Cell
Phones and Cancer Risk
Why is there concern that cell
phones may cause cancer or other health problems?
There are three main reasons why people are concerned that cell phones
(also known as “mobile” or “wireless” telephones) might have the potential to
cause certain types of cancer or other health problems:
- Cell phones emit radiofrequency radiation (radio waves), a form of non-ionizing radiation, from their antennas. Parts of the body nearest to the antenna can absorb this energy.
- The number of cell phone users has increased rapidly. There were over 400 million cell phone subscribers in the United States in 2017, according to the Cellular Telecommunications and Internet AssociationExit Disclaimer. Globally, there are more than 5 billion cell phone usersExit Disclaimer.
- Over time, the number of cell phone calls per day, the length of each call, and the amount of time people use cell phones have increased. Because of changes in cell phone technology and increases in the number of base stations for transmitting wireless signals, the exposure from cell phone use—power output—has changed, mostly lowered, in many regions of the United States (1).
The NCI fact sheet Electromagnetic
Fields and Cancer includes information on wireless local area networks
(commonly known as Wi-Fi), cell phone base stations, and cordless telephones.
What is
radiofrequency radiation and how does it affect the human body?
Radiofrequency
radiation is a form of electromagnetic
radiation. Electromagnetic radiation can be categorized into two types:
ionizing (e.g., x-rays,
radon,
and cosmic rays) and non-ionizing (e.g., radiofrequency and extremely low
frequency, or power frequency). Electromagnetic radiation is defined according
to its wavelength and frequency, which is the number of cycles of a wave that
pass a reference point per second. Electromagnetic frequencies are described in
units called hertz (Hz).
The energy of electromagnetic radiation is determined by its frequency; ionizing
radiation is high frequency, and therefore high energy, whereas non-ionizing
radiation is low frequency, and therefore low energy. The NCI fact
sheet Electromagnetic
Fields and Cancer lists sources of radiofrequency radiation. More
information about ionizing radiation can be found on the Radiation
page.
The frequency of radiofrequency electromagnetic radiation ranges from 30
kilohertz (30 kHz, or 30,000 Hz) to 300 gigahertz (300 GHz, or 300 billion Hz).
Electromagnetic fields in the radiofrequency range are used for telecommunications
applications, including cell phones, televisions, and radio transmissions.
The human body absorbs energy from devices that emit radiofrequency
electromagnetic radiation. The dose of the absorbed energy is estimated using a
measure called the specific absorption rate (SAR), which is expressed in watts
per kilogram of body weight.
Exposure to ionizing radiation, such as from x-rays, is known to increase the risk of cancer. However, although many
studies have examined the potential health effects of non-ionizing radiation
from radar, microwave ovens, cell phones, and other sources, there is
currently no consistent evidence that non-ionizing radiation increases cancer
risk in humans (2).
The only consistently recognized biological effect of radiofrequency
radiation in humans is heating. The ability of microwave ovens to heat food is
one example of this effect of radiofrequency radiation. Radiofrequency exposure
from cell phone use does cause heating to the area of the body where
a cell phone or other device is held (e.g., the ear and head). However, it
is not sufficient to measurably increase body temperature. There are no other
clearly established effects on the human body from radiofrequency radiation.
How is
radiofrequency radiation exposure measured in epidemiologic studies?
Epidemiologic
studies use information from several sources, including questionnaires
and data from cell phone service providers, to estimate
radiofrequency radiation exposure. Direct measurements are not yet possible
outside of a laboratory setting. Estimates take into account the following:
- How “regularly” study participants use cell phones (the number of calls per week or month)
- The age and the year when study participants first used a cell phone and the age and the year of last use (allows calculation of the duration of use and time since the start of use)
- The average number of cell phone calls per day, week, or month (frequency)
- The average length of a typical cell phone call
- The total hours of lifetime use, calculated from the length of typical call times, the frequency of use, and the duration of use
What has epidemiologic research
shown about the association between cell phone use and cancer risk?
