PRCTICAPROFESIONALIZANTEI

CellPhonesandCancerRisk
1. Whyisthereconcernthatcellphonesmaycausecancerorotherhealthproblems?
There are three main reasons why people are concerned that cell phones (also known as
wirelessormobiletelephones)mighthavethepotentialtocausecertaintypesofcanceror
otherhealthproblems:
o Cell phones emit radiofrequency energy (radio waves), a form of nonionizing radiation.
Tissuesnearesttowherethephoneisheldcanabsorbthisenergy.
o Thenumberofcellphoneusershasincreasedrapidly.Asof2010,thereweremorethan303
million subscribers to cell phone service in the United States, according to the Cellular
Telecommunications and Internet Association. This is a nearly threefold increase from the
110millionusersin2000.Globally,thenumberofcellphonesubscriptionsisestimatedby
theInternationalTelecommunicationsUniontobe5billion.
o Overtime,thenumberofcellphonecallsperday,thelengthofeachcall,andtheamountof
time people use cell phones have increased. Cell phone technology has also undergone
substantialchanges.
2. Whatisradiofrequencyenergyandhowdoesitaffectthebody?
Radiofrequencyenergyisaformofelectromagneticradiation.Electromagneticradiationcan
becategorizedintotwotypes:ionizing(e.g.,xrays,radon,andcosmicrays)andnonionizing
(e.g.,radiofrequencyandextremelylowfrequencyorpowerfrequency).
Exposuretoionizingradiation,suchasfromradiationtherapy,isknowntoincreasetheriskof
cancer. However, although many studies have examined the potential health effects of non
ionizing radiation from radar, microwave ovens, and other sources, there is currently no
consistentevidencethatnonionizingradiationincreasescancerrisk(1).
The only known biological effect of radiofrequency energy is heating. The ability of
microwave ovens to heat food is one example of this effect of radiofrequency energy.
Radiofrequencyexposurefromcellphoneusedoescauseheatinghowever,itisnotsufficient
tomeasurablyincreasebodytemperature.
Arecentstudyshowedthatwhenpeopleusedacellphonefor50minutes,braintissuesonthe
samesideoftheheadasthephonesantennametabolizedmoreglucosethandidtissuesonthe
opposite side of the brain (2). The researchers noted that the results are preliminary, and
possiblehealthoutcomesfromthisincreaseinglucosemetabolismarestillunknown.
3. Howisradiofrequencyenergyexposuremeasuredinepidemiologicstudies?
Levelsofradiofrequencyexposureareindirectlyestimatedusinginformationfrominterviews
orquestionnaires.Thesemeasuresincludethefollowing:
o Howregularlystudyparticipantsusecellphones(theminimumnumberofcallsperweek
ormonth)
o Theageandtheyearwhenstudyparticipantsfirstusedacellphoneandtheageandtheyear
oflastuse(allowscalculationofthedurationofuseandtimesincethestartofuse)
o Theaveragenumberofcellphonecallsperday,week,ormonth(frequency)
o Theaveragelengthofatypicalcellphonecall
o Thetotalhoursoflifetimeuse,calculatedfromthelengthoftypicalcalltimes,thefrequency
ofuse,andthedurationofuse
4. What has research shown about the possible cancercausing effects of radiofrequency
energy?

