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  • 1
    Keywords: brain ; CANCER ; radiotherapy ; Germany ; EPIDEMIOLOGY ; EXPOSURE ; RISK ; meningioma ; radiation ; tumour ; ASSOCIATION ; X-RAYS ; NERVOUS-SYSTEM ; risk factors ; REGION ; REGIONS ; HEAD ; NECK ; case-control studies ; ONCOLOGY ; case control study ; case-control study ; CHILDHOOD ; GLIOMA ; brain tumour ; case control studies ; INTERVAL ; methods ; intracranial meningioma ; INCREASED RISK ; odds ratio ; MAGNETIC-FIELDS ; ionising radiation ; case control ; aetiology ; acoustic neuroma ; brain tumours ; GERMAN PART ; LOS-ANGELES COUNTY ; mobile phone ; MOBILE PHONE USE ; TINEA-CAPITIS
    Abstract: Background: The role of exposure to low doses of ionising radiation in the aetiology of brain tumours has yet to be clarified. The objective of this study was to investigate the association between medically or occupationally related exposure to ionising radiation and brain tumours. Methods: We used self-reported medical and occupational data collected during the German part of a multinational case-control study on mobile phone use and the risk of brain tumours (Interphone study) for the analyses. Results: For any exposure to medical ionising radiation we found odds ratios (ORs) of 0.63 (95% confidence interval (CI) = 0.48-0.83), 1.08 (95% CI = 0.80-1.45) and 0.97 (95% CI = 0.54-1.75) for glioma, meningioma and acoustic neuroma, respectively. Elevated ORs were found for meningioma (OR 2.32, 95% CI: 0.90-5.96) and acoustic neuroma (OR 6.45, 95% CI: 0.62-67.16) for radiotherapy to the head and neck regions. Conclusion: We did not find any significant increased risk of brain tumours for exposure to medical ionising radiation. (C) 2007 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 17689954
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  • 2
    Keywords: MODEL ; EXPOSURE ; FEASIBILITY ; dosimetry ; SYMPTOMS ; HYPERSENSITIVITY ; ELECTROMAGNETIC-FIELDS ; COGNITIVE PERFORMANCE ; SLEEP QUALITY INDEX
    Abstract: Objective: The aim of the cross-sectional study was to test the hypothesis that exposure to continuous low-level radio frequency electromagnetic fields (RF-EMFs) emitted from mobile phone base stations was related to various health disturbances. Methods: For the investigation people living mainly in urban regions were selected from a nationwide study in 2006. In total, 3526 persons responded to a questionnaire (response rate 85%). For the exposure assessment a dosimeter measuring different RF-EMF frequencies was used. Participants answered a postal questionnaire on how mobile phone base stations affected their health and they gave information on sleep disturbances, headaches, health complaints and mental and physical health using standardised health questionnaires. Information on stress was also collected. Multiple linear regression models were used with health outcomes as dependent variables (n=1326). Results: For the five health scores used, no differences in their medians were observed for exposed versus non-exposed participants. People who attributed adverse health effects to mobile phone base stations reported significantly more sleep disturbances and health complaints, but they did not report more headaches or less mental and physical health. Individuals concerned about mobile phone base stations did not have different wellbeing scores compared with those who were not concerned. Conclusions: In this large population-based study, measured RF-EMFs emitted from mobile phone base stations were not associated with adverse health effects
    Type of Publication: Journal article published
    PubMed ID: 19151228
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  • 3
    Keywords: MODEL ; EXPOSURE ; POPULATION ; RISK ; HYPERSENSITIVITY ; ELECTROMAGNETIC-FIELDS
    Abstract: Objective: The aim of this first phase of a cross-sectional study from Germany was to investigate whether proximity of residence to mobile phone base stations as well as risk perception is associated with health complaints. Methods: The researchers conducted a population-based, multi-phase, cross-sectional study within the context of a large panel survey regularly carried out by a private research institute in Germany. In the initial phase, reported on in this paper, 30 047 persons from a total of 51 444 who took part in the nationwide survey also answered questions on how mobile phone base stations affected their health. A list of 38 health complaints was used. A multiple linear regression model was used to identify predictors of health complaints including proximity of residence to mobile phone base stations and risk perception. Results: Of