Jinyoung Moon, Physician's Weekly, Mar 13, 2023
The aim of this study is to investigate the relationship between the nationwide cell phone subscription rate and the nationwide incidence of brain tumors in South Korea. The nationwide cell phone subscription rate was used as a proxy for the RF-EMR [radio frequency electromagnetic radiation] exposure assessment.
The
data for cell phone subscriptions per 100 persons from 1985 to 2019
were found in the Statistics, International Telecom Union (ITU). The
brain tumor incidence data from 1999 to 2018 provided by the South Korea
Central Cancer Registry operated by the National Cancer Center were
used.
In South Korea, the subscription rate increased from 0 per 100 persons in 1991 to 57 per 100 persons in 2000. The subscription rate became 97 per 100 persons in 2009 and 135 per 100 persons in 2019. For the correlation coefficient between cell phone subscription rate before 10 years and ASIR per 100,000, a positive correlation coefficient with a statistical significance was reported in 3 benign brain tumors (International Classification of Diseases, ICD-10 code, D32, D33, and D32.0) and in 3 malignant brain tumors (ICD-10 code, C71.0, C71.1, and C71.2). Positive correlation coefficients with a statistical significance in malignant brain tumors ranged from 0.75 (95% CI 0.46-0.90) for C71.0 to 0.85 (95% CI 0.63-0.93) for C71.1.
In consideration of the fact that the main route for RF-EMR exposure has been through the frontotemporal side of the brain (the location of both ears), the positive correlation coefficient with a statistical significance in the frontal lobe (C71.1) and temporal lobe (C71.2) can be understood. Statistically insignificant results from recent cohort and large population international studies and contrasting results from many previous case-control studies could indicate a difficulty in identifying a factor as a determinant of a disease in ecological study design.
Moon J. The relationship between radiofrequency-electromagnetic radiation from cell phones and brain tumor: The brain tumor incidence trends in South Korea. Environmental Research (2023). doi: 10.1016/j.envres.2023.115657.
• Positive correlation for malignant neoplasm of cerebrum, except lobes and ventricles/the frontal lobe/the temporal lobe.
C71 Malignant neoplasm of brain
C72 Malignant neoplasm of the spinal cord, cranial nerves, and other parts of the central nervous system
C70.0 Malignant neoplasm of cerebral meninges
C70.9 Malignant neoplasm of meninges, unspecified
C71.0 Malignant neoplasm of cerebrum, except lobes and ventricles
C71.1 Malignant neoplasm of the frontal lobe
C71.2 Malignant neoplasm of the temporal lobe
C71.9 Malignant neoplasm of brain, unspecified
C72.0 Malignant neoplasm of spinal cord
D32 Benign neoplasm of meninges
D33 Benign neoplasm of brain and other parts of the central nervous system
D32.0 Benign neoplasm of brain
In South Korea, for the correlation coefficient between cell phone subscription rate before 10 years and ASIR per 100,000, a positive correlation coefficient with a statistical significance was reported in 3 malignant brain tumors (C71.0, C71.1, and C71.2) [i.e., cerebrum except lobes and ventricles, frontal lobe and temporal lobe] and 3 benign brain tumors (D32, D33, and D32.0) [i.e. nonmalignant meninges, brain and other CNS, and brain, supratentorial]. Among these results, that for malignant brain tumors in the frontal lobe (C71.1) and in the temporal lobe (C71.2) is suspicious of the association with RF-EMR emitted from cellular phones. The other 4 possible hypotheses do not fit well with the observed phenomena.
Statistically insignificant results from recent cohort or large population international studies and contrasting results from many previous case-control studies might come from several issues. A statistically significant increased risk can be found if (ⅰ) a more accurate exposure assessment such as site-specific, time-integral of SAR for each individual is applied or (ⅱ) massive populations over 100,000 are studied.
https://www.sciencedirect.com/"This ecological data is not sufficient to dismiss every potential mobile phone related risk scenario, but suggests that the risk – if it exists - would be very small, only occur after very long latency periods of several decades, or only affect small subgroups within glioma patients."