Researchers have carried out several types of epidemiologic studies in
humans to investigate the possibility of a relationship between cell phone use
and the risk of malignant
(cancerous) brain tumors, such as gliomas,
as well as benign
(noncancerous) tumors, such as acoustic
neuroma
(tumors in the cells of the nerve responsible for hearing that are also known
as vestibular schwannomas),
meningiomas
(usually benign tumors in the membranes that cover and protect the brain and
spinal cord), and parotid gland tumors (tumors in the salivary
glands) (3).
In one type of study, called a case–control
study, cell phone use is compared between people with these types of tumors
and people without them. In another type of study, called a cohort
study, a large group of people who do not have cancer at study entry is
followed over time and the rate of these tumors in people who did and didn’t
use cell phones is compared. Cancer incidence
data can also be analyzed over time to see if the rates of brain tumors changed
in large populations during the time that cell phone use increased
dramatically. These studies have not shown clear evidence of a relationship
between cell phone use and cancer. However, researchers have reported some statistically
significant associations for certain subgroups of people.
Three large epidemiologic studies have examined the possible association
between cell phone use and cancer: Interphone, a case–control study; the Danish
Study, a cohort study; and the Million Women Study, another cohort study.
Interphone
How the study was done: This is the largest health-related case–control
study of cell phone use and the risk of head and neck tumors. It was conducted
by a consortium of researchers from 13 countries. The data came from
questionnaires that were completed by study participants.
What the study showed: Most published analyses from this study have shown
no statistically significant increases in brain or other central
nervous system cancers related to higher amounts of cell phone use. One
analysis showed a statistically significant, although modest, increase in the
risk of glioma among the small proportion of study participants who spent the
most total time on cell phone calls. However, the researchers considered this
finding inconclusive because they felt that the amount of use reported by some
respondents was unlikely and because the participants who reported lower levels
of use appeared to have a slightly reduced risk of brain cancer compared with
people who did not use cell phones regularly (4–6).
An analysis of data from all 13 countries participating in the Interphone
study reported a statistically significant association between intracranial
distribution of tumors within the brain and self-reported location of the phone
(7).
However, the authors of this study noted that it is not possible to draw firm
conclusions about cause and effect based on their findings.
Additional analyses of data from Interphone countries
An analysis of
data from five Northern European countries in the Interphone study showed an
increased risk of acoustic neuroma only in those who had used a cell phone for
10 or more years (8).
In subsequent analyses of Interphone data, investigators addressed issues
of risk according to specific location of the tumor and estimated exposures.
One analysis of data from seven of the countries in the Interphone study found
no relationship between brain tumor location and regions of the brain that were
exposed to the highest level of radiofrequency
radiation from cell phones (9).
However, another study, using data from
five of the countries, reported suggestions of an increased risk of glioma and,
to a lesser extent, of meningioma developing in areas of the brain experiencing
the highest exposure (10).
Danish Study
How the study was done: This cohort study, conducted in Denmark, linked
billing information from more than 358,000 cell phone subscribers with brain
tumor incidence data from the Danish Cancer Registry.
What the study showed: No association was observed between cell phone use
and the incidence of glioma, meningioma, or acoustic neuroma, even among people
who had been cell phone subscribers for 13 or more years (11–13).
Million Women Study
How the study was done: This prospective
cohort study conducted in the United Kingdom used data obtained from questionnaires
that were completed by study participants.
What the study showed: Self-reported cell phone use was not associated
with an increased risk of glioma, meningioma, or non-central nervous system
tumors. Although the original published
findings reported an association with an increased risk of acoustic neuroma
(14),
this association disappeared after additional years of follow-up
of the cohort (15).
In addition to these three large studies, other, smaller epidemiologic
studies have looked for associations between cell phone use and cancer. These
include:
- Two NCI-sponsored case–control studies, each conducted in multiple U.S. academic medical centers or hospitals between 1994 and 1998 that used data from questionnaires (16) or computer-assisted personal interviews (17). Neither study showed a relationship between cell phone use and the risk of glioma, meningioma, or acoustic neuroma.
- The CERENAT study, another case–control study conducted in multiple areas in France from 2004 to 2006 using data collected in face-to-face interviews using standardized questionnaires (18). This study found no association for either gliomas or meningiomas when comparing regular cell phone users with non-users. However, the heaviest users had significantly increased risks of both gliomas and meningiomas.