the 30 047 participants (response rate 58.6%), 18.7% of participants were concerned about adverse health effects of mobile phone base stations, while an additional 10.3% attributed their personal adverse health effects to the exposure from them. Participants who were concerned about or attributed adverse health effects to mobile phone base stations and those living in the vicinity of a mobile phone base station (500 m) reported slightly more health complaints than others. Conclusions: A substantial proportion of the German population is concerned about adverse health effects caused by exposure from mobile phone base stations. The observed slightly higher prevalence of health complaints near base stations can not however be fully explained by attributions or concerns
    Type of Publication: Journal article published
    PubMed ID: 19017702
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  • 4
    Keywords: brain ; EXPOSURE ; LONG-TERM ; POPULATION ; RISK ; meningioma ; HEALTH ; NUMBER ; COUNTRIES ; HEAD ; case-control study ; GLIOMA ; methods ; pooled analysis ; INCREASED RISK ; CANCER-RISK ; INTERNATIONAL CASE-CONTROL ; brain tumours ; CORDLESS TELEPHONES ; mobile phones ; SELECTION BIAS ; PHONE USE ; CELLULAR TELEPHONES ; NONDIFFERENTIAL MISCLASSIFICATION ; radiofrequency fields
    Abstract: Methods An interview-based case-control study with 2708 glioma and 2409 meningioma cases and matched controls was conducted in 13 countries using a common protocol. Results A reduced odds ratio (OR) related to ever having been a regular mobile phone user was seen for glioma [OR 0.81; 95% confidence interval (CI) 0.70-0.94] and meningioma (OR 0.79; 95% CI 0.68-0.91), possibly reflecting participation bias or other methodological limitations. No elevated OR was observed 〉= 10 years after first phone use (glioma: OR 0.98; 95% CI 0.76-1.26; meningioma: OR 0.83; 95% CI 0.61-1.14). ORs were 〈 1.0 for all deciles of lifetime number of phone calls and nine deciles of cumulative call time. In the 10th decile of recalled cumulative call time, 〉= 1640 h, the OR was 1.40 (95% CI 1.03-1.89) for glioma, and 1.15 (95% CI 0.81-1.62) for meningioma; but there are implausible values of reported use in this group. ORs for glioma tended to be greater in the temporal lobe than in other lobes of the brain, but the CIs around the lobe-specific estimates were wide. ORs for glioma tended to be greater in subjects who reported usual phone use on the same side of the head as their tumour than on the opposite side. Conclusions Overall, no increase in risk of glioma or meningioma was observed with use of mobile phones. There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and error prevent a causal interpretation. The possible effects of long-term heavy use of mobile phones require further investigation
    Type of Publication: Journal article published
    PubMed ID: 20483835
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  • 5
    Abstract: A low within-country variability and a large between-country variability in cancer incidence may indicate that ecologic factors are involved in the etiology of the disease. The aim of this study is to explore the within- and between-country variability of cancer incidence to motivate high-quality ecologic studies. We extracted age-standardized incidence rate estimates (world standard population) from 135 regions for the ten most frequent invasive cancers in Europe for non-Hispanic white populations from Cancer Incidence in Five Continents, Volume X. We fitted weighted multilevel Poisson regression models with random country effects for each cancer and sex. We estimated intraclass correlation coefficients (ICCs) and 95% confidence intervals (95% CIs). A high ICC indicates a low within- and a high between-country variability of rates. The two cancer sites with the highest ICC among men were prostate cancer (0.96, 95% CI: 0.92-0.99) and skin melanoma (0.78, 0.64-0.93). Among women, high ICCs were observed for lung cancer (0.84, 0.73-0.95) and breast cancer (0.80, 0.69-0.91). The two most prominent sex differences for ICC occurred for cancers of the head and neck (men: 0.70, 0.55-0.85, women: 0.19, 0.08-0.30) and breast cancer (men: 0.04, 0.01-0.07, women: 0.80, 0.69-0.91). ICCs were relatively low for pancreatic cancer (men: 0.23, 0.10-0.35; women: 0.13, 0.04-0.21) and leukemia (men: 0.12, 0.04-0.21; women: 0.08, 0.02-0.14). For cancers with high ICC for which systematic factors of the health care system, screening and diagnostic activities are not plausible explanations for between-country variations in incidence, cross-country sex-specific ecologic studies may be especially promising.