o
o

Although there have been some concerns that radiofrequency energy from cell phones held
closely to the head may affect the brain and other tissues, to date there is no evidence from
studiesofcells,animals,orhumansthatradiofrequencyenergycancausecancer.
It is generally accepted that damage to DNA is necessary for cancer to develop. However,
radiofrequencyenergy,unlikeionizingradiation,doesnotcauseDNAdamageincells,andit
has not been found to cause cancer in animals or to enhance the cancercausing effects of
knownchemicalcarcinogensinanimals(35).
Researchers have carried out several types of epidemiologic studies to investigate the
possibilityofarelationshipbetweencellphoneuseandtheriskofmalignant(cancerous)brain
tumors, such asgliomas, as well as benign (noncancerous) tumors, such
asacousticneuromas(tumors in the cells of the nerve responsible for hearing),
mostmeningiomas(tumorsinthemeninges,membranesthatcoverandprotectthebrainand
spinalcord),andparotidglandtumors(tumorsinthesalivaryglands)(6).
Inonetypeofstudy,calledacasecontrolstudy,cellphoneuseiscomparedbetweenpeople
withthesetypesoftumorsandpeoplewithoutthem.Inanothertypeofstudy,calledacohort
study,alargegroupofpeopleisfollowedovertimeandtherateofthesetumorsinpeoplewho
didanddidntusecellphonesiscompared.Cancerincidencedatacanalsobeanalyzedover
timetoseeiftheratesofcancerchangedinlargepopulationsduringthetimethatcellphone
use increased dramatically. The results of these studies have generally not provided clear
evidence of a relationship between cell phone use and cancer, but there have been some
statisticallysignificantfindingsincertainsubgroupsofpeople.
Findingsfromspecificresearchstudiesaresummarizedbelow:
The Interphone Study, conducted by a consortium of researchers from 13 countries, is the
largest healthrelated casecontrol study of use of cell phones and head and neck tumors.
Mostpublishedanalysesfromthisstudyhaveshownnostatisticallysignificantincreasesin
brain or central nervous system cancers related to higher amounts of cell phone use. One
recentanalysisshowedastatisticallysignificant,albeitmodest,increaseintheriskofglioma
amongthesmallproportionofstudyparticipantswhospentthemosttotaltimeoncellphone
calls.However,theresearchersconsideredthisfindinginconclusivebecausetheyfeltthatthe
amountofusereportedbysomerespondentswasunlikelyandbecausetheparticipantswho
reported lower levels of use appeared to have a slightly reduced risk of brain cancer
comparedwithpeoplewhodidnotusecellphonesregularly(79).Anotherrecentstudyfrom
thegroupfoundnorelationshipbetweenbraintumorlocationsandregionsofthebrainthat
wereexposedtothehighestlevelofradiofrequencyenergyfromcellphones(10).
A cohort study in Denmark linked billing information from more than 358,000 cell phone
subscriberswithbraintumorincidencedatafromtheDanishCancerRegistry.Theanalyses
found no association between cell phone use and the incidence of glioma, meningioma, or
acousticneuroma,evenamongpeoplewhohadbeencellphonesubscribersfor13ormore
years(1113).
TheprospectiveMillionWomenStudyintheUnitedKingdomfoundthatselfreportedcell
phoneusewasnotassociatedwithanincreasedriskofglioma,meningioma,ornoncentral
nervoussystemtumors.Theresearchersdidfindthattheuseofcellphonesformorethan5
yearswasassociatedwithanincreasedriskofacousticneuroma,andthattheriskofacoustic
neuromaincreasedwithincreasingdurationofcellphoneuse(14).However,theincidenceof
thesetumorsamongmenandwomenintheUnitedKingdomdidnotincreaseduring1998to
2008,eventhoughcellphoneuseincreaseddramaticallyoverthatdecade(14).
An early casecontrol study in the United States was unable to demonstrate a relationship
betweencellphoneuseandgliomaormeningioma(15).
SomecasecontrolstudiesinSwedenfoundstatisticallysignificanttrendsofincreasingbrain
cancer risk for the total amount of cell phone use and the years of use among people who
began using cell phones before age 20 (16). However, another large, casecontrol study in

Swedendidnotfindanincreasedriskofbraincanceramongpeoplebetweentheagesof20
and 69 (17). In addition, the international CEFALO study, which compared children who
werediagnosedwithbraincancerbetweenages7and19withsimilarchildrenwhowerenot,
foundnorelationshipbetweentheircellphoneuseandriskforbraincancer(18).
NCI's Surveillance, Epidemiology, and End Results (SEER) Program, which tracks cancer
incidenceintheUnitedStatesovertime,foundnoincreaseintheincidenceofbrainorother
centralnervoussystemcancersbetween1987and2007,despitethedramaticincreaseincell
phoneuseinthiscountryduringthattime(19,20).Similarly,incidencedatafromDenmark,
Finland,Norway,andSwedenfortheperiod19742008revealednoincreaseinageadjusted
incidence of brain tumors (21,22). A 2012 study by NCI researchers, which compared
observedgliomaincidenceratesinSEERwithprojectedratesbasedonrisksobservedinthe
Interphonestudy(8),foundthattheprojectedrateswereconsistentwithobservedU.S.rates.
TheresearchersalsocomparedtheSEERrateswithprojectedratesbasedonaSwedishstudy
published in 2011 (16). They determined that the projected rates were at least 40 percent
higherthan,andincompatiblewith,theactualU.S.rates.
Studiesofworkersexposedtoradiofrequencyenergyhaveshownnoevidenceofincreased
risk of brain tumors among U.S. Navy electronics technicians, aviation technicians, or fire
control technicians, those working in an electromagnetic pulse test program, plasticware
workers,cellularphonemanufacturingworkers,orNavypersonnelwithahighprobabilityof
exposuretoradar(6).

