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(Database last updated on Mar 27, 2024)
| ID Number | 1648 | |
| Study Type | Epidemiology | |
| Model | CEFALO: Case control study of teenage (9-17 yr) mobile phone use and correlations with brain tumors. | |
| Details | Children 9-17 yrs (n = 550 cases, 1000 controls) in Denmark, Sweden, Norway, Switzerland, and UK identified with brain tumors and other health endpoints (2004 through May 2008) evaluated to determine if correlations exist with mobile phone use. The study will also collect data on allergies, contact with animals, contact with other children, medical history, and saliva for future genetic epidemiology. AUTHORS' ABSTRACT: Aydin et al. 2011 (#5072): Background It has been hypothesized that children and adolescents might be more vulnerable to possible health effects from mobile phone exposure than adults. We investigated whether mobile phone use is associated with brain tumor risk among children and adolescents. Methods CEFALO is a multicenter case-control study conducted in Denmark, Sweden, Norway, and Switzerland that includes all children and adolescents aged 7-19 years who were diagnosed with a brain tumor between 2004 and 2008. We conducted interviews, in person, with 352 case patients (participation rate: 83%) and 646 control subjects (participation rate: 71%) and their parents. Control subjects were randomly selected from population registries and matched by age, sex, and geographical region. We asked about mobile phone use and included mobile phone operator records when available. Odds ratios (ORs) for brain tumor risk and 95% confidence intervals (CIs) were calculated using conditional logistic regression models. Results Regular users of mobile phones were not statistically significantly more likely to have been diagnosed with brain tumors compared with nonusers (OR = 1.36; 95% CI = 0.92 to 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, 95% CI = 0.70 to 2.28). In a 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. Conclusion 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. Author's abstract: Feychting 2011 (IEEE #5124): In 2004, when WHO organized a workshop on children's sensitivity to electromagnetic fields, very few studies on radiofrequency fields were available. With the recent increase in mobile phone use among children and adolescents, WHO has identified studies on health effects in this age-group as a high priority research area. There are no empirical data supporting the notion that children and adolescents are more susceptible to RF exposure, but the number of studies is still relatively small. There are a few cross-sectional studies on well-being, cognitive effects and behavioral problems, and some cohort studies, mainly of maternal use of mobile phones during pregnancy. Cancer outcomes have been studied in relation to environmental RF exposure, e.g. from transmitters, and only one study on mobile phone use in children and adolescents and brain tumor risk has been published. Several methodological limitations need to be taken into consideration when interpreting the findings of the epidemiological studies. The cross-sectional design does not allow determination of the temporal sequence of exposure and outcome, and for several outcomes there is a large potential for reversed causality, i.e. that the outcome causes an increased RF exposure rather than the opposite. Biases such as recall errors in self-reported mobile phone use, lack of confounding control, e.g. of other aspects of mobile phone use than RF fields, trained behaviors, and pubertal development, makes causal interpretations impossible. Future studies need to include prospectively collected exposure information, incident outcomes, and proper confounding control. Monitoring of brain tumor incidence trends is strongly recommended. AUTHORS' ABSTRACT: Roosli, Feychting and Schuz 2014 (IEEE #5451): Use of mobile phones among children and adolescents has steeply increased over the last decade and this has raised concerns about a potential increased brain tumor risk in this age group from radiofrequency electromagnetic waves emitted by mobile phones. Until now, only one multi-center case-control study and various incidence rate time trend analyses have addressed the issue. Overall these data do not suggest an increased brain tumor risk from using mobile phones. However, some uncertainties remain with respect to heavy mobile phone use, with early life exposure, with rare histological subtypes or with longer latencies and subsequent development of brain tumors in adulthood. In this special situation, with a steep increase in exposure prevalence (mobile phone use), the availability of virtually complete cancer registry data in various countries, and the limited number of known other environmental co-risk factors, result of incidence time trends analyses are considered more informative than in many other situations. Thus, further monitoring of childhood brain tumor incidence rate time trends is warranted given the dramatic public health consequences of even a small individual risk increase. AUTHORS' ABSTRACT: Aydin, Feychting, Schüz, Röösli et al. 2011 (IEEE #5467): A growing body of literature addresses possible health effects of mobile phone use in children and adolescents by relying on the study participants' retrospective reconstruction of mobile phone use. In this study, we used data from the international case-control study CEFALO to compare self-reported with objectively operator-recorded mobile phone use. The aim of the study was to assess predictors of level of mobile phone use as well as factors that are associated with overestimating own mobile phone use. For cumulative number and duration of calls as well as for time since first subscription we calculated the ratio of self-reported to