    Type of Publication: Journal article published
    PubMed ID: 26595447
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  • 6
    Keywords: CANCER ; Germany ; MODEL ; MODELS ; DISEASE ; DISEASES ; EPIDEMIOLOGY ; EXPOSURE ; HISTORY ; RISK ; RISKS ; meningioma ; radiation ; MECHANISM ; RISK-FACTORS ; mechanisms ; ASSOCIATION ; FIELD ; risk factors ; case-control studies ; CENTRAL-NERVOUS-SYSTEM ; REGRESSION-MODELS ; ONCOLOGY ; PERSISTENT ; case control study ; case-control study ; REGRESSION ; RE ; BRAIN-TUMORS ; brain tumour ; case control studies ; INTERVAL ; CELLULAR-TELEPHONE USE ; INCREASED RISK ; odds ratio ; UNIT ; RISK-FACTOR ; electromagnetic fields ; LOGISTIC-REGRESSION ; acoustic neuroma ; mobile phone ; MOBILE PHONE USE ; DENTAL RADIOGRAPHY ; noise allergy ionising radiation ; NOISE-EXPOSED WORKERS ; VESTIBULAR SCHWANNOMAS
    Abstract: The only known risk factor for sporadic acoustic neuroma is high-dose ionising radiation. Environmental exposures, such as radiofrequency electromagnetic fields and noise are under discussion, as well as an association with allergic diseases. We performed a population-based case-control study in Germany investigating these risk factors in 97 cases with acoustic neuroma, aged 30 to 69 years, and in 194 matched controls. Odds ratios (ORs) and 95% confidence intervals (Cls) were calculated in multiple logistic regression models. Increased risks were found for exposure to persistent noise (OR = 2.31; 95% CI 1.15-4.66), and for hay fever (OR = 2.20; 95% CI 1.09-4.45), but not for ionising radiation (OR = 0.91; 95 % CI 0.51-1.61) or regular mobile phone use (OR = 0.67; 95% CI 0.38-1.19). The study confirms results of recently published studies, although the pathogenetic mechanisms are still unknown. (c) 2007 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 17600696
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  • 7
    Abstract: This overview describes the principles of the 4th edition of the European Code against Cancer and provides an introduction to the 12 recommendations to reduce cancer risk. Among the 504.6 million inhabitants of the member states of the European Union (EU28), there are annually 2.64 million new cancer cases and 1.28 million deaths from cancer. It is estimated that this cancer burden could be reduced by up to one half if scientific knowledge on causes of cancer could be translated into successful prevention. The Code is a preventive tool aimed to reduce the cancer burden by informing people how to avoid or reduce carcinogenic exposures, adopt behaviours to reduce the cancer risk, or to participate in organised intervention programmes. The Code should also form a base to guide national health policies in cancer prevention. The 12 recommendations are: not smoking or using other tobacco products; avoiding second-hand smoke; being a healthy body weight; encouraging physical activity; having a healthy diet; limiting alcohol consumption, with not drinking alcohol being better for cancer prevention; avoiding too much exposure to ultraviolet radiation; avoiding cancer-causing agents at the workplace; reducing exposure to high levels of radon; encouraging breastfeeding; limiting the use of hormone replacement therapy; participating in organised vaccination programmes against hepatitis B for newborns and human papillomavirus for girls; and participating in organised screening programmes for bowel cancer, breast cancer, and cervical cancer.
    Type of Publication: Journal article published
    PubMed ID: 26164654
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  • 8
    Abstract: BACKGROUND: Testicular germ cell tumors (TGCT) were suggested to have a prenatal environmentally related origin. The potential endocrine disrupting properties of certain solvents may interfere with the male genital development in utero. OBJECTIVES: We aimed to assess the association between maternal and paternal occupational exposures to organic solvents during the prenatal period and TGCT risk in their offspring. METHODS: This registry-based case control study included TGCT cases aged 14-49 y (n=8,112) diagnosed from 1978 to 2012 in Finland, Norway, and Sweden. Controls (n=26,264) were randomly selected from the central population registries and were individually matched to cases on year and country of birth. Occupational histories of parents prior to the child's birth were extracted from the national censuses. Job codes were converted into solvent exposure using the Nordic job-Nordic Occupational Cancer Study Job-Exposure Matrix. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Overall, no association was found between prenatal maternal exposure to solvents and TGCT risk. In subset analyses using only mothers for whom occupational information was available in the year of or in the year prior to the child's birth, there was an association with maternal exposure to aromatic hydrocarbon solvents (ARHC) (OR=1.53; CI: 1.08, 2.17), driven by exposure to toluene (OR=1.67; CI: 1.02, 2.73). No association was seen for any paternal occupational exposure to solvents with the exception of exposure to perchloroethylene in Finland (OR=2.42; CI: 1.32, 4.41). CONCLUSIONS: This study suggests a modest increase in TGCT risk associated with maternal prenatal exposure to ARHC. https://doi.org/10.1289/EHP864.
