Lagorio Susanna, Röösli Martin
National Institute of Health, Rome, Italy.
Bioelectromagnetics. 2014 Feb;35(2):79-90. doi: 10.1002/bem.21829. Epub 2013 Nov 6.
A meta-analysis of studies on intracranial tumors and mobile phone use published by the end of 2012 was performed to evaluate the overall consistency of findings, assess the sensitivity of results to changes in the dataset, and try to detect the sources of between-study heterogeneity. Twenty-nine papers met our inclusion criteria. These papers reported on 47 eligible studies (17 on glioma, 15 on meningioma, 15 on acoustic neuroma), consisting of either primary investigations or pooled analyses. Five combinations of non-overlapping studies per outcome were identified. The combined relative risks (cRRs) in long-term mobile phone users (≥10 years) ranged between 0.98 (0.75-1.28) and 1.11 (0.86-1.44) for meningioma, with little heterogeneity across studies. High heterogeneity was detected across estimates of glioma and acoustic neuroma risk in long term users, with cRRs ranging between 1.19 (95% CI 0.86-1.64) and 1.40 (0.96-2.04), and from 1.14 (0.65-1.99) to 1.33 (0.65-2.73), respectively. A meta-regression of primary studies showed that the methodological differences embedded in the variable "study-group" explained most of the overall heterogeneity in results. Summary risk estimates based on heterogeneous findings should not be over-interpreted. Overall, the results of our study detract from the hypothesis that mobile phone use affects the occurrence of intracranial tumors. However, reproducibility (or lack of) is just one clue in the critical appraisal of epidemiological evidence. Based on other considerations, such as the limited knowledge currently available on risk beyond 15 years from first exposure, or following mobile phone use started in childhood, the pursuance of epidemiological surveillance is warranted.
对截至2012年底发表的关于颅内肿瘤与手机使用的研究进行了一项荟萃分析,以评估研究结果的总体一致性,评估结果对数据集变化的敏感性,并试图找出研究间异质性的来源。29篇论文符合我们的纳入标准。这些论文报告了47项符合条件的研究(17项关于胶质瘤,15项关于脑膜瘤,15项关于听神经瘤),包括初步调查或汇总分析。针对每个结果确定了五种不重叠研究的组合。长期手机用户(≥10年)中,脑膜瘤的合并相对风险(cRRs)在0.98(0.75 - 1.28)至1.11(0.86 - 1.44)之间,各研究间异质性较小。长期用户中,胶质瘤和听神经瘤风险估计值存在高度异质性,cRRs分别在1.19(95%可信区间0.86 - 1.64)至1.40(0.96 - 2.04)之间,以及从1.14(0.65 - 1.99)至1.33(0.65 - 2.73)之间。对初步研究的荟萃回归表明,变量“研究组”中包含的方法学差异解释了结果中大部分的总体异质性。基于异质性结果的汇总风险估计不应过度解读。总体而言,我们的研究结果不支持手机使用会影响颅内肿瘤发生的假设。然而,可重复性(或缺乏可重复性)只是流行病学证据批判性评估中的一个线索。基于其他考虑因素,例如目前对于首次接触后15年以上风险的了解有限,或者儿童期开始使用手机后的风险了解有限,有必要进行流行病学监测。