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The effects of recall errors and of selection bias in epidemiologic studies of mobile phone use and cancer risk

Abstract

This paper examines the effects of systematic and random errors in recall and of selection bias in case–control studies of mobile phone use and cancer. These sensitivity analyses are based on Monte–Carlo computer simulations and were carried out within the INTERPHONE Study, an international collaborative case–control study in 13 countries. Recall error scenarios simulated plausible values of random and systematic, non-differential and differential recall errors in amount of mobile phone use reported by study subjects. Plausible values for the recall error were obtained from validation studies. Selection bias scenarios assumed varying selection probabilities for cases and controls, mobile phone users, and non-users. Where possible these selection probabilities were based on existing information from non-respondents in INTERPHONE. Simulations used exposure distributions based on existing INTERPHONE data and assumed varying levels of the true risk of brain cancer related to mobile phone use. Results suggest that random recall errors of plausible levels can lead to a large underestimation in the risk of brain cancer associated with mobile phone use. Random errors were found to have larger impact than plausible systematic errors. Differential errors in recall had very little additional impact in the presence of large random errors. Selection bias resulting from underselection of unexposed controls led to J-shaped exposure–response patterns, with risk apparently decreasing at low to moderate exposure levels. The present results, in conjunction with those of the validation studies conducted within the INTERPHONE study, will play an important role in the interpretation of existing and future case–control studies of mobile phone use and cancer risk, including the INTERPHONE study.

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Acknowledgements

This work was supported in part by grants from the European Union Fifth Framework Program, “Quality of Life and Management of living Resources” (contract QLK4-CT-1999-01563) and the International Union against Cancer (UICC), and national funding sources. The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. Provision of funds to the INTERPHONE study investigators via the UICC was governed by agreements that guaranteed INTERPHONE's complete scientific independence. These agreements are publicly available at http://www.iarc.fr/pageroot/UNITS/RCA4.html.

D Krewski is the NSERC/SSHRC/McLaughlin Chair in Population Health Risk Assessment at the University of Ottawa, and a Visiting Scientist at the International Agency for Research on Cancer.

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Vrijheid, M., Deltour, I., Krewski, D. et al. The effects of recall errors and of selection bias in epidemiologic studies of mobile phone use and cancer risk. J Expo Sci Environ Epidemiol 16, 371–384 (2006). https://doi.org/10.1038/sj.jes.7500509

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