Survival of glioma patients in relation to mobile phone use in Denmark, Finland and Sweden
- 353 Downloads
Gliomas are the most common cancer of the brain, with a poor prognosis in particular for glioblastoma. In 2014, a study suggested reduced survival in relation to latency of mobile phone use among glioblastoma patients. A joint epidemiological/experimental project to study effects of RF-EMF on tumor development and progression was established. The current analysis relates to the epidemiological part and addresses whether pre-diagnostic mobile phone use was associated with survival among glioma patients.
Glioma cases (n = 806) previously enrolled in a collaborative population-based case–control study in Denmark, Finland and Sweden were followed up for survival. Vital status, date of death, date of emigration, or date last known to be alive was obtained based on registry linkages with a unique personal ID in each country. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) stratified by country. Covariates investigated were sex, age, education, histology, treatment, anatomic location and marital status.
No indication of reduced survival among glioblastoma patients was observed for various measures of mobile phone use (ever regular use, time since start of regular use, cumulative call time overall or in the last 12 months) relative to no or non-regular use. All significant associations suggested better survival for mobile phone users. Results were similar for high-grade and low-grade gliomas.
We found no evidence of reduced survival among glioma patients in relation to previous mobile phone use.
KeywordsGlioma Radiofrequency electromagnetic fields Survival Case–control studies Mobile phones
This work was supported by the French National Research Program for Environmental and Occupational Health of ANSES (2014/2 RF/002) and the International Agency for Research on Cancer, Lyon, France. The INTERPHONE study was supported by the European Union Fifth Framework Program “Quality of Life and Management of Living Resources” (contract number QLK4-CT-1999-01563), and The Union for International Cancer Control (UICC). The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. The provision of funds to the INTERPHONE study investigators via the UICC was governed by agreements that guaranteed INTERPHONE’s complete scientific independence. Additional support was obtained for the Swedish part from the Swedish Research Council and the Swedish Cancer Society, for the Danish part from the Danish Cancer Society, and the Finnish part from the Emil Aaltonen Foundation and Academy of Finland. The treatment data were collected separately with specific funding from Cancer Foundation Norrland and the cutting edge hospital grant for Umeå University hospital in Sweden.
Compliance with ethical standards
Conflict of interest
Anssi Auvinen has received research funding for the COSMOS cohort study from the National Technology Agency (TEKES) including contributions from Nokia and mobile network operators Elisa and Sonera and from Mobile Manufacturers’ Forum through Pirkanmaa Hospital District as a firewall. Professor Auvinen holds a part-time employment at STUK Radiation and Nuclear Safety Authority and is member of ICNIRP expert group on Data Gaps. Maria Feychting is vice chairman of the International Commission on Non-Ionizing Radiation Protection, an independent body setting guidelines for non-ionizing radiation protection. She serves as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to non-ionizing radiation. Professor Feychting is co-investigator of the COSMOS cohort study, funded by the Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, AFA Insurance (https://www.afaforsakring.se/andra-sprak/engelska/), and VINNOVA (The Swedish Governmental Agency for Innovation Systems, https://www.vinnova.se/en/). VINNOVA received funds for this purpose from TeliaSonera, Ericsson AB, and Telenor. The provision of funds to the COSMOS study investigators via VINNOVA is governed by agreements that guarantees COSMOS’ complete scientific independence. Remaining authors declare no conflicts of interest.
Ethical approvals for the original case-control studies were obtained in accordance with legislation in each country, and the ethical approval for the current study was obtained from the IARC Ethics Committee (Project 15-09).
- 1.Ervik M, Lam F, Ferley J, Mery L, Soerjomataram I, Bray F (2016) Cancer today. Lyon, France: International Agency for Research on Cancer. Cancer Today. http://gco.iarc.fr/today, Accessed 28 May 2018
- 2.Ostrom QT, Bauchet L, Davis FG, Deltour I, Fisher JL, Langer CE, Pekmezci M, Schwartzbaum JA, Turner MC, Walsh KM, Wrensch MR, Barnholtz-Sloan JS (2014) The epidemiology of glioma in adults: a “state of the science” review. Neuro Oncol 16:896–913. https://doi.org/10.1093/neuonc/nou087 CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Melin BS, Barnholtz-Sloan JS, Wrensch MR, Johansen C, Il’yasova D, Kinnersley B, Ostrom QT, Labreche K, Chen Y, Armstrong G, Liu Y, Eckel-Passow JE, Decker PA, Labussiere M, Idbaih A, Hoang-Xuan K, Di Stefano AL, Mokhtari K, Delattre JY, Broderick P, Galan P, Gousias K, Schramm J, Schoemaker MJ, Fleming SJ, Herms S, Heilmann S, Nothen MM, Wichmann HE, Schreiber S, Swerdlow A, Lathrop M, Simon M, Sanson M, Andersson U, Rajaraman P, Chanock S, Linet M, Wang Z, Yeager M, Wiencke JK, Hansen H, McCoy L, Rice T, Kosel ML, Sicotte H, Amos CI, Bernstein JL, Davis F, Lachance D, Lau C, Merrell RT, Shildkraut J, Ali-Osman F, Sadetzki S, Scheurer M, Shete S, Lai RK, Claus EB, Olson SH, Jenkins RB, Houlston RS, Bondy ML (2017) Genome-wide association study of glioma subtypes identifies specific differences in genetic susceptibility to glioblastoma and non-glioblastoma tumors. Nat Genet 49:789–794. https://doi.org/10.1038/ng.3823 CrossRefPubMedPubMedCentralGoogle Scholar
