Children and adolescent cell phone users at no greater risk of brain cancer than non-users, study suggests

ScienceDaily (July 28, 2011) — Children and adolescents who use mobile phones are not at a statistically significant increased risk of brain cancer compared to their peers who do not use mobile phones, according to a study published July 27 in the Journal of The National Cancer Institute.

Mobile phone usage has increased among children and adolescents in recent years. The increased usage has raised a concern about the possibility of the development of brain tumors in this population since children have a developing nervous system; also, because their head circumference is smaller, the radio frequency electromagnetic fields may penetrate regions that are deeper in their brains. However, no previous study has examined whether mobile phone usage among children and adolescents is associated with a difference in brain tumor risk.

To determine the relationship between mobile phone usage and brain tumor risk among children and adolescents, Martin Röösli, Ph.D, of the Swiss Tropical and Public Health Institute in Basel, Switzerland, and colleagues looked at the medical records of children aged 7-19 with brain tumors, identified through population registries. Researchers did face-to-face interviews with them regarding their mobile phone usage. They also consulted data from phone network providers.

The study, conducted between 2004 and 2008, included participants from Norway, Denmark, Sweden and Switzerland. They looked at data for 352 brain cancer patients, and 646 control subjects.

The researchers found that patients with brain tumors were not statistically significantly more likely to have been regular mobile phone users than control subjects. They found that 265 (75.3%) of case patients and 466 control subjects (72.1%) reported having spoken on a mobile phone more than 20 times before the time when the case patient was diagnosed. Furthermore, 194 case patients (55%) and 329 control subjects (51%) reported regular mobile phone usage. However, in a subset of study participants for whom operator recorded data were available, brain tumor risk was related to the time elapsed since the mobile phone subscription was started (but not to amount of use). No increased risk of brain tumors was observed for brain areas receiving the highest amount of exposure.

The researchers write, "Because we did not find a clear exposure-response relationship in most of these analyses, the available evidence does not support a causal association between the use of mobile phones and brain tumors." Nevertheless, since mobile phone usage among children and adolescents has increased over the years, they encourage a careful watch on the trend.

In an accompanying editorial, John D Boice, Jr., ScD. and Robert E. Tarone, PhD., of the International Epidemiology Institute in Rockville, Maryland and Vanderbilt University in Nashville, Tennessee write that Röösli and his colleagues "have filled an important gap in knowledge by showing no increased risk of brain tumors among children and adolescents who are regular cell phone users"

Boice and Tarone conclude that it is reassuring that the incidence rates of brain cancer in the general population, including children and teenagers, have not changed over the past 20 years in the United States and many other countries despite the steady and marked rise in the use of cell phones throughout the world since the 1980s. They recommend that investigators continue to monitor population incidence rates and that in the meantime, individuals who are concerned might consider alternatives to holding a cell phone up to their ears, such as using an ear piece or using the phone's speaker. They also point out that individuals should heed what is known about real risks by avoiding the use of cell phones while driving a car, because such distractions have been clearly documented to increase the risk of accidents and injuries.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Journal of the National Cancer Institute, via EurekAlert!, a service of AAAS.

Journal References:

John D. Boice, Jr and Robert E. Tarone. Cell Phones, Cancer, and Children. J Natl Cancer Inst, July 27, 2011 DOI: 10.1093/jnci/djr285Denis Aydin, Maria Feychting, Joachim Schüz, Tore Tynes, Tina Veje Andersen, Lisbeth Samsø Schmidt, Aslak Harbo Poulsen, Christoffer Johansen, Michaela Prochazka, Birgitta Lannering, Lars Klæboe, Tone Eggen, Daniela Jenni, Michael Grotzer, Nicolas Von der Weid, Claudia E. Kuehni, and Martin Röösli. Mobile Phone Use and Brain Tumors in Children and Adolescents: A Multicenter Case–Control Study. J Natl Cancer Inst, July 27, 2011 DOI: 10.1093/jnci/djr244

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Doctors differ in how best to care for America's 12 million cancer survivors

ScienceDaily (July 25, 2011) — There are major differences between oncologists and primary care physicians regarding knowledge, attitudes, and practices required to care for American's 12 million cancer survivors. That is the key finding of the first nationally representative survey of doctors that reveals how these differences pose significant barriers to effective communication and coordination of care following initial cancer treatment.