- A pooled analysis of two case–control studies conducted in Sweden that reported statistically significant trends of increasing brain cancer risk for the total amount of cell phone use and the years of use among people who began using cell phones before age 20 (19).
- Another case–control study in Sweden, part of the Interphone pooled studies, did not find an increased risk of brain cancer among long-term cell phone users between the ages of 20 and 69 (20).
- The CEFALO study, an international case–control study of children diagnosed with brain cancer between ages 7 and 19, which found no relationship between their cell phone use and risk for brain cancer (21).
Investigators have also conducted analyses of incidence trends to determine
whether the incidence of brain or other cancers has changed during the time
that cell phone use increased dramatically. These include:
- An analysis of data from NCI's Surveillance, Epidemiology, and End Results (SEER) Program evaluated trends in cancer incidence in the United States. This analysis found no increase in the incidence of brain or other central nervous system cancers between 1992 and 2006, despite the dramatic increase in cell phone use in this country during that time (22).
- An analysis of incidence data from Denmark, Finland, Norway, and Sweden for the period 1974–2008 similarly revealed no increase in age-adjusted incidence of brain tumors (23).
- A series of studies testing different scenarios (called simulations by the study authors) were carried out using incidence data from the Nordic countries to determine the likelihood of detecting various levels of risk as reported in studies of cell phone use and brain tumors between 1979 and 2008. The results were compatible with no increased risks from cell phones, as reported by most epidemiologic studies. The findings did suggest that the increase reported among the subset of heaviest regular users in the Interphone study could not be ruled out but was unlikely. The highly increased risks reported in the Swedish pooled analysis were strongly inconsistent with the observed glioma rates in the Nordic countries (24).
- A 2012 study by NCI researchers (25) compared observed glioma incidence rates in U.S. SEER data with rates simulated from the small risks reported in the Interphone study (6) and the greatly increased risk of brain cancer among cell phone users reported in the Swedish pooled analysis (19). The authors concluded that overall, the incidence rates of glioma in the United States did not increase over the study period. They noted that the US rates could be consistent with the small increased risk seen among the subset of heaviest users in the Interphone study. The observed incidence trends were inconsistent with the high risks reported in the Swedish pooled study. These findings suggest that the increased risks observed in the Swedish study are not reflected in U.S. incidence trends.
- An analysis of primary brain tumor incidence data (including some of the first benign brain and central nervous system tumor data that SEER began collecting in 2004) reported that the incidence of acoustic neuromas (also known as vestibular schwannomas) was stable (unchanged) from 2004 to 2010 (26).
- A 2018 national study that examined trends in brain tumor incidence among adults aged 20–59 years in Australia found that incidence rates for brain tumors overall and for individual histologic types, including glioma, were stable over three time periods—1982–1992, 1993–2002, and 2003–2013—including one (2003–2013) during which cell phone use was substantial (27).
- An analysis of U.S. cancer incidence during 1993–2013 found no change in the overall incidence rate of malignant CNS cancers among children ages 0 to 19 years in the United States (28).
What are the findings from
experimental studies?
In 2011, two small studies were published that examined brain glucose
metabolism
in people after they had used cell phones. The results were inconsistent;
whereas one study showed increased glucose metabolism in the region of the
brain close to the antenna compared with tissues on the opposite side of the
brain (29),
the other study (30)
found reduced glucose metabolism on the side of the brain where the phone was
used.
The authors of these studies noted that the results were preliminary and
that possible health outcomes from changes in glucose metabolism in humans were
unknown. Such inconsistent findings are not uncommon in experimental studies of
the biological effects of radiofrequency
electromagnetic
radiation in people (4).
Some factors that can contribute to inconsistencies across such studies include
assumptions used to estimate doses, failure to consider temperature effects,
and lack of blinding of investigators to exposure status.
Another study investigated the flow of blood in the brain of people exposed
to the radiofrequency radiation from cell phones and found no evidence of
an effect on blood flow in the brain (31).
Early studies
involving laboratory animals showed no evidence that radiofrequency radiation
increased cancer risk or enhanced the cancer-causing effects of known chemical
carcinogens (32–35).