    Type of Publication: Journal article published
    PubMed ID: 28893722
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  • 9
    Abstract: BACKGROUND: Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. METHODS: In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED). Whole-genome sequences and exome sequences from blood and tumour samples were analysed for rare damaging germline mutations in cancer predisposition genes. DNA methylation profiling was done to determine consensus molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGroup3), and group 4 (MBGroup4). Medulloblastoma predisposition genes were predicted on the basis of rare variant burden tests against controls without a cancer diagnosis from the Exome Aggregation Consortium (ExAC). Previously defined somatic mutational signatures were used to further classify medulloblastoma genomes into two groups, a clock-like group (signatures 1 and 5) and a homologous recombination repair deficiency-like group (signatures 3 and 8), and chromothripsis was investigated using previously established criteria. Progression-free survival and overall survival were modelled for patients with a genetic predisposition to medulloblastoma. FINDINGS: We included a total of 1022 patients with medulloblastoma from the retrospective cohorts (n=673) and the four prospective studies (n=349), from whom blood samples (n=1022) and tumour samples (n=800) were analysed for germline mutations in 110 cancer predisposition genes. In our rare variant burden analysis, we compared these against 53 105 sequenced controls from ExAC and identified APC, BRCA2, PALB2, PTCH1, SUFU, and TP53 as consensus medulloblastoma predisposition genes according to our rare variant burden analysis and estimated that germline mutations accounted for 6% of medulloblastoma diagnoses in the retrospective cohort. The prevalence of genetic predispositions differed between molecular subgroups in the retrospective cohort and was highest for patients in the MBSHH subgroup (20% in the retrospective cohort). These estimates were replicated in the prospective clinical cohort (germline mutations accounted for 5% of medulloblastoma diagnoses, with the highest prevalence [14%] in the MBSHH subgroup). Patients with germline APC mutations developed MBWNT and accounted for most (five [71%] of seven) cases of MBWNT that had no somatic CTNNB1 exon 3 mutations. Patients with germline mutations in SUFU and PTCH1 mostly developed infant MBSHH. Germline TP53 mutations presented only in childhood patients in the MBSHH subgroup and explained more than half (eight [57%] of 14) of all chromothripsis events in this subgroup. Germline mutations in PALB2 and BRCA2 were observed across the MBSHH, MBGroup3, and MBGroup4 molecular subgroups and were associated with mutational signatures typical of homologous recombination repair deficiency. In patients with a genetic predisposition to medulloblastoma, 5-year progression-free survival was 52% (95% CI 40-69) and 5-year overall survival was 65% (95% CI 52-81); these survival estimates differed significantly across patients with germline mutations in different medulloblastoma predisposition genes. INTERPRETATION: Genetic counselling and testing should be used as a standard-of-care procedure in patients with MBWNT and MBSHH because these patients have the highest prevalence of damaging germline mutations in known cancer predisposition genes. We propose criteria for routine genetic screening for patients with medulloblastoma based on clinical and mole
    Type of Publication: Journal article published
    PubMed ID: 29753700
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  • 10
    Keywords: CANCER ; Germany ; COMMON ; INFORMATION ; EXPOSURE ; HISTORY ; POPULATION ; RISK ; RISKS ; meningioma ; TISSUE ; IMPACT ; RISK-FACTORS ; TISSUES ; tumour ; FREQUENCY ; FIELD ; FREQUENCIES ; HEALTH ; DESIGN ; NUMBER ; risk factors ; COUNTRIES ; SWEDEN ; FRANCE ; NETHERLANDS ; case-control studies ; study design ; AUSTRALIA ; FINLAND ; case control study ; case-control study ; RE ; BRAIN-TUMORS ; INCREASE ; GLIOMA ; RECALL ; GLAND ; case control studies ; methods ; CELLULAR-TELEPHONE USE ; RISK-FACTOR ; CANCER-RISK ; E ; carcinogenic ; INCREASES ; case control ; acoustic neuroma ; brain tumours ; mobile phone ; MOBILE PHONE USE ; SETUP ; acoustic neurinoma ; benign tumours ; case-control ; CORDLESS TELEPHONES ; FIELDS ; mobile phones ; parotid gland tumours ; SELECTION BIAS
    Abstract: The very rapid worldwide increase in mobile phone use in the last decade has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. A multinational case-control study, INTERPHONE, was set-up to investigate whether mobile phone use increases the risk of cancer and, more specifically, whether the RF fields emitted by mobile phones are carcinogenic. The study focused on tumours arising in the tissues most exposed to RF fields from mobile phones: glioma, meningioma, acoustic neurinoma and parotid gland tumours. In addition to a detailed history of mobile phone use, information was collected on a number of known and potential risk factors for these tumours. The study was conducted in 13 countries. Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK using a common core protocol. This paper describes the study design and methods and the main characteristics of the study population. INTERPHONE is the largest case-control study to date investigating risks related to mobile phone use and to other potential risk factors for the tumours of interest and includes 2,765 glioma, 2,425 meningioma, 1,121 acoustic neurinoma, 109 malignant parotid gland tumour cases and 7,658 controls. Particular attention was paid to estimating the amount and direction of potential recall and participation biases and their impact on the study results
    Type of Publication: Journal article published
    PubMed ID: 17636416
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