebro and Linköping medical regions 1997-2003, Stockholm and Gothenburg regions 1997-2000)
Data source: Cancer registry, Swedish population registry

Study size

Type	Value
Total	1,251
Eligible	1,233

Statistical analysis method:

Cox proportional regressions analysis

(adjustment:

age
sex
socioeconomic status
year of diagnosis, study (living cases interviewed or next-of-kin interviewed)

)

Results (acc. to author)

In total, a statistically non-significant, marginal increased risk for the association between survival of glioma cases and the use of mobile phones and cordless phones was found (HR 1.1, CI 0.9-1.2). The hazard ratio was 1.2 (CI 1.002-1.5, p trend = 0.02) for glioma in the highest exposure group with > 10-year latency. For astrocytoma grade I-II (low-grade), a statistically decreased risk was observed (HR 0.5, CI 0.3-0.9) and for astrocytoma grade IV (glioblastoma) the hazard ratio was 1.1 (CI 0.95-1.4), with > 10 year latency 1.3 (CI 1.03-1.7). In the highest tertile ( 1 426 h) of cumulative use, a statistically non-significant increased risk was found (HR 1.2, CI 0.95-1.5) for glioblastoma. The results were similar for mobile phones and cordless phones.
The authors concluded that a decreased survival of glioma cases with long-term and high cumulative use of wireless phones was found. A survival disadvantage for astrocytoma grade IV, but a survival benefit for astrocytoma grade I-II was observed which could be due to exposure-related tumor symptoms leading to earlier diagnosis and surgery in that patient group.

Study funded by

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

de Vocht F (2016): Inferring the 1985-2014 impact of mobile phone use on selected brain cancer subtypes using Bayesian structural time series and synthetic controls
Grell K et al. (2016): The Intracranial Distribution of Gliomas in Relation to Exposure From Mobile Phones: Analyses From the INTERPHONE Study
Yoon S et al. (2015): Mobile phone use and risk of glioma: a case-control study in Korea for 2002-2007
Carlberg M et al. (2014): Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones
Akhavan-Sigari R et al. (2014): Connection between Cell Phone use, p53 Gene Expression in Different Zones of Glioblastoma Multiforme and Survival Prognoses
Lagorio S et al. (2014): Mobile phone use and risk of intracranial tumors: A consistency analysis
Benson VS et al. (2013): Mobile phone use and risk of brain neoplasms and other cancers: prospective study
International Agency for Research on Cancer (IARC) (2013): Non-Ionizing Radiation, Part 2: Radiofrequency Electromagnetic Fields. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 102
Barchana M et al. (2012): Changes in brain glioma incidence and laterality correlates with use of mobile phones - a nationwide population based study in Israel
Carlberg M et al. (2012): On the association between glioma, wireless phones, heredity and ionising radiation
Little MP et al. (2012): Mobile phone use and glioma risk: comparison of epidemiological study results with incidence trends in the United States
Deltour I et al. (2012): Mobile Phone Use and Incidence of Glioma in the Nordic Countries 1979-2008: Consistency Check
Hardell L et al. (2011): Pooled analysis of case-control studies on malignant brain tumours and the use of mobile and cordless phones including living and deceased subjects
Frei P et al. (2011): Use of mobile phones and risk of brain tumours: update of Danish cohort study
INTERPHONE Study Group et al. (2011): Acoustic neuroma risk in relation to mobile telephone use: Results of the INTERPHONE international case-control study
Schüz J et al. (2011): Long-Term Mobile Phone Use and the Risk of Vestibular Schwannoma: A Danish Nationwide Cohort Study
Sato Y et al. (2011): A case-case study of mobile phone use and acoustic neuroma risk in Japan
Hardell L et al. (2010): Mobile Phone Use and the Risk for Malignant Brain Tumors: A Case-Control Study on Deceased Cases and Controls
INTERPHONE Study Group et al. (2010): Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE international case-control study
Kundi M (2010): Essential problems in the interpretation of epidemiologic evidence for an association between mobile phone use and brain tumours
Myung SK et al. (2009): Mobile phone use and risk of tumors: a meta-analysis
Hardell L et al. (2009): Mobile phones, cordless phones and the risk for brain tumours
Kan P et al. (2008): Cellular phone use and brain tumor: a meta-analysis
Cardis E et al. (2007): The INTERPHONE study: design, epidemiological methods, and description of the study population
Schlehofer B et al. (2007): Environmental risk factors for sporadic acoustic neuroma (Interphone Study Group, Germany)
Lahkola A et al. (2006): Meta-analysis of mobile phone use and intracranial tumors
Hardell L et al. (2006): Pooled analysis of two case-control studies on use of cellular and cordless telephones and the risk for malignant brain tumours diagnosed in 1997-2003
Schüz J et al. (2006): Cellular telephone use and cancer risk: update of a nationwide Danish cohort
Takebayashi T et al. (2006): Mobile phone use and acoustic neuroma risk in Japan
Schoemaker MJ et al. (2005): Mobile phone use and risk of acoustic neuroma: results of the Interphone case-control study in five North European countries
Hardell L et al. (2005): Case-Control Study on Cellular and Cordless Telephones and the Risk for Acoustic Neuroma or Meningioma in Patients Diagnosed 2000-2003
Lönn S et al. (2004): Mobile Phone Use and the Risk of Acoustic Neuroma
Christensen HC et al. (2004): Cellular telephone use and risk of acoustic neuroma
Muscat JE et al. (2002): Handheld cellular telephones and risk of acoustic neuroma
Johansen C et al. (2001): Cellular telephones and cancer--a nationwide cohort study in Denmark
Cardis E et al. (1999): International Case-Control Study of Adult Brain, Head and Neck Tumours: Results of the Feasibility Study