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Epidemiological Study (case-control study)Cellular phone use and risk of benign and malignant parotid gland tumors--a nationwide case-control study. epidemiol. By: Sadetzki S, Chetrit A, Jarus-Hakak A, Cardis E, Deutch Y, Duvdevani S, Zultan A, Novikov I, Freedman L, Wolf M
Published in: Am J Epidemiol 2008; 167 (4): 457 - 467 (  full article, PubMed Entry , Journal web site )Aim of study (according to author)
The association between cellular phone use and parotid gland tumors was investigated in a nationwide case-control study in Israel. This study is part of the INTERPHONE project.
Background/further details:
The association between laterality of tumor and side of cellular phone use was assessed by case-only analysis (including only cases who were regular users reporting on a single dominant side of use) and by case-control analysis stratified to ipsilateral and contralateral use.
Regular use of a mobile phone was defined as at least once a week for at least six months. Endpoint/type of risk estimation Estimate of incidence by odds ratio (OR)
Exposure - mobile communication system, analog mobile phone, digital mobile phone, personal exposure
- type of exposure: personal
- assessment by interview (use of cellular phone, types including start and end dates, number and average duration of calls, use of headsets and hands-free devices, side of the head on which the phone was predominantly held, handedness, main area of use (urban, rural, both))
groups of exposure:
| Reference group 1: | regular user: no or < 1year | | group 2: | regular user: yes | | Reference group 3: | regular user 5 years in the past: no | | group 4: | regular user 5 years in the past: yes | | Reference group 5: | regular user 10 years in the past: no | | group 6: | regular user 10 years in the past: yes | | Reference group 7: | time since start use: never or < 1 year | | group 8: | time since start use: 1 - 4.9 years | | group 9: | time since start use: 5 - 9.9 years | | group 10: | time since start use: ≥ 10 years | | Reference group 11: | duration of use: never or < 1 year | | group 12: | duration of use: 1 - 4.9 years | | group 13: | duration of use: 5 - 9.9 years | | group 14: | duration of use: ≥ 10 years | | Reference group 15: | cumulative number of calls: nonusers or < 1 year | | group 16: | cumulative number of calls: ≤ 5,479 | | group 17: | cumulative number of calls: ≥ 5,480 | | group 18: | cumulative number of calls: ≥ 18,997 | | Reference group 19: | cumulative call time: nonusers or < 1 year | | group 20: | cumulative call time: ≤ 266.3 hours | | group 21: | cumulative call time: > 266.3 hours | | group 22: | cumulative call time: > 1,035 hours | | Reference group 23: | cumulative call time by time since start use: nonusers or < 1 year | | group 24: | cumulative call time by time since start use: < 5 years, ≤ 266.3 hours | | group 25: | cumulative call time by time since start use: < 5 years, > 266.3 hours | | group 26: | cumulative call time by time since start use: ≥ 5 years, ≤ 266.3 hours | | group 27: | cumulative call time by time since start use: ≥ 5 years, > 266.3 hours | | Reference group 28: | cumulative number of calls by time since start use: nonusers or < 1 year | | group 29: | cumulative number of calls by time since start use: < 5 years, ≤ 5479 | | group 30: | cumulative number of calls by time since start use: < 5 years, > 5479 | | group 31: | cumulative number of calls by time since start use: ≥ 5 years, ≤ 5479 | | group 32: | cumulative number of calls by time since start use: ≥ 5 years, > 5479 | | Reference group 33: | regular users only, time since start use: 1 - 4.9 years | | group 34: | regular users only, time since start use: 5 - 9.9 years | | group 35: | regular users only, time since start use: ≥ 10 years | | Reference group 36: | regular users only, duration of use: 1 - 4.9 years | | group 37: | regular users only, duration of use: 5 - 9.9 years | | group 38: | regular users only, duration of use: ≥ 10 years | | Reference group 39: | regular users only, cumulative number of calls: ≤ 5,479 | | group 40: | regular users only, cumulative number of calls: 5,480 - 18,996 | | group 41: | regular users only, cumulative number of calls: ≥ 18,997 | | Reference group 42: | regular users only, cumulative call time: ≤ 266.3 hours | | group 43: | regular users only, cumulative call time: 266.4 - 1034.9 hours | | group 44: | regular users only, cumulative call time: ≥ 1035 hours |
Population
- case group
men and women, aged over 18 years
diagnosis: benign or malignant parotid gland tumor, histologically or cytologically confirmed
observation period: January 2001 - December 2003
study location: Israel
source of data: all 22 otolaryngology departments of hospitals in Israel
- control group
selection: population-based
matching: sex, age, continent of birth
exclusion criteria: not living in Israel, mentally disabled
Further parameters acquired by interview (demographic details, other possible risk factors)
Study size  | cases | controls |
|---|
| number eligible | 531 | 1,920 | | number participating | 460 | 1266 | | rate of participating | 87% | 66% |
Other: 402 benign and 58 malignant tumors
Confounders: smoking
Statistically significant results
| group | exposure | endpoint | cases | controls | parameter (OR) | confidence interval |
|---|
| 4 | regular user 5 years in the past: yes | ipsilateral use, parotid gland tumor | 96 | 166 | 1.3 | 0.99-1.83 | | 17 | cumulative number of calls: ≥ 5,480 | ipsilateral use, parotid gland tumor | 121 | 159 | 1.6 | 1.11-2.24 | | 18 | cumulative number of calls: ≥ 18,997 | rural use, parotid gland tumor | 32 | 41 | 1.8 | 1.04-3.14 | | 20 | cumulative call time: ≤ 266.3 hours | ipsilateral use, parotid gland tumor | 115 | 158 | 1.5 | 1.05-2.13 | | 21 | cumulative call time: > 266.3 hours | rural use, parotid gland tumor | 32 | 38 | 2.0 | 1.11-3.44 | | 41 | regular users only, cumulative number of calls: ≥ 18,997 | parotid gland tumor | 81 | 140 | 1.5 | 1.05-2.17 | | 44 | regular users only, cumulative call time: ≥ 1035 hours | parotid gland tumor | 83 | 134 | 1.5 | 1.04-2.16 |
Statistical analysis using logistic regression (adjusted for age, sex, year of interview), trend tests Results/conclusion (according to author)
Cellular phone users in Israel are exceptionally heavy users compared to cellular phone users in other countries participating in the Interphone study.
No increased risk of parotid gland tumors was observed for ever having been a regular cellular phone user for the entire group. For ipsilateral use, the odds ratios in the highest category of cumulative number of calls and call time were significantly elevated.
The authors concluded that the results suggest a relation between long-term and heavy cellular phone use and parotid gland tumors. This association was seen in analyses restricted to regular users, analyses of laterality of cellular phone use, and analyses of area of main use (urban, rural, or both) .
(Study character: epidemiological study, case-control study)
Study funded by - European Union (EU)/European Commission
- GSM Association, UK/Ireland
- International Union against Cancer (UICC; Union Internationale Contre le Cancer), Switzerland
- Israel Cancer Association (ICA)
- Mobile Manufacturers Forum (MMF), Belgium
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Glossary: analog, benign, case-control study, case-only analysis, cellular phone, confidence interval, Confounders, contralateral, cumulative, cytologically, digital, endpoint, epidemiological, exposure, handedness, histologically, incidence, Interphone, ipsilateral, laterality, logistic regression, malignant, matching, mobile communication, Odds Ratios, parotid gland tumors, population-based, risk, risk factors, significantly, statistical, trend, tumors |
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