Trends in the incidence of primary brain, central nervous system and intracranial tumors in Israel, 1990-2015

Cancer Epidemiol · 2018 · No effect · Low evidence

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No effectLow evidencePaper 1808

Study snapshot

PublicationCancer Epidemiol · 2018

Study typeecological

Reported directionNo effect

Evidence ratingLow

Abstract

Trends in the incidence of primary brain, central nervous system and intracranial tumors in Israel, 1990-2015 Keinan-Boker L, Friedman E, Silverman BG. Trends in the incidence of primary brain, central nervous system and intracranial tumors in Israel, 1990-2015. Cancer Epidemiol. 2018 Oct;56:6-13. doi: 10.1016/j.canep.2018.07.003. Highlights • Exponential growth in cellphone use fueled concerns regarding brain and CNS tumors. • Results so far are inconsistent. Studying cancer incidence trends may thus be informative. • We studied brain tumor trends from 1990 to 2015 in Israel, when cellphone use dramatically increased. • Results do not support a substantial role for cellphone use; smaller risks in special subgroups may exist. • Future research is needed; implementation of the precautionary principle is prudent. Abstract BACKGROUND: The association between cellphone technology and brain, central nervous system (CNS) and intracranial tumors is unclear. Analysis of trends in incidence of such tumors for periods during which cellphone use increased dramatically may add relevant information. Herein we describe secular trends in the incidence of primary tumors of the brain and CNS from 1990 to 2015 in Israel, a period during which cellphone technology became extremely prevalent in Israel. METHODS: All cases of primary brain, CNS and intracranial tumors (excluding lymphomas) diagnosed in Israel from 1990 to 2015 were identified in the Israel National Cancer Registry database and categorized by behavior (malignant; benign/uncertain behavior) and histologic type. Annual age-standardized incidence rates by sex and population group (Jews; Arabs) were computed, and the annual percent changes and 95% confidence intervals per category were calculated using Joinpoint software. RESULTS: Over 26 years (1990-2015) no significant changes in the incidence of malignant brain, CNS and intracranial tumors were observed, except for an increase in malignant glioma incidence in Jewish women up to 2008 and Arab men up to 2001, which levelled off in both subgroups thereafter. The incidence of benign/uncertain behavior brain, CNS and intracranial tumors increased in most population groups up to the mid-2000s, a trend mostly driven by changes in the incidence of meningioma, but either significantly decreased (Jews) or stabilized (Arabs) thereafter. CONCLUSIONS: Our findings are not consistent with a discernable effect of cellphone use patterns in Israel on incidence trends of brain, CNS and intracranial tumors. ncbi.nlm.nih.gov Excerpts "When cancer occurrence rates referred to glioblastomas only, Joinpoint analysis of incidence trends was restricted to the period from 1995 to 2015 due to small numbers of cases in the Arab population prior to 1995. Stable incidence trends were noted, with non-significant APCs, in all population subgroups: APC1995-2015 for Jewish men was +0.6% (95%CI -0.4%,+1.6%); APC1995-2015 for Jewish women was +0.6% (95%CI -0.1%,+1.6%); APC1995-2015 for Arab men was -1.6% (95%CI -3.9%,+0.8%); APC1995-2015 for Arab women was +0.4% (95%CI -2.9%,+3.8%). Analysis of time trends by age groups disclosed stable trends in most population- age- and sex groups, except for a mild increase in Jewish males aged 65 and over (APC1990-2015 +1.2%, p < 0.05) and in Arab males aged 20-64 (APC1990-2015 +1.5%, p < 0.05). In the population of Arab females, lack of cases in the age groups of 20-64 and 65+ in certain years prevented an analysis of trends." "However, ecologic studies, of which ours is an example, may be insensitive to excess in risk which is restricted to certain groups (for example, heavy users or subjects exposed from very young ages) or to certain tumor types (e.g., tumors that are very rare, that involve specific anatomical sites, or that have unusually long latency periods) [34]. Little et al. [35] also commented that the predicted rates of glioma based on data derived from the small proportion of highly exposed people in the Interphone study, could be consistent with the observed rates in their study [35]. Therefore, although a substantial risk is not very plausible, smaller risks cannot be ruled out and future research should address specific exposure groups, and tumor types and sites, and should allow for longer follow up periods."