5. Why are the findings from different studies of cell phone use and cancer risk
inconsistent?
Alimitednumberofstudieshaveshownsomeevidenceofstatisticalassociationofcellphone
use and brain tumor risks, but most studies have found no association. Reasons for these
discrepanciesincludethefollowing:
o Recallbias,whichmayhappenwhenastudycollectsdataaboutpriorhabitsandexposures
using questionnaires administered after disease has been diagnosed in some of the study
participants.Itispossiblethatstudyparticipantswhohavebraintumorsmayremembertheir
cellphoneusedifferentlythanindividualswithoutbraintumors.Manyepidemiologicstudies
of cell phone use and brain cancer risk lack verifiable data about the total amount of cell
phoneuseovertime.Inaddition,peoplewhodevelopabraintumormayhaveatendencyto
recall using their cell phone mostly on the same side of their head where the tumor was
found,regardlessofwhethertheyactuallyusedtheirphoneonthatsideoftheirheadalotor
onlyalittle.
o Inaccurate reporting, which may happen when people say that something has happened
moreorlessoftenthanitactuallydid.Peoplemaynotrememberhowmuchtheyusedcell
phonesinagiventimeperiod.
o Morbidityandmortalityamong study participants who have brain cancer. Gliomas are
particularly difficult to study, for example, because of their high death rate and the short
survivalofpeoplewhodevelopthesetumors.Patientswhosurviveinitialtreatmentareoften
impaired,whichmayaffecttheirresponsestoquestions.Furthermore,forpeoplewhohave
died, nextofkin are often less familiar with the cell phone use patterns of their deceased
familymemberandmaynotaccuratelydescribetheirpatternsofusetoaninterviewer.
o Participationbias,whichcanhappenwhenpeoplewhoarediagnosedwithbraintumorsare
more likely than healthy people (known ascontrols) to enroll in a research study. Also,
controls who did not or rarely used cell phones were less likely to participate in the
Interphonestudythancontrolswhousedcellphonesregularly.Forexample,theInterphone
studyreportedparticipationratesof78percentformeningiomapatients(range5692percent
fortheindividualstudies),64percentforthegliomapatients(range3692percent),and53
percentforcontrolsubjects(range4274percent)(9).OneseriesofSwedishstudiesreported

participationratesof85percentinpeoplewithbraincancerand84percentincontrolsubjects
(17).
Changing technology and methods of use. Older studies evaluated radiofrequency energy
exposurefromanalogcellphones.However,mostcellphonestodayusedigitaltechnology,
whichoperatesatadifferentfrequencyandalowerpowerlevelthananalogphones.Digital
cell phones have been in use for more than a decade in the United States, and cellular
technologycontinuestochange(6).Texting,forexample,hasbecomeapopularwayofusing
a cell phone to communicate that does not require bringing the phone close to the head.
Furthermore, the use of handsfree technology, such as wired and wireless headsets, is
increasingandmaydecreaseradiofrequencyenergyexposuretotheheadandbrain.

