Abstract

Abstract Summary

Overview

The Interphone Study, which is the largest case-control study to examine glioma risk linked to mobile phone use, demonstrated a J-shaped relationship, indicating reduced relative risks for moderate users and a significant increase in risk among the heaviest users.

Methods

• Monte-Carlo simulations were employed to analyze the probability of biases in the Interphone study impacting the reported risk estimates.
• These simulations considered several types of reporting errors and selection biases, using parameters from prior Interphone validation studies and a non-response questionnaire.

Findings

The simulation that included both systematic and random reporting errors replicated the J-shaped risk relationship seen in the Interphone study, suggesting the increased risk among heavy users could be spurious.

Main determinants in the simulations were a higher variance in reporting errors among cases than controls, alongside an influence from selection bias.

Conclusion

The simulation results provide new perspectives, suggesting that heavy mobile phone use may be less likely to be causally associated with increased glioma risk, despite some persistent uncertainties.