Because of inconsistent findings from epidemiologic studies in humans and
the lack of clear data from previous experimental studies in animals, in 1999
the Food and Drug Administration nominated radiofrequency radiation exposure
associated with cell phone exposures for study in animal models by the U.S.
National Toxicology Program (NTP), an interagency program that coordinates
toxicology research and testing across the U.S. Department of Health and Human
Services and is headquartered at the National Institute of Environmental Health
Sciences, part of NIH.
The NTP studied
radiofrequency radiation (2G and 3G frequencies) in rats and mice (36,
37).
This large project was conducted in highly specialized labs that specified and
controlled sources of radiation and measured their effects. The rodents
experienced whole-body exposures of 3, 6, or 9 watts per kilogram of body weight for
5 or 7 days per week for 18 hours per day in cycles of 10 minutes on, 10
minutes off. A research
overview of the rodent studies, with links to the peer-review summary, is
available on NTP website. The primary outcomes observed were a small number
of cancers of Schwann cells in the heart and non-cancerous changes (hyperplasia)
in the same tissues for male rats, but not female rats, nor in mice overall.
These experimental findings raise new questions as to the potential for
radiofrequency radiation to result in cellular changes and offer potential avenues
for further laboratory studies. Cancers in the heart are extremely rare in
humans, where the primary outcomes of potential concern with respect to
radiofrequency radiation exposure from cell phones are tumors in the brain and central
nervous system. Schwann cells of the heart in rodents are similar to the
kind of cells in humans that give rise to acoustic
neuromas
(also known as vestibular schwannomas),
which some studies have suggested are increased in people who reported the
heaviest use of cell phones. The NTP has stated that they will continue to
study this exposure in animal models to further advance our understanding of
the biological underpinnings of the effects reported above.
Another animal
study, in which rats were exposed 7 days per week for 19 hours per day to radiofrequency
radiation at 0.001, 0.03, and 0.1 watts per kilogram of body weight was
reported by investigators at the Italian Ramazzini Institute (38).
Among the rats with the highest exposure levels, the researchers noted an
increase in heart schwannomas in male rats and non-malignant Schwann
cell growth in the heart in male and female rats. However, key
details necessary for interpretation of the results were missing: exposure
methods, other standard operating procedures, and nutritional/feeding aspects.
The gaps in the report from the study raise questions that have not been
resolved.
Why are the findings from
different studies of cell phone use and cancer risk inconsistent?
A few studies have shown some evidence of statistical association of cell
phone use and brain tumor risks in humans, but most studies have found no
association. Reasons for these discrepancies include the following:
- Recall bias, which can occur when data about prior habits and exposures are collected from study participants using questionnaires administered after diagnosis of a disease in some of the participants. It is possible that study participants who have brain tumors may remember their cell phone use differently from individuals without brain tumors. Many epidemiologic studies of cell phone use and brain cancer risk lack verifiable data about the total amount of cell phone use over time. In addition, people who develop a brain tumor may have a tendency to recall cell phone use mostly on the same side of the head where their tumor was found, regardless of whether they actually used their phone on that side of the head a lot or only a little.
- Inaccurate reporting, which can happen when people say that something has happened more or less often than it actually did. People may not remember how much they used cell phones in a given time period.
- Morbidity and mortality among study participants who have brain cancer. Gliomas are particularly difficult to study, for example, because of their high death rate and the short survival of people who develop these tumors. Patients who survive initial treatment are often impaired, which may affect their responses to questions. Furthermore, for people who have died, next-of-kin are often less familiar with the cell phone use patterns of their deceased family member and may not accurately describe their patterns of use to an interviewer.
- Participation bias, which can happen when people who are diagnosed with brain tumors are more likely than healthy people (known as controls) to enroll in a research study. Also, controls who did not or rarely used cell phones were less likely to participate in the Interphone study than controls who used cell phones regularly. For example, the Interphone study reported participation rates of 78% for meningioma patients (range among the individual studies 56–92%), 64% for glioma patients (range 36–92%), and 53% for control subjects (range 42–74%) (6).