6. Whatdoexpertorganizationsconclude?
TheAmerican Cancer Society (ACS) states that the IARC classification means that there
could be some risk associated with cancer, but the evidence is not strong enough to be
consideredcausalandneedstobeinvestigatedfurther.Individualswhoareconcernedabout
radiofrequency exposure can limit their exposure, including using an ear piece and limiting
cellphoneuse,particularlyamongchildren.
TheNationalInstituteofEnvironmentalHealthSciences(NIEHS)statesthattheweightofthe
currentscientificevidencehasnotconclusivelylinkedcellphoneusewithanyadversehealth
problems,butmoreresearchisneeded.
TheU.S.FoodandDrugAdministration(FDA),whichisresponsibleforregulatingthesafety
of machines and devices that emit radiation (including cell phones), notes that studies
reporting biological changes associated with radiofrequency energy have failed to be
replicated and that the majority of human epidemiologic studies have failed to show a
relationship between exposure to radiofrequency energy from cell phones and health
problems.
TheU.S.CentersforDiseaseControlandPrevention(CDC)statesthat,althoughsomestudies
haveraisedconcernsaboutthepossiblerisksofcellphoneuse,scientificresearchasawhole
does not support a statistically significant association between cell phone use and health
effects.
TheFederal Communications Commission(FCC) concludes that there is no scientific
evidencethatprovesthatwirelessphoneusecanleadtocancerortootherhealthproblems,
includingheadaches,dizziness,ormemoryloss.
7. What studies are under way that will help further our understanding of the health
effectsofcellphoneuse?
A largeprospective cohort studyof cell phone use and its possible longterm health effects
was launched in Europe in March 2010. This study, known asCOSMOS , has enrolled
approximately290,000cellphoneusersaged18yearsoroldertodateandwillfollowthem
for20to30years.
Participants in COSMOS will complete a questionnaire about their health, lifestyle, and
currentandpastcellphoneuse.Thisinformationwillbesupplementedwithinformationfrom
healthrecordsandcellphonerecords.
Thechallengeofthisambitiousstudyistocontinuefollowingtheparticipantsforarangeof
health effects over many decades. Researchers will need to determine whether participants
wholeavearesomehowdifferentfromthosewhoremainthroughoutthefollowupperiod.
Another study already under way is acasecontrol studycalledMobiKids , which will
include2000youngpeople(aged1024years)withnewlydiagnosedbraintumorsand4000
healthyyoungpeople.Thegoalofthestudyistolearnmoreaboutriskfactorsforchildhood
braintumors.Resultsareexpectedin2016.

Althoughrecallbiasisminimizedinstudiesthatlinkparticipantstotheircellphonerecords,
suchstudiesfaceotherproblems.Forexample,itisimpossibletoknowwhoisusingthelisted
cell phone or whether that individual also places calls using other cell phones. To a lesser
extent,itisnotclearwhethermultipleusersofasinglephonewillberepresentedonasingle
phonecompanyaccount.
TheNIEHS,whichispartoftheNationalInstitutesofHealth,iscarryingoutastudyofrisks
related to exposure to radiofrequency energy (the type used in cell phones) in highly
specializedlabsthatcanspecifyandcontrolsourcesofradiationandmeasuretheireffectson
rodents.
8. Dochildrenhaveahigherriskofdevelopingcancerduetocellphoneusethanadults?
In theory, children have the potential to be at greater risk than adults for developing brain
cancer from cell phones. Their nervous systems are still developing and therefore more
vulnerabletofactorsthatmaycausecancer.Theirheadsaresmallerthanthoseofadultsand
thereforehaveagreaterproportionalexposuretothefieldofradiofrequencyradiationthatis
emitted by cell phones. And children have the potential of accumulating more years of cell
phoneexposurethanadultsdo.
So far, the data from studies in children with cancer do not support this theory. The first
published analysis came from a large casecontrol study called CEFALO, which was
conductedinDenmark,Sweden,Norway,andSwitzerland.Thestudyincludedchildrenwho
werediagnosedwithbraintumorsbetween2004and2008,whentheiragesrangedfrom7to
19.Researchersdidnotfindanassociationbetweencellphoneuseandbraintumorriskinthis
groupofchildren.However,theynotedthattheirresultsdidnotruleoutthepossibilityofa
slightincreaseinbraincancerriskamongchildrenwhousecellphones,andthatdatagathered
through prospective studies and objective measurements, rather than participant surveys and
recollections,willbekeyinclarifyingwhetherthereisanincreasedrisk(19).
Researchers from the Centre for Research in Environmental Epidemiology in Spain are
conducting another international studyMobiKids to evaluate the risk associated with
newcommunicationstechnologies(includingcellphones)andotherenvironmentalfactorsin
youngpeoplenewlydiagnosedwithbraintumorsatages10to24years.
9. Whatcancellphoneusersdotoreducetheirexposuretoradiofrequencyenergy?
The FDA and FCC have suggested some steps that concerned cell phone users can take to
reducetheirexposuretoradiofrequencyenergy(1,23):
o Reservetheuseofcellphonesforshorterconversationsorfortimeswhenalandlinephoneis
notavailable.
o Useahandsfreedevice,whichplacesmoredistancebetweenthephoneandtheheadofthe
user.
Handsfreekitsreducetheamountofradiofrequencyenergyexposuretotheheadbecausethe
antenna,whichisthesourceofenergy,isnotplacedagainstthehead.
10. WherecanIfindmoreinformationaboutradiofrequencyenergyfrommycellphone?
The FCC provides information about the specific absorption rate (SAR) of cell phones
produced and marketed within the last 1 to 2 years. The SAR corresponds with the relative
amountofradiofrequencyenergyabsorbedbytheheadofacellphoneuser(24).Consumers
canaccessthisinformationusingthephonesFCCIDnumber,whichisusuallylocatedonthe
caseofthephone,andtheFCCsIDsearchform.
11. Whatareothersourcesofradiofrequencyenergy?

