Authors' recommendations: To borrow from recent reviewers, whose conclusions have not been changed by subsequently published research or over much of the past decade:“Studies published to date cannot adequately determine whether cell phone use or other exogenous environmental factors such as increasing noise may have contributed to the increasing rates of AN. In 1997, the International Agency for Research on Cancer (IARC) coordinated an international collaborative case-control study on cell phone use and the incidence of brain tumors in 13 countries (the INTERPHONE study; Appendix Table 3). All of these studies relied on self-reported cell phone use through various questionnaires. The results of these studies remain controversial, in part, because most suffer from various methodological deficiencies including insufficient statistical power to detect an excess risk of brain tumors, reliance on small populations, short-term exposure periods, and difficulty in characterizing changing exposures throughout a lifetime in large populations. In addition, most negative studies have been substantially funded by the cell phone industry.” (Han, 2009).“Nine case-control studies containing 5,259 cases of primary brain tumors and 12,074 controls were included (in a systematic review with meta-analysis). All studies reported ORs according to brain tumor subtypes, and five provided ORs on patients with ≥ 10 years of follow up. Pooled analysis showed an OR of 0.90 (95% confidence interval [CI] 0.81-0.99) for cellular phone use and brain tumor development. The pooled OR for long-term users of ≥ 10 years (5 studies) was 1.25 (95% C, 1.01-1.54). No increased risk was observed according to analog or digital phone use…We found no increased risk of brain tumors among cellular phone users. The potential elevated risk of brain tumors after long-term cellular phone use awaits confirmation by future studies.” (Kan, 2008).“It is too soon for a verdict on the health risks from cellular telephones, especially in view of changing technology. From the Interphone Study and some other large studies in progress, better information may emerge. From the epidemiological information available now, the main public-health concern is clearly motor vehicle collisions, a behavioral effect rather than an effect of radiofrequency exposure as such. Neither the several studies of occupational exposure nor the few of cellular telephone users offer any clear evidence of an association with brain tumors or other malignancies. Even if the studies in progress were to find large relative effects for brain cancer, the absolute increase in risk would probably be much smaller than the risk stemming from motor vehicle collisions. Cellular telephones affect quality of life in myriad ways, for good and ill; the health risk is just one part of a picture that is slowly coming into focus.” (Rothman, 2000).The literature on cell phone safety is controversial and inconclusive, hampered by the relatively short history of phones, difficulties precisely quantifying exposures, changing technology, confounding environmental or occupational sources of radiation, and industry funding. Phones ultimately may not be demonstrated to be completely safe, but neither is it likely that their close integration into daily activities by much of the human population will permit foregoing use in absence of an alternative:“Ultimately the perception of safety will be heavily influenced by the perceived level of benefit from the activity in question. This level is clearly high in the case of mobile telephones and in many other domains where individuals exercise freedom of choice. …an editorial in the Guardian in 1977…an inquiry into a cluster of explosions of domestic gas:” Whatever the findings, gas will not become safe. Some oaf will always leave a tap on and then go down at the dead of night with a lighted taper”. This highly explosive substance is piped into millions of homes in the country. Is it safe? Of course not, but the amenity value is such that people are prepared to live with the risk. Researchers into the pursuit of safety, of mobile phones or other features of modern living, would be well advised to take this political element into consideration.” (Dendy 2000).It may be useful to consider cell phone exposure research in context with the early cigarette/lung cancer literature: the magnitude of risk with phones [best estimate non-significant odds ratio (OR), 0.7 from the Danish cohort: Appendix Table 3) is certainly less than that for tobacco (OR, approximately 10) and will be difficult to prove with certainty lacking the natural experiment available in the 1950s, when the first tobacco hazards research was conducted among British physicians (Lilienfeld and Stolley, 1994).To summarize: any link between cell phone use and disease has yet to be definitively demonstrated and any risk quantified. Several factors (human, politico-cultural, technological) argue against imminent resolution of the issues or subsequent change in human behavior although the INTERPHONE Study (Appendix Table 3) final results are pending publication.The single most rigorous study available (Schüz, 2006 and 2009; Johansen, 2001: Appendix Table 2), a population cohort, found no association between cell phone use and a variety of cranial tumors in comparing all private cell phone subscribers in Denmark versus the entire population during twenty years of follow-up.Finally, concluding a report on the absence of time trends in brain tumor incidence from four Nordic countries, Deltour (2009; Appendix Table 2) lays out possible explanations:“The lack of a detectable trend change in incidence rates up to 2003 in this study suggests that the induction period for brain tumors associated with mobile phone use exceeds 5-10 years, that the increased risk of brain tumors associated with mobile phone use in this population is too small to be observed, that the risk is restricted to subgroups of brain tumors, or there is no increased risk associated with mobile phone use. Because of the high prevalence of mobile phone exposure in this population and worldwide, longer follow-up of time trends in brain tumor incidence rates are warranted.” Deltour (2009).

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/Cellphonemt2009.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)