* Luo J, Li H, Deziel NC, Huang H, Zhao N, Ma S, Nie X, Udelsman R, Zhang Y. Genetic susceptibility may modify the association between cell phone use and thyroid cancer: A population-based case-control study in Connecticut. Environmental Research. 2020 Mar;182:109013. doi: 10.1016/j.envres.2019.109013. (see also Thyroid Cancer and Mobile Phone Use)
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Deltour I, Schuz J.
Nutzung von Mobiltelefonen und Verlauf der Gliom-Inzidenz seit 1979: Vorhaben 3618S00000 (FM 8867). International Agency for Research on Cancer. Jun 2022. Open access report: https://doris.bfs.de/jspui/
Incidence trends of adult malignant brain tumors in Finland, 1990-2016
Natukka T, Raitanen J, Haapasalo H, Auvinen A. Incidence trends of adult malignant brain tumors in Finland, 1990-2016. Acta Oncol. 2019 Apr 15:1-7. doi: 10.1080/0284186X.2019.1603396.
Abstract
BACKGROUND: Several studies have reported increased incidence trends of malignant gliomas in the late 1900s with a plateau in the 2000s, but also some recent increases have been reported. The purpose of our study was to analyze incidence trends of malignant gliomas in Finland by morphology and tumor location.
MATERIAL AND METHODS: Data on 4730 malignant glioma patients were obtained from case notifications to the nationwide, population-based Finnish Cancer Registry (FCR), and less detailed data on 3590 patients up to 2016. Age-standardized incidence rates (ASR) and average annual percent changes (APCs) in the incidence rates were calculated by histological subtype and tumor location.
RESULTS: The incidence rate of gliomas was 7.7/100,000 in 1990-2006 and 7.3 in 2007-2016. The incidence of all gliomas combined was stable during both study periods, with no departure from linearity. In an analysis by age group, increasing incidence was found only for ages 80 years and older (1990-2006). During both study periods, incidence rates were increasing in glioblastoma and decreasing in unspecified brain tumors. In 1990-2006, rates were also increasing for anaplastic oligodendroglioma, oligoastrocytoma and unspecified malignant glioma, while decreasing for astrocytoma. As for tumor location, incidence in 1990-2006 was increasing for frontal lobe and brainstem tumors, as well as those with an unspecified location, but decreasing for the parietal lobes, cerebrum and ventricles.
CONCLUSIONS: No increasing incidence trend was observed for malignant gliomas overall. An increasing incidence trend of malignant gliomas was found in the oldest age group during 1990-2006.
Excerpts
The incidence trend of glioblastoma was slightly increasing (APC: +0.8%; 95% CI: 0.0, +1.7 for 1990–2006 and +1.9%; 95% CI: +0.2, +3.5 for 2007–2016; Tables 2 and 3).
Incidence of glioblastoma increased slightly throughout the study period, while unspecified tumors of the brain showed a decreasing incidence trend.
We also found a slightly increasing incidence trend for the most common histological subtype, glioblastoma, which is consistent with several other studies [1,5,7–9,11,17,18]. A study from United States showed an increasing incidence trend for gliomas in the frontal lobe and decreasing trends for the cerebrum, ventricles and overlapping subtypes [17].
References
[1] Ostrom QT, Gittleman H, Liao P, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol. 2017;19: v1–v88.
[5] Ho VKY, Reijneveld JC, Enting RH, et al. Changing incidence and improved survival of gliomas. Eur J Cancer. 2014;50:2309–2318.
[7] Arora RS, Alston RD, Eden TOB, et al. Are reported increases in incidence of primary CNS tumours real? An analysis of longitudinal trends in England, 1979–2003. Eur J Cancer. 2010;46: 1607–1616.
[8] Deorah S, Lynch CF, Sibenaller ZA, et al. Trends in brain cancer incidence and survival in the United States: surveillance, epidemiology, and end results program, 1973 to 2001. Neurosurg Focus. 2006;20:E1.
[9] Hess KR, Broglio KR, Bondy ML. Adult glioma incidence trends in the United States, 1977–2000. Cancer. 2004;101:2293–2299.
[11] Lonn S, Klaeboe L, Hall P, et al. Incidence trends of adult primary intracerebral tumors in four Nordic countries. Int J Cancer. 2004; 108:450–455.