operator-recorded mobile phone use. We used multiple linear regression models to assess possible predictors of the average number and duration of calls per day and logistic regression models to assess possible predictors of overestimation. The cumulative number and duration of calls as well as the time since first subscription of mobile phones were overestimated on average by the study participants. Likelihood to overestimate number and duration of calls was not significantly different for controls compared to cases (OR=1.1, 95%-CI: 0.5 to 2.5 and OR=1.9, 95%-CI: 0.85 to 4.3, respectively). However, likelihood to overestimate was associated with other health related factors such as age and sex. As a consequence, such factors act as confounders in studies relying solely on self-reported mobile phone use and have to be considered in the analysis. AUTHORS' ABSTRACT: Aydin et al. 2012 (IEEE #5468): The first case-control study on mobile phone use and brain tumour risk among children and adolescents (CEFALO study) has recently been published. In a commentary published in Environmental Health, Söderqvist and colleagues argued that CEFALO suggests an increased brain tumour risk in relation to wireless phone use. In this article, we respond and show why consistency checks of case-control study results with observed time trends of incidence rates are essential, given the well described limitations of case-control studies and the steep increase of mobile phone use among children and adolescents during the last decade. There is no plausible explanation of how a notably increased risk from use of wireless phones would correspond to the relatively stable incidence time trends for brain tumours among children and adolescents observed in the Nordic countries. Nevertheless, an increased risk restricted to heavy mobile phone use, to very early life exposure, or to rare subtypes of brain tumours may be compatible with stable incidence trends at this time and thus further monitoring of childhood brain tumour incidence rate time trends is warranted. AUTHORS' ABSTRACT: Shu et al. 2014 (IEEE #5495):BACKGROUND: A number of epidemiological studies indicate an inverse association between atopy and brain tumors in adults, particularly gliomas. We investigated the association between atopic disorders and intracranial brain tumors in children and adolescents, using international collaborative CEFALO data. PATIENTS AND METHODS: CEFALO is a population-based case-control study conducted in Denmark, Norway, Sweden, and Switzerland, including all children and adolescents in the age range 7-19 years diagnosed with a primary brain tumor between 2004 and 2008. Two controls per case were randomly selected from population registers matched on age, sex, and geographic region. Information about atopic conditions and potential confounders was collected through personal interviews. RESULTS: In total, 352 cases (83%) and 646 controls (71%) participated in the study. For all brain tumors combined, there was no association between ever having had an atopic disorder and brain tumor risk [odds ratio 1.03; 95% confidence interval (CI) 0.70-1.34]. The OR was 0.76 (95% CI 0.53-1.11) for a current atopic condition (in the year before diagnosis) and 1.22 (95% CI 0.86-1.74) for an atopic condition in the past. Similar results were observed for glioma. CONCLUSIONS: There was no association between atopic conditions and risk of all brain tumors combined or of glioma in particular. Stratification on current or past atopic conditions suggested the possibility of reverse causality, but may also the result of random variation because of small numbers in subgroups. In addition, an ongoing tumor treatment may affect the manifestation of atopic conditions, which could possibly affect recall when reporting about a history of atopic diseases. Only a few studies on atopic conditions and pediatric brain tumors are currently available, and the evidence is conflicting. AUTHOR'S Letter: Milham 2012 (IEEE #6232): If, as the authors of this article (1) conclude, mobile phone use is not associated with brain cancer in children and adolescents, there should be as many odds ratios greater than 1 as the number of odds ratios less than 1 (1.0). In table 2, all of the 13 calculated odds ratios are greater than 1.0. A simple binomial probability for this result is P = .0004. In table 4, 33 of 36 odds ratios are greater than 1.0 and three are less than 1.0 (P < .001). In table 5, all of the 13 odds ratios for ipsilateral use are greater than 1.0, all of the 13 odds ratios for contralateral use are greater than 1.0, and, remarkably, all of the 13 odds ratios for central or unknown location are less than 1.0. The major media are already citing this article as a justification for cell phone use by children or adolescents. If anything, I think it may reflect a positive association between cell phone use and brain tumors. AUTHORS' SUMMARY: Morgan et al. 2012 (IEEE #6233): These numerous discrepancies suggest a poor peer-review process and/or a rush to publish. Overall, the findings of Aydin et al. (1) are supportive of a positive relationship between cell phone use in children and increased risk for brain tumors with shorter latency than those that have generally been found for adults. In that regard, it is noteworthy that Cardis et al. (3) recently reported that heaviest cell phone users had a statistically significantly (P = .01) increasing trend in gliomas with increasing radiofrequency dose after seven years. |
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| Findings | Ongoing | |
| Status | Ongoing | |
| Start Date | ||
| End Date | ||
| Principal Investigator | Danish Cancer Society, Denmark - christof@cancer.dk | |
| Funding Agency | EU | |
| Country | DENMARK | |
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