- Changing technology and methods of use. Older studies evaluated radiofrequency radiation exposure from analog cell phones. Today, cell phones use digital technology, which operates at a different frequency and a lower power level than analog phones. Digital cell phones have been in use for more than two decades in the United States, and cellular technology continues to change (3). Texting and other applications, for example, are common uses of cell phones that do not require bringing the phone close to the head. Furthermore, the use of hands-free technology, such as wired and wireless headsets, is increasingExit Disclaimer and may reduce exposure by distancing the phone from the body (39, 40).
What are other possible health
effects from cell phone use?
A broad range of health effects have been reported with cell phone use. Neurologic
effects are of particular concern in young persons since the brain is the
primary exposed organ. However, studies of memory, learning, and cognitive
function have generally produced inconsistent results (41–44).
The most consistent health risk associated with cell phone use is distracted driving and vehicle accidents
(45,
46).
What have expert organizations
said about the cancer risk from cell phone use?
In 2011, the International
Agency for Research on CancerExit
Disclaimer (IARC), a component of the World
Health Organization, appointed an expert Working Group to review all
available evidence on the use of cell phones. The Working Group classified cell
phone use as “possibly carcinogenic to humans,” based on limited evidence from
human studies, limited evidence from studies of radiofrequency
radiation and cancer in rodents, and inconsistent evidence from mechanistic
studies (4).
The Working Group indicated that, although the human studies were
susceptible to bias,
the findings could not be dismissed as reflecting bias alone, and that a causal
interpretation could not be excluded. The Working Group noted that any
interpretation of the evidence should also consider that the observed
associations could reflect chance, bias, or confounding rather than an
underlying causal effect. In addition, the Working Group stated that the
investigation of risk of cancer of the brain associated with cell phone use
poses complex methodologic challenges in the conduct of the research and in the
analysis and interpretation of findings.
In 2011, the American
Cancer SocietyExit Disclaimer (ACS) stated that the IARC
classification means that there could be some cancer risk associated with
radiofrequency radiation, but the evidence is not strong enough to be
considered causal and needs to be investigated further. Individuals who are
concerned about radiofrequency radiation exposure can limit their exposure,
including using an ear piece and limiting cell phone use, particularly among
children.
In 2018, the ACS
issued a statement on the draft NTP reportsExit
Disclaimer noting that the findings were still inconclusive, and that, so
far, a higher cancer risk in people has not been seen, but that people who are
concerned should wear an earpiece when using a cell phone.
The National
Institute of Environmental Health Sciences (NIEHS) states that the weight
of the current scientific evidence has not conclusively linked cell phone use
with any adverse health problems, but more research is needed.
The U.S.
Food and Drug Administration (FDA) notes that studies reporting biological
changes associated with radiofrequency radiation have failed to be replicated
and that the majority of human epidemiologic studies have failed to show a
relationship between exposure to radiofrequency radiation from cell phones and
health problems. The FDA, which originally nominated this exposure for review
by the NTP in 1999, issued
a statement on the draft NTP reports released in February 2018, saying
“based on this current information, we believe the current safety limits for
cell phones are acceptable for protecting the public health.” FDA and the
Federal Communications Commission share responsibility for regulating cell
phone technologies.
The U.S.
Centers for Disease Control and Prevention (CDC) states that no scientific
evidence definitively answers whether cell phone use causes cancer.
The Federal
Communications Commission (FCC) concludes that currently no scientific
evidence establishes a definite link between wireless device use and
cancer or other illnesses.
In 2015, the European Commission Scientific Committee on Emerging and Newly
Identified Health Risks concluded that, overall, the epidemiologic studies on
cell phone radiofrequency electromagnetic radiation exposure do not show an
increased risk of brain tumors or of other cancers of the head and neck region
(2).
The Committee also stated that epidemiologic studies do not indicate increased
risk for other malignant diseases, including childhood cancer (2).
What studies are under way that
will help further our understanding of the possible health effects of cell
phone use?
A large prospective
cohort study of cell phone use and its possible long-term health effects
was launched in Europe in March 2010. This study, known as COSMOSExit
Disclaimer, has enrolled approximately 290,000 cell phone users aged 18
years or older to date and will follow them for 20 to 30 years (47,
48).