[17] Zada G, Bond AE, Wang YP, et al. Incidence trends in the anatomic location of primary malignant brain tumors in the United States: 1992–2006. World Neurosurg. 2012;77:518–524.
[18] Dubrow R, Darefsky AS. Demographic variation in incidence of adult glioma by subtype, United States, 1992–2007. BMC Cancer. 2011;11:325.
[1] Ostrom QT, Gittleman H, Liao P, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol. 2017;19: v1–v88.
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Trends in the incidence of primary brain, central nervous system and intracranial tumors in Israel, 1990-2015
Keinan-Boker
L, Friedman E, Silverman BG. Trends in the incidence of primary brain,
central nervous system and intracranial tumors in Israel, 1990-2015.
Cancer Epidemiol. 2018 Oct;56:6-13. doi: 10.1016/j.canep.2018.07.003.
Highlights
• Exponential growth in cellphone use fueled concerns regarding brain and CNS tumors.
• Results so far are inconsistent. Studying cancer incidence trends may thus be informative.
• We studied brain tumor trends from 1990 to 2015 in Israel, when cellphone use dramatically increased.
• Results do not support a substantial role for cellphone use; smaller risks in special subgroups may exist.
• Future research is needed; implementation of the precautionary principle is prudent.
Abstract
BACKGROUND:
The association between cellphone technology and brain, central nervous
system (CNS) and intracranial tumors is unclear. Analysis of trends in
incidence of such tumors for periods during which cellphone use
increased dramatically may add relevant information. Herein we describe
secular trends in the incidence of primary tumors of the brain and CNS
from 1990 to 2015 in Israel, a period during which cellphone technology
became extremely prevalent in Israel.
METHODS:
All cases of primary brain, CNS and intracranial tumors (excluding
lymphomas) diagnosed in Israel from 1990 to 2015 were identified in the
Israel National Cancer Registry database and categorized by behavior
(malignant; benign/uncertain behavior) and histologic type. Annual
age-standardized incidence rates by sex and population group (Jews;
Arabs) were computed, and the annual percent changes and 95% confidence
intervals per category were calculated using Joinpoint software.
RESULTS:
Over 26 years (1990-2015) no significant changes in the incidence of
malignant brain, CNS and intracranial tumors were observed, except for
an increase in malignant glioma incidence in Jewish women up to 2008 and
Arab men up to 2001, which levelled off in both subgroups thereafter.
The incidence of benign/uncertain behavior brain, CNS and intracranial
tumors increased in most population groups up to the mid-2000s, a trend
mostly driven by changes in the incidence of meningioma, but either
significantly decreased (Jews) or stabilized (Arabs) thereafter.
CONCLUSIONS:
Our findings are not consistent with a discernable effect of cellphone
use patterns in Israel on incidence trends of brain, CNS and
intracranial tumors.
Excerpts
"When
cancer occurrence rates referred to glioblastomas only, Joinpoint
analysis of incidence trends was restricted to the period from 1995 to
2015 due to small numbers of cases in the Arab population prior to 1995.
Stable incidence trends were noted, with non-significant APCs, in all
population subgroups: APC1995–2015 for Jewish men was +0.6% (95%CI
-0.4%,+1.6%); APC1995–2015 for Jewish women was +0.6% (95%CI
-0.1%,+1.6%); APC1995–2015 for Arab men was -1.6% (95%CI -3.9%,+0.8%);
APC1995–2015 for Arab women was +0.4% (95%CI -2.9%,+3.8%).
Analysis
of time trends by age groups disclosed stable trends in most
population- age- and sex groups, except for a mild increase in Jewish
males aged 65 and over (APC1990–2015 +1.2%, p < 0.05) and in Arab
males aged 20–64 (APC1990–2015 +1.5%, p < 0.05). In the population of
Arab females, lack of cases in the age groups of 20–64 and 65+ in
certain years prevented an analysis of trends."
"However,
ecologic studies, of which ours is an example, may be insensitive to
excess in risk which is restricted to certain groups (for example, heavy
users or subjects exposed from very young ages) or to certain tumor
types (e.g., tumors that are very rare, that involve specific anatomical
sites, or that have unusually long latency periods) [34]. Little et al.
