Department of Oncology, University Hospital, Örebro, Sweden.
The Environment and Cancer Research Foundation, Studievägen 35, SE-702 17 Örebro, Sweden.
Rev Environ Health. 2022 May 5;38(3):409-421. doi: 10.1515/reveh-2022-0040. Print 2023 Sep 26.
The MOBI-Kids case-control study on wireless phone use and brain tumor risk in childhood and adolescence included the age group 10-24 years diagnosed between 2010 and 2015. Overall no increased risk was found although for brain tumors in the temporal region an increased risk was found in the age groups 10-14 and 20-24 years. Most odds ratios (ORs) in MOBI-Kids were <1.0, some statistically significant, suggestive of a preventive effect from RF radiation; however, this is in contrast to current knowledge about radiofrequency (RF) carcinogenesis. The MOBI-Kids results are not biologically plausible and indicate that the study was flawed due to methodological problems. For example, not all brain tumor cases were included since central localization was excluded. Instead, all brain tumor cases should have been included regardless of histopathology and anatomical localization. Only surgical controls with appendicitis were used instead of population-based controls from the same geographical area as for the cases. In fact, increased incidence of appendicitis has been postulated to be associated with RF radiation which makes selection of control group in MOBI-Kids questionable. Start of wireless phone use up to 10 years before diagnosis was in some analyses included in the unexposed group. Thus, any important results demonstrating late carcinogenesis, a promoter effect, have been omitted from analysis and may underestimate true risks. Linear trend was in some analyses statistically significant in the calculation of RF-specific energy and extremely low frequency (ELF)-induced current in the center of gravity of the tumor. Additional case-case analysis should have been performed. The data from this study should be reanalyzed using unconditional regression analysis adjusted for potential confounding factors to increase statistical power. Then all responding cases and controls could be included in the analyses. In sum, we believe the results as reported in this paper seem uninterpretable and should be dismissed.
MOBI-Kids 病例对照研究调查了儿童和青少年时期使用无线电话与脑肿瘤风险之间的关系，纳入了 2010 年至 2015 年间确诊的年龄在 10-24 岁的患者。总体而言，未发现风险增加，尽管在颞叶区域的脑肿瘤中，10-14 岁和 20-24 岁年龄组的风险增加。MOBI-Kids 中的大多数比值比（OR）均小于 1.0，一些具有统计学意义，表明射频辐射具有预防作用；然而，这与当前关于射频（RF）致癌的知识相矛盾。MOBI-Kids 的研究结果在生物学上是不可信的，表明该研究由于方法学问题存在缺陷。例如，并非所有脑肿瘤病例都被纳入研究，因为排除了中央定位。相反，无论组织病理学和解剖学定位如何，都应该纳入所有脑肿瘤病例。仅使用阑尾炎手术对照组，而不是来自与病例相同地理区域的基于人群的对照组。事实上，已经提出 RF 辐射与阑尾炎发病率增加有关，这使得 MOBI-Kids 对照组的选择受到质疑。在一些分析中，诊断前 10 年内开始使用无线电话被纳入未暴露组。因此，任何表明晚期致癌作用、促进作用的重要结果都被从分析中遗漏，可能低估了真实风险。在计算肿瘤重心处的射频特定能量和极低频（ELF）感应电流的线性趋势在一些分析中具有统计学意义。应该进行额外的病例对照分析。应该使用调整潜在混杂因素的无条件回归分析重新分析该研究的数据，以提高统计效力。然后可以将所有应答病例和对照纳入分析。总之，我们认为报告中的研究结果似乎无法解释，应该被否定。
