Cell Phones and Tumors: Mixed Signals as Epidemiologists Play Tit for Tat
Don’t Worry, Be Happy, Says ICNIRP
The battle over Interphone continues. This time it's in full public view as key players publish papers detailing where they stand on cell phone tumor risks. There haven't been any big surprises since their opinions have long been known. Yet, the diametrically opposing views have led to conflicting stories in the media as each new study is released.
The latest chapter came late last week when the International Commission for Non-Ionizing Radiation Protection (ICNIRP) announced that its epidemiologists believe that phones are safe. They conceded that they couldn't be certain, though they sounded as if they were nearly there. This is their bottom line: "The trend in the accumulating evidence is increasingly against the hypothesis that mobile phone use causes brain tumors." The commentary was published in Environmental Health Perspectives.
The BBC was in such a rush to announce the news that it was willing to break the journal's embargo. "Mobile Phones 'Unlikely' to Cause Cancer," ran its headline. Just a month earlier, the same reporter wrote an item on the findings of another group —a larger one assembled by the International Agency for Research on Cancer (IARC). That expert panel had a very different message: RF radiation from cell phones is a possible cause of cancer. "Mobiles 'May Cause Brain Cancer'," was the BBC headline on May 31.
The BBC was not the only one. Here's Reuters on June 1, "WHO Says Cell Phone Use 'Possibly Carcinogenic'," and then on July 4, "Evidence 'Increasingly Against' Phone Cancer Risk." And CBS News on May 31: "Mobile Phones May Cause Cancer, Experts Say." Its July 5 story on the ICNIRP paper expressed what everybody must have been thinking by then: "Cell Phone Cause Cancer. No They Don't. Yes They Do."
How is anyone possibly going to make sense of all this?
There was no overlap between the ICNIRP and IARC panels. For more than a decade, many of them had worked together —or at least were supposed to have worked together— on IARC's Interphone project, the largest epidemiological study of cell-phone users ever. Sometime midway through the study as the results pointed to a brain tumor risk, tensions flared and Interphone ground to a halt. Two opposing blocs emerged. On one side were those who accepted the results and began to speak out for precaution, and on the other were those who saw the results as too tainted with bias to have much meaning. As the deadlock continued, Christopher Wild, the director of IARC, stepped in and insisted that the Interphone brain tumor results be published. But there was so little common ground between the two factions that when the paper finally appeared, it offered little in the way of in-depth analysis and it, too, left confusion in its wake.
Much of what has been published on cell phones and tumors over the last year has filled in those opposing views on Interphone. The near unanimous decision by the IARC panel to classify cell phone radiation as a possible human carcinogen on May 31 was based on the Interphone studies together with the work of the group led by Sweden's Lennart Hardell. Given IARC's prestigious reputation in evaluating what is and is not a cancer agent, one might have thought that its decision would point to the ascendency of Interphone's precautionary bloc led by Australia's Bruce Armstrong and Spain's Elisabeth Cardis, both of whom were members the IARC working group.
But precautionary policies have always been anathema to ICNIRP. Perhaps its members were unsure as to how the IARC meeting would turn out and did not want to take any chances that their opinions would be ignored. The timing had to be more than fortuitous. ICNIRP's commentary reads like a dissenting opinion on the IARC decision. Two of its authors, Sweden's Maria Feychting and U.K.'s Tony Swerdlow, were members of Interphone and its leading skeptics.
The ICNIRP paper also serves as a counterweight to an editorial published earlier this year in Occupational and Environmental Medicine by Cardis and Israel's Siegal Sadetzki. Siegal is also a member of Interphone. In contrast to ICNIRP's advice that there's nothing to worry about, Cardis and Sadetzki cautioned people to play it safe by using hands-free sets and speakerphones.
Perhaps the starkest example of the two dueling camps is the recent publication of two separate analyses from different members of the Interphone project. These investigated the location of tumors relative to the RF radiation plumes from cell phones. The two papers appeared within a couple of weeks of each other. On May 24, the American Journal of Epidemiology posted a paper by a large group that included Feychting and Swerdlow that concluded that tumors were not located in the parts of the brain with the highest RF exposures. It was followed on June 9 by a separate analysis from an Interphone group led by Cardis. This latter paper found that location was an important factor not to be discounted.
ICNIRP cites the location paper that Feychting and Swerdlow coauthored but fail to mention the Cardis analysis that would undermine their argument that everything is okay.
The dueling tumor location papers prompted the U.K.'s Daily Mail to run two opposing headlines two days apart: "Number of People with Brain Cancer Could Soar 20-Fold in 20 Years Because of Mobile Phones, Experts Warn" and "Mobile Phones May NOT Increase Cancer Risk as Most Brain Tumours 'Not Within Radiation Range'" (see our June 16 Short Take).
Does ICNIRP Speak for Public Health?
Once again what's at stake has gotten lost. The controversy over whether cell phones lead to tumors is not some intellectual exercise like counting angels on the head of a pin. It's about public health, and you can't get more "public" than when you're talking about the health of 4-5 billion users of cell phones. The facts are that three different types of tumors have been linked to long-term users of mobile phones and that two independent groups have documented associations with glioma (a type of brain tumor) and with acoustic neuroma.
Yes, the studies are flawed. Epidemiology is always flawed, but they're all we've got. Are ICNIRP's epidemiologists really so sure that they are right than they are willing to throw out all the studies including their own? Are they really so sure that they see no reason to tell people to take simple precautions until we know more?
ICNIRP is a self-perpetuating group that declines to disclose its finances. Its Standing Committee on Epidemiology, which wrote the new commentary, has only welcomed the like-minded. Its previous chairman, Anders Ahlbom, has also registered his opinion that cell phone tumor risks are nonexistent. (He was the lead author of the last ICNIRP review of cell phones and cancer.) Another former member, Maria Blettner, was the lone dissenting voice in the final vote of the IARC working group. Both Blettner and Ahlbom worked on Interphone.
The feud over Interphone and the Hardell studies cheapens the cancer debate. That's one message that is getting through. The correspondent for the Economist, no doubt said what many now believe when he recently wrote that "the whole brouhaha over mobile phones causing brain cancer is monumentally irrelevant compared with all the other things there are to worry about." Score one for ICNIRP.
What's the game plan for finding out whether cell phones cause cancer? ICNIRP says that we should simply wait and see if tumor rates go up. If we see a measurable uptick in the next decade or two, we'll know that ICNIRP gave us some bad advice. Or as Feychting, Swerdlow and the other ICNIRP epidemiologists put it, "There will be a case to answer."