[35] also commented that the predicted rates of glioma based on data
derived from the small proportion of highly exposed people in the
Interphone study, could be consistent with the observed rates in their
study [35]. Therefore, although a substantial risk is not very
plausible, smaller risks cannot be ruled out and future research should
address specific exposure groups, and tumor types and sites, and should
allow for longer follow up periods."
--England: Brain Cancer Incidence Increased in Temporal and Frontal Lobes of Brain since 1995
A new study of cancer data in England essentially replicated the results of the Philips et al study (see below). The study found that the two age groups most vulnerable to carcinogenic effects from cell phone use -- young and elderly adults -- showed increased incidence over time in brain cancer in the frontal and temporal lobes of the brain -- the two lobes that receive the greatest dose of microwave radiation when cell phones are used near the head during phone calls.
However, Frank de Vocht, the author of this paper, rejected the explanation that cell phone use caused the increased cancer risk. He attributed the increased incidence to better diagnosis of brain tumors, especially in the elderly. Of course, this does not explain why the increase was only observed in the frontal and temporal lobes. He did not rule out the possibility that cell phone radiation may be a contributing factor to the observed increase.
Microwave News reported on this study and published the following graph obtained from Alasdair Philips (Microwave News, "Location, Location, Location: Aggressive Brain Tumors Tell a Story; GBM Rise Only in Frontal and Temporal Lobes, Oct 26, 2018.)
de Vocht F. Analyses of temporal and spatial patterns of Glioblastoma Multiforme and other brain cancers subtypes in relation to mobile phones using synthetic counterfactuals. Environmental Research. Available online 17 October 2018. https://doi.org/10.1016/j.
• English 1985–2005 brain cancer subtype rates were compared to counterfactual trends
• Excess GBM increases were found in the frontal and temporal lobes, and cerebellum
• Mobile phone use was unlikely to have been an important putative factor
• No evidence of an effect of mobile phone use on acoustic neuroma and meningioma
Abstract
This study assesses whether temporal trends in glioblastoma multiforme (GBM) in different brain regions, and of different malignant and benign (including acoustic neuroma and meningioma) subtypes in the temporal lobe, could be associated with mobile phone use.
Increases in excess of the counterfactuals for GBM were found in the temporal (+38% [95% Credible Interval -7%,78%]) and frontal (+36% [-8%,77%]) lobes, which were in agreement with hypothesised temporal and spatial mechanisms of mobile phone usage, and cerebellum (+59% [-0%,120%]). However, effects were primarily present in older age groups, with largest effects in 75+ and 85+ groups, indicating mobile phone use is unlikely to have been an important putative factor. There was no evidence of an effect of mobile phone use on incidence of acoustic neuroma and meningioma.
Although 1985–2014 trends in GBM in the temporal and frontal lobes, and probably cerebellum, seem consistent with mobile phone use as an important putative factor, age-group specific analyses indicate that it is unlikely that this correlation is causal.
Excerpts
Assessment of specific cancer subtypes in the temporal lobe indicated that the excess incidence was mainly found for GBM, with similar trends observed in the frontal lobe and cerebellum.... The increased rates of specific brain cancer subtypes in excess of the counterfactuals correspond to the spatial and temporal patterns that would be expected if exposure to RF from mobile phones were an important putative factor (Cardis et al., 2008, Morgan et al., 2016) ... However, age group-specific analyses indicate that the excess relative impacts increased with age over 65 years and were primarily found in the very old (75/85+ years of age) for whom it is unlikely that mobile phone use had been an important causal factor. In addition, excess numbers of newly diagnosed cases were also observed in the young (<24 years of age) for whom mobile phone use is also an unlikely causal factor....
The assumption that a 10-year lag was the most plausible period between first exposure and when increased risk could be observed in registry data was based on the previous analyses (De Vocht (2016)). Although sensitivity analysis using a 15-year lag showed no evidence of excesses relative to counterfactuals, this may still have been too short....
Mar 25, 2018
The Incidence of Meningioma, a Non-Malignant Brain Tumor, is Increasing in the U.S.
Source: Alasdair Philips via Microwave News. |
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