Participants in COSMOS will complete a questionnaire about their health,
lifestyle, and current and past cell phone use. This information will be
supplemented with information from health records and cell phone records.
The challenge of this ambitious study is to continue following the
participants for a range of health effects over many decades. Researchers will
need to determine whether participants who leave the study are somehow
different from those who remain throughout the follow-up period.
Although recall bias
is minimized in studies such as COSMOS that link participants to their cell
phone records, such studies face other problems. For example, it is impossible
to know who is using the listed cell phone or whether that individual also
places calls using other cell phones. To a lesser extent, it is not clear
whether multiple users of a single phone, for example family members who may
share a device, will be represented on a single phone company account.
Additionally, for many long-term cohort studies, participation tends to decline
over time.
Has radiofrequency radiation from
cell phone use been associated with cancer risk in children?
There are theoretical considerations as to why the possible risk should be
investigated separately in children. Their nervous systems are still developing
and, therefore, more vulnerable to factors that may cause cancer. Their heads
are smaller than those of adults and consequently have a greater proportional
exposure to the field of radiofrequency
radiation that is emitted by cell phones. And, children have the potential
of accumulating more years of cell phone exposure than adults do.
Thus far, the data from studies in children with cancer do not support this
theory. The first published analysis came from a large case–control
study called CEFALO, which was conducted in Denmark, Sweden, Norway, and
Switzerland. The study included children who were diagnosed with brain tumors
between 2004 and 2008, when their ages ranged from 7 to 19 years. Researchers
did not find an association between cell phone use and brain tumor risk either
by time since initiation of use, amount of use, or by the location of the tumor
(21).
Several studies that will provide more information are under way.
Researchers from the Centre for Research in Environmental Epidemiology in Spain
are conducting another international case–control study—Mobi-KidsExit
Disclaimer—that will include 2000 young people (aged 10–24 years) with
newly diagnosed brain tumors and 4000 healthy young people. The goal of the
study is to learn more about risk
factors for childhood brain tumors.
What can cell phone users do
to reduce their exposure to radiofrequency radiation?
The FDA has suggested some steps that concerned cell phone users can
take to reduce their exposure to radiofrequency radiation (49):
- Reserve the use of cell phones for shorter conversations or for times when a landline phone is not available.
- Use a device with hands-free technology, such as wired headsets, which place more distance between the phone and the head of the user.
Hands-free kits reduce the amount of radiofrequency radiation exposure to
the head because the antenna, which is the source of energy, is not placed
against the head (40).
Exposures decline dramatically when cell phones are used hands-free.
Where can I find more information
about radiofrequency radiation from my cell phone?
The FCC provides information about the specific absorption rate (SAR) of
cell phones produced and marketed within the last 1 to 2 years. The SAR
corresponds with the relative amount of radiofrequency radiation absorbed by
the head of a cell phone user (50).
Consumers can access this information using the phone’s FCC ID number, which is
usually located on the case of the phone, and the FCC’s ID search form.
How common is brain cancer? Has
the incidence of brain cancer changed over time?
In the United States, 23,820 new diagnoses and 17,760 deaths from brain and
other central
nervous system cancers are estimated for 2019 (51).
Brain cancer incidence
rates have declined slightly in recent years and mortality
(death) rates have increased slightly (52).
There is great variability in survival by brain tumor subtype, and by age
at diagnosis. Overall, the 5-year relative survival for brain cancers diagnosed
from 2008 through 2014 was 33.2% (53).
This is the percentage of people diagnosed with brain cancer who will still be
alive 5 years after diagnosis compared with the survival of a person of the
same age and sex who does not have cancer.
The risk of developing brain cancer increases with age. From 2011 through
2015, there were fewer than 4.5 brain cancer cases for every 100,000 people in
the United States under age 65, compared with approximately 19.1 cases for
every 100,000 people in the United States who were ages 65 or older (53).
Related Resources
- Updated: January 9, 2019
Reference:
Cell Phones and Cancer Risk was originally published by the National Cancer
Institute.
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