CEFALO

An international case-control study on brain tumours in children and adolescents

Study Description

Background: It has been hypothesized, that children could be more vulnerable to radio frequency electromagnetic field exposures from mobile telephones than adults, but no epidemiological studies of the relationship have been performed so far. The lack of knowledge causes conflicting recommendations from decision-makers, leading to anxiety and insecurity in the population. WHO has put a case-control study on childhood brain tumours as high priority on their 2006 research agenda on radio frequency electromagnetic fields.

Objectives: The main goal of the study is to investigate whether use of mobile telephones increases the risk of developing brain tumours for children or adolescents. In addition, our study will provide a comprehensive dataset to investigate other potential risk factors for childhood brain tumour.

Study design: The questions under study will be investigated by means of a case-control study in Denmark, Norway, Sweden and Switzerland. Cases will be identified through a combination of registry data and information from the wards treating the patients (e.g. Swiss Paediatric Oncology Group: SPOG). All incident cases of brain tumour in the age group 7-19 years between May 2004 and April 2008 will be invited to participate. In total, the study is expected to include 550 cases of brain tumours in the participating countries, thereof 100 originating from Switzerland. For each case, two control persons will be randomly selected from the general population, matched on age, sex and geographic regions.

Exposure assessment: Information on the extent of exposure to radio frequency fields from mobile phones and on other known and suspected risk factors for childhood brain tumours will be obtained by means of computer assisted personal interviews conducted by an interviewer trained for this purpose. The interviews will take place either at the hospital or at the study participant?s home. Objective information on the frequency and duration of mobile phone use will be obtained from mobile phone operators and from the information stored in the telephone that is in current use.

Data analyses: The data will be analyzed using established statistical methods for case-control studies, primarily via logistic regression models adjusted for potential confounding factors. In order to investigate potential gene-environment interactions, DNA from saliva samples will be extracted and analysed. Polymorphisms in genes that affect oxidative metabolism, detoxification of carcinogens, DNA stability and repair, or immune response, are candidates that might confer genetic susceptibility to brain tumors.

Publications

Original peer-reviewed papers

Aydin D, Feychting M, Schüz J, Andersen TV, Harbo AP, Prochazka M, Klaeboe L, Kuehni CE, Tynes T, Roeoesli M.
Predictors and overestimation of recall mobile phone use among children and adolescents
Progress in Biophysics & Molecular Biology 2011. Doi:10.1016/j.pbiomolbio.201108.013.

Aydin D, Feychting M, Schüz J, Tynes T, Andersen TV, Schmidt LS, Poulsen AH, Johansen C, Prochazka M, Lannering B, Klaeboe L, Eggen T, Jenni D, Grotzer M, Von der Weid NX, Kuehni CE, Roeoesli M.
Mobile phone use and brain tumors in children and adolescents: a multicenter case-control study.
Journal of the National Cancer Institute 2011;103:1264-1276.

Aydin D, Feychting M, Schüz J, Andersen TV, Poulsen AH, Prochazka M, Klaebo L, Kuehni CE, Tynes T, Roeoesli M.
Impact of random and systematic recall errors and of selection bias in case-control studies on mobile phone use and brain tunors in adolescents (CEFALO study).
Bioelectromagnetics 2011;32:396-407.

Röösli M, Michel G, Kuehni CE, Spoerri A.
Cellular telephone use and time trends in brain tumour mortality in Switzerland form 1969 to 2002.
European Journal of Cancer Prevention 2007;16:77-82.

Kheifets L, Repacholi M, Saunders R and van Deventer E.
The sensitivity of children to electromagnetic fields.
Pediatrics 2005; 116(2): e303-13

Conference or workshop abstracts

Schüz, J., Feychting, M., Röösli M., Tynes T., Samsø Schmidt L., Johansen C., Prochazka M., Sverin E., Jenni D., Kuehni C., Klaboe L.
An international case-control study on mobile phone use and the risk of brain tumors in children and adolescents (Cefalo study): a report from the field work and first results on mobile phone usage among children.
8th International Congress of the European Bioelectromagnetics Association (EBEA), Bordeaux 10-13 April 2007.

Röösli M., for the CEFALO Study Group.
An international case-control study on mobile phone use and the risk of brain tumors in children and adolescents (Cefalo study): study design and first experiences from the field work.
Scientific Workshop hosted by the FGF: Do Children Represent a Special Sensitive Group for EMF-Exposure? - State of Research. Stuttgart, 27-29 November 2006. (www.cost281.org)

Feychting M. for the CEFALO Study Group.
A case-control study of brain tumours in children and adolescents and mobile phone use.
Symposium at the Joint Conference of the International Society for Environmental Epidemiology (ISEE) and the International Society for Exposure Assessment (ISEA), September 2-6, 2006, Paris. Epidemiology 2006, 17 (6) S74.

Other publications

Röösli M.
Ursachen von Hirntumoren bei Kindern und Jugendlichen.
Jahresbericht 2006 der Forschungsstiftung Mobilkommunikation; p. 22-23.
(http://www.mobile-research.ethz.ch/var/jb2006.pdf)

Study Team

- Röösli, Martin (PL).Swiss Tropical and Public Health Institute, Basel
- Aydin, Denis. Swiss Tropical and Public Health Institute, Basel
- Jenny, Daniela. Institute of Social and Preventive Medicine, University of Bern
- Rey, Diane. Institute of Social and Preventive Medicine, University of Bern
- Kuehni, Claudia. Institute of Social and Preventive Medicine, University of Bern
- Michel, Gisela. Institute of Social and Preventive Medicine, University of Bern

Applicants

- Röösli, Martin (PL). Swiss Tropical and Public Health Institute, Basel
- Kuehni, Claudia. Institute of Social and Preventive Medicine, University of Bern
- Grotzer, Michael. Pediatric Neuro-Oncology, University of Zurich
- Feychting, Maria. Karolinska Institute, Stockholm
- Tynes, Tore. Cancer Registry of Norway, Oslo
- Von der Weid, Nicolas. Pediatric Oncology, CHUV Lausanne
- Schütz, Joachim. Institute of Cancer Epidemiology, University of Bielefeld

state

ongoing

© ISPM - University of Bern 2016