The study, published online July 25 in the Journal of General Internal Medicine, included results of a survey of 1,072 primary cancer physicians (PCP) and 1,130 oncologists randomly sampled from among all U.S. practicing physicians during 2009.

The authors say the findings are of considerable concern, given the rapidly increasing cancer survivor population and looming shortages of both oncology specialists and primary care physicians who will be needed to provide care to this population. Because many individuals stop seeing their oncologist after the first few years following their initial cancer treatment, primary care doctors often assume a large share of providing care to survivors. Optimal cancer survivorship care includes not only surveillance for recurrence or second cancers, but also addressing the long-term and late medical effects of cancer or its treatment, providing psychosocial support, and managing other diseases or conditions.

Several factors may present challenges to ensuring a smooth transition for survivors as they move from initial acute care to post-treatment care, says the study's lead author, Arnold L Potosky, Ph.D., director of health services research at Georgetown Lombardi Comprehensive Cancer Center, a part of Georgetown University Medical Center.

"What the survey tells us is that many doctors, particularly primary care doctors don't have a high level of confidence in their own knowledge of some aspects of survivorship care, and many oncologists believe that PCPs are not adequately prepared to provide such care. We also see some evidence of knowledge deficits in both physician groups in terms of guideline-based care for survivors," he says.

"Although both oncologists and primary care doctors routinely recommended the use of several laboratory and imaging tests to detect cancer recurrence that are not part of guideline-directed care, more of the primary care physicians recommended these tests than did oncologists," Potosky says.

He says reasons for over-testing may include the practice of defensive medicine, reimbursement incentives for office-based lab testing, or uncertainty regarding best care practices. In some cases, such testing may also be influenced by survivors' requests.

The "Survey of Physicians Attitudes Regarding the Care of Cancer Survivors" asked both groups of doctors several questions about providing cancer survivorship care including the doctors' confidence in their knowledge about such care, and cancer surveillance practices.

In 2006, a report from the Institute of Medicine (IOM) recommended that patients completing primary treatment for cancer, and their primary care providers, be given a summary of their treatment and a comprehensive plan for follow-up.

Such a plan would inform patients (and their providers) of the long-term effects of cancer and its treatment, identify psychosocial support resources in their communities, and provide guidance on follow-up care, prevention, and health maintenance.

Julia Rowland, Ph.D., director of the Office of Cancer Survivorship at the National Cancer Institute and a co-author, says this study suggests several key insights regarding the implementation of the IOM's recommendations.

"More training and education on cancer survivorship is critical for the primary care physician and the oncologist," she says. "This might include identification of who may be best equipped to provide different aspects of care. Use of a survivorship care plan has the potential to serve as a valuable tool for helping to improve communication about as well as coordination of care between specialists and primary care physicians for survivors who are post-treatment."

The authors suggest that a cancer survivor, upon finishing treatment, meet with the treating oncologist to summarize the care received and outline appropriate follow-up care based on personal treatment history. They add that patients should find out what aspects of care to expect from the oncologist and the primary care physician respectively.

Funding for the Survey of Physicians Attitudes Regarding the Care of Cancer Survivors was provided by National Cancer Institute and American Cancer Society. All the co-authors report no personal financial interests related to the study.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Georgetown University Medical Center.

Journal Reference:

Arnold L. Potosky, Paul K. J. Han, Julia Rowland, Carrie N. Klabunde, Tenbroeck Smith, Noreen Aziz, Craig Earle, John Z. Ayanian, Patricia A. Ganz, Michael Stefanek. Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors. Journal of General Internal Medicine, 2011; DOI: 10.1007/s11606-011-1808-4

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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