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeecological

Effect directionno_effect

PopulationIsrael population (subgroups by sex and population group: Jews; Arabs)

Sample sizeNot supplied

ExposureRF · 1990-2015 (period of increasing cellphone use; cancer incidence assessed 1990-2015)

Evidence strengthLowConfidence: 78% · Peer reviewed: yes

Main findings

Using Israel National Cancer Registry data (1990-2015), no significant changes were observed in incidence of malignant brain/CNS/intracranial tumors overall, aside from subgroup increases in malignant glioma up to 2008 (Jewish women) and up to 2001 (Arab men) that later levelled off. Benign/uncertain tumors increased in most groups up to the mid-2000s (largely driven by meningioma) and then decreased (Jews) or stabilized (Arabs). The authors conclude the trends are not consistent with a discernable effect of cellphone use patterns on tumor incidence trends.

Outcomes measured

Incidence trends of primary malignant brain, CNS and intracranial tumors (excluding lymphomas)
Incidence trends of benign/uncertain behavior brain, CNS and intracranial tumors
Histologic subtypes including malignant glioma/glioblastoma and meningioma

Limitations

Ecological design; may be insensitive to risks limited to specific groups (e.g., heavy users, very young exposure) or specific rare tumor types/sites or long latency periods
No individual-level cellphone exposure assessment reported in abstract
Potential for changes in diagnostic practices/ascertainment over time (implied by discussion of benign/uncertain tumors and meningioma trends; not explicitly detailed)

View raw extracted JSON

{
  "study_type": "ecological",
  "exposure": {
    "band": "RF",
    "source": "mobile phone",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "1990-2015 (period of increasing cellphone use; cancer incidence assessed 1990-2015)"
  },
  "population": "Israel population (subgroups by sex and population group: Jews; Arabs)",
  "sample_size": null,
  "outcomes": [
    "Incidence trends of primary malignant brain, CNS and intracranial tumors (excluding lymphomas)",
    "Incidence trends of benign/uncertain behavior brain, CNS and intracranial tumors",
    "Histologic subtypes including malignant glioma/glioblastoma and meningioma"
  ],
  "main_findings": "Using Israel National Cancer Registry data (1990-2015), no significant changes were observed in incidence of malignant brain/CNS/intracranial tumors overall, aside from subgroup increases in malignant glioma up to 2008 (Jewish women) and up to 2001 (Arab men) that later levelled off. Benign/uncertain tumors increased in most groups up to the mid-2000s (largely driven by meningioma) and then decreased (Jews) or stabilized (Arabs). The authors conclude the trends are not consistent with a discernable effect of cellphone use patterns on tumor incidence trends.",
  "effect_direction": "no_effect",
  "limitations": [
    "Ecological design; may be insensitive to risks limited to specific groups (e.g., heavy users, very young exposure) or specific rare tumor types/sites or long latency periods",
    "No individual-level cellphone exposure assessment reported in abstract",
    "Potential for changes in diagnostic practices/ascertainment over time (implied by discussion of benign/uncertain tumors and meningioma trends; not explicitly detailed)"
  ],
  "evidence_strength": "low",
  "confidence": 0.78,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "brain tumor",
    "central nervous system tumor",
    "intracranial tumor",
    "glioma",
    "glioblastoma",
    "meningioma",
    "cancer registry",
    "incidence trends",
    "Israel",
    "cellphone use",
    "RF exposure",
    "Joinpoint"
  ],
  "suggested_hubs": [
    {
      "slug": "who-icnirp",
      "weight": 0.32,
      "reason": "Addresses population-level brain/CNS tumor incidence trends in relation to mobile phone use; relevant to major RF health risk assessments."
    }
  ]
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1016/j.canep.2018.07.003
PubMed: Not supplied

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