Themostcommonexposurestoradiofrequencyenergyarefromtelecommunicationsdevices
andequipment(1).IntheUnitedStates,cellphonescurrentlyoperateinafrequencyrangeof
about 1,800 to 2,200 megahertz (MHz) (6). In this range, the electromagnetic radiation
producedisintheformofnonionizingradiofrequencyenergy.
Cordlessphones(phonesthathaveabaseunitconnectedtothetelephonewiringinahouse)
often operate at radio frequencies similar to those of cell phones however, since cordless
phoneshavealimitedrangeandrequireanearbybase,theirsignalsaregenerallymuchless
powerfulthanthoseofcellphones.
Among other radiofrequency energy sources, AM/FM radios and VHF/UHF televisions
operate at lower radio frequencies than cell phones, whereas sources such as radar, satellite
stations,magnetic resonance imaging(MRI) devices, industrial equipment, and microwave
ovensoperateatsomewhathigherradiofrequencies(1).
12. Howcommonisbraincancer?Hastheincidenceofbraincancerchangedovertime?
Braincancerincidenceandmortality(death)rateshavechangedlittleinthepastdecade.Inthe
United States, 23,130 new diagnoses and 14,080 deaths from brain cancer are estimated for
2013.
The 5year relative survival for brain cancers diagnosed from 2003 through 2009 was 35
percent (25). This is the percentage of people diagnosed with brain cancer who will still be
alive5yearsafterdiagnosiscomparedwiththesurvivalofapersonofthesameageandsex
whodoesnothavecancer.
Theriskofdevelopingbraincancerincreaseswithage.From2006through2010,therewere
fewerthan5braincancercasesforevery100,000peopleintheUnitedStatesunderage65,
compared with approximately 19 cases for every 100,000 people in the United States who
wereages65orolder(25).
SelectedReferences
1. U.S. Food and Drug Administration (2009).RadiationEmitting Products: Reducing
Exposure: Handsfree Kits and Other Accessories. Silver Spring, MD. Retrieved June 18,
2012.
2. Volkow ND, Tomasi D, Wang GJ, et al. Effects of cell phone radiofrequency signal
exposureonbrainglucosemetabolism.JAMA2011305(8):808813.[PubMedAbstract]
3. Hirose H, Suhara T, Kaji N, et al. Mobile phone base station radiation does not affect
neoplastic
transformation
in
BALB/3T3
cells.Bioelectromagnetics2008
29(1):5564.[PubMedAbstract]
4. Oberto G, Rolfo K, Yu P, et al. Carcinogenicity study of 217 Hz pulsed 900 MHz
electromagnetic fields in Pim1 transgenic mice.Radiation Research2007
168(3):316326.[PubMedAbstract]
5. Zook BC, Simmens SJ. The effects of pulsed 860 MHz radiofrequency radiation on the
promotion
of
neurogenic
tumors
in
rats.Radiation
Research2006
165(5):608615.[PubMedAbstract]