- 7.McCarthy BJ, Rankin KM, Aldape K, Bondy ML, Brannstrom T, Broholm H, Feychting M, Il’yasova D, Inskip PD, Johansen C, Melin BS, Ruder AM, Butler MA, Scheurer ME, Schuz J, Schwartzbaum JA, Wrensch MR, Davis FG (2011) Risk factors for oligodendroglial tumors: a pooled international study. Neuro Oncol 13:242–250. https://doi.org/10.1093/neuonc/noq173 CrossRefPubMedGoogle Scholar
- 8.Bondy ML, Scheurer ME, Malmer B, Barnholtz-Sloan JS, Davis FG, Il’yasova D, Kruchko C, McCarthy BJ, Rajaraman P, Schwartzbaum JA, Sadetzki S, Schlehofer B, Tihan T, Wiemels JL, Wrensch M, Buffler PA (2008) Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium. Cancer 113:1953–1968. https://doi.org/10.1002/cncr.23741 CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Feychting M, Schuz J (2017) 15—Electromagnetic fields. In: Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D (eds) Cancer epidemiology and prevention. 4th edn. Oxford Scholarship Online, OxfordGoogle Scholar
- 12.(2010) Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE international case-control study. Int J Epidemiol 39: 675–694 https://doi.org/10.1093/ije/dyq079
- 13.IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2011) Non-ionizing radiation, Part II: radiofrequency electromagnetic fields, IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, LyonGoogle Scholar
- 14.Wrensch M, Rice T, Miike R, McMillan A, Lamborn KR, Aldape K, Prados MD (2006) Diagnostic, treatment, and demographic factors influencing survival in a population-based study of adult glioma patients in the San Francisco Bay Area. Neuro Oncol 8:12–26. https://doi.org/10.1215/S1522851705000268 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Eckel-Passow JE, Lachance DH, Molinaro AM, Walsh KM, Decker PA, Sicotte H, Pekmezci M, Rice T, Kosel ML, Smirnov IV, Sarkar G, Caron AA, Kollmeyer TM, Praska CE, Chada AR, Halder C, Hansen HM, McCoy LS, Bracci PM, Marshall R, Zheng S, Reis GF, Pico AR, O’Neill BP, Buckner JC, Giannini C, Huse JT, Perry A, Tihan T, Berger MS, Chang SM, Prados MD, Wiemels J, Wiencke JK, Wrensch MR, Jenkins RB (2015) Glioma groups based on 1p/19q, IDH, and TERT Promoter mutations in tumors. N Engl J Med 372:2499–2508. https://doi.org/10.1056/NEJMoa1407279 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Meng W, Jiang Y, Ma J (2017) Is the prognostic significance of O6-methylguanine- DNA methyltransferase promoter methylation equally important in glioblastomas of patients from different continents? A systematic review with meta-analysis. Cancer Manag Res 9:411–425. https://doi.org/10.2147/cmar.S140447 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Carlberg M, Hardell L (2014) Decreased survival of glioma patients with astrocytoma grade IV (glioblastoma multiforme) associated with long-term use of mobile and cordless phones. Int J Environ Res Public Health 11:10790–10805. https://doi.org/10.3390/ijerph111010790 CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Lahkola A, Auvinen A, Raitanen J, Schoemaker MJ, Christensen HC, Feychting M, Johansen C, Klaeboe L, Lonn S, Swerdlow AJ, Tynes T, Salminen T (2007) Mobile phone use and risk of glioma in 5 North European countries. Int J Cancer 120:1769–1775. https://doi.org/10.1002/ijc.22503 CrossRefPubMedGoogle Scholar
- 25.Cardis E, Richardson L, Deltour I, Armstrong B, Feychting M, Johansen C, Kilkenny M, McKinney P, Modan B, Sadetzki S, Schuz J, Swerdlow A, Vrijheid M, Auvinen A, Berg G, Blettner M, Bowman J, Brown J, Chetrit A, Christensen HC, Cook A, Hepworth S, Giles G, Hours M, Iavarone I, Jarus-Hakak A, Klaeboe L, Krewski D, Lagorio S, Lonn S, Mann S, McBride M, Muir K, Nadon L, Parent ME, Pearce N, Salminen T, Schoemaker M, Schlehofer B, Siemiatycki J, Taki M, Takebayashi T, Tynes T, van Tongeren M, Vecchia P, Wiart J, Woodward A, Yamaguchi N (2007) The INTERPHONE study: design, epidemiological methods, and description of the study population. Eur J Epidemiol 22:647–664. https://doi.org/10.1007/s10654-007-9152-z CrossRefPubMedGoogle Scholar
- 30.Wijnenga MMJ, Mattni T, French PJ, Rutten GJ, Leenstra S, Kloet F, Taphoorn MJB, van den Bent MJ, Dirven CMF, van Veelen ML, Vincent A (2017) Does early resection of presumed low-grade glioma improve survival? A clinical perspective. J Neurooncol 133:137–146. https://doi.org/10.1007/s11060-017-2418-8 CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996. https://doi.org/10.1056/NEJMoa043330 CrossRefGoogle Scholar
- 32.Vrijheid M, Armstrong BK, Bedard D, Brown J, Deltour I, Iavarone I, Krewski D, Lagorio S, Moore S, Richardson L, Giles GG, McBride M, Parent ME, Siemiatycki J, Cardis E (2009) Recall bias in the assessment of exposure to mobile phones. J Exp Sci Environ Epidemiol 19:369–381. https://doi.org/10.1038/jes.2008.27 CrossRefGoogle Scholar