6. Ahlbom A, Green A, Kheifets L, et al. Epidemiology of health effects of radiofrequency

exposure.Environmental Health Perspectives2004 112(17):17411754.[PubMed
Abstract]
7. CardisE,RichardsonL,DeltourI,etal.TheINTERPHONEstudy:design,epidemiological
methods,anddescriptionofthestudypopulation.EuropeanJournalofEpidemiology2007
22(9):647664.[PubMedAbstract]
8. International Agency for Research on Cancer (2008).INTERPHONE Study: latest results
update8October2008 .Lyon,France.RetrievedJune18,2012.
9. The INTERPHONE Study Group. Brain tumour risk in relation to mobile telephone use:
results of the INTERPHONE international casecontrol study.International Journal of
Epidemiology201039(3):675694.[PubMedAbstract]
10. Larjavaara S, Schz J, Swerdlow A, et al. Location of gliomas in relation to mobile
telephone use: a casecase and casespecular analysis.American Journal of
Epidemiology2011174(1):211.[PubMedAbstract]
11. Johansen C, Boice J Jr, McLaughlin J, Olsen J. Cellular telephones and cancer: a
nationwide cohort study in Denmark.Journal of the National Cancer Institute2001
93(3):203207.[PubMedAbstract]
12. Schz J, Jacobsen R, Olsen JH, et al. Cellular telephone use and cancer risk: update of a
nationwide Danish cohort.Journal of the National Cancer Institute2006
98(23):17071713.[PubMedAbstract]
13. Frei P, Poulsen AH, Johansen C, et al. Use of mobile phones and risk of brain tumours:
update of Danish cohort study.British Medical Journal2011 343:d6387.[PubMed
Abstract]
14. BensonVS,PirieK,SchzJ,etal.Mobilephoneuseandriskofbrainneoplasmsandother
cancers: Prospective study.International Journal of Epidemiology2013First published
online:May8,2013.doi:10.1093/ije/dyt072
15. Muscat JE, Malkin MG, Thompson S, et al. Handheld cellular telephone use and risk of
braincancer.JAMA2000284(23):30013007.[PubMedAbstract]
16. Hardell L, Carlberg M, Hansson Mild K. Pooled analysis of casecontrol studies on
malignant brain tumours and the use of mobile and cordless phones including living and
deceased subjects.International Journal of Oncology2011 38(5):14651474.[PubMed
Abstract]
17. Lnn S, Ahlbom A, Hall P, Feychting M. Longterm mobile phone use and brain tumor
risk.AmericanJournalofEpidemiology2005161(6):526535.[PubMedAbstract]
18. AydinD,FeychtingM,SchzJ,etal.Mobilephoneuseandbraintumorsinchildrenand
adolescents: a multicenter casecontrol study.Journal of the National Cancer
Institute2011103(16):12641276.[PubMedAbstract]
19. Inskip PD, Hoover RN, Devesa SS. Brain cancer incidence trends in relation to cellular
telephone use in the United States.NeuroOncology2010 12(11):11471151.[PubMed
Abstract]
20. LittleMP,RajaramanP,CurtisRE,etal.Mobilephoneuseandgliomarisk:comparisonof
epidemiological study results with incidence trends in the United States.British Medical
Journal2012344:e1147.

[PubMedAbstract]
21. Deltour I, Johansen C, Auvinen A, et al. Time trends in brain tumor incidence rates in
Denmark, Finland, Norway, and Sweden, 19742003.Journal of the National Cancer
Institute2009101(24):17211724.[PubMedAbstract]
22. DeltourI,AuvinenA,FeychtingM,etal.Mobilephoneuseandincidenceofgliomainthe
Nordiccountries19792008:consistencycheck.Epidemiology201223(2):301307.
[PubMedAbstract]
23. U.S. Federal Communications Commission (2010).Wireless. Washington, D.C. Retrieved
June18,2012.
24. U.S.FederalCommunicationsCommission.(n.d.).FCCEncyclopedia:SpecificAbsorption
Rate(SAR)forCellularTelephones.RetrievedJune18,2012.
25. HowladerN,NooneAM,KrapchoM,etal.(eds.).(2013)SEERCancerStatisticsReview,
19752010.Bethesda,MD:NationalCancerInstitute.RetrievedJune24,2013.
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Reviewed:June24,2013
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