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An increasing number of patients are treated for brain tumor “of unknown nature” in Sweden since 2008, but the increase is not reflected in the national cancer registry. – It is serious if the statistics on new cases of brain tumors is incorrect because the brain tumor statistics is widely being used as an argument that cell phones do not increase the risk of cancer and brain tumors, says Mona Nilsson, Chairman of Swedish Radiation Protection Foundation.

Updated June 30, 2015

Swedish Radiation Protection Foundation has compiled statistics from the Swedish Health Board registry’s database on the number of patients treated for brain tumors in Sweden as well as from the cancer registry and cause of death registry, during the last decade. The number of people receiving treatment fora brain tumor”of unknown nature” increased by almost 30% only between 2008 and 2012. At the same time, the number of patients with a confirmed brain tumor diagnosis remained at arelatively stable level.

In April 2015, the Swedish scientists, oncologist Lennart Hardell and Michael Carlberg published a scientific analyse of the brain tumour data from Swedens registries that confirmed that

1. There is an increase in the numeber of patients treated for brain tumours and dying from brain tumours in Sweden during recent years;

2. The Swedish cancer registry data on brain tumour incidence is not reliable.

Diagnosis in Swedish health care, Number of patients, Age: 0-85+ Both sexes. Source: Swedish National Board of Health (Socialstyrelsen)

Diagnosis 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 C71 Malignant tumor in the brain 1 340 1 339 1 388 1 434 1 392 1 425 1 434 1 457 1 442 1 403 D43 Tumor of unknown nature in brain/CNS 723 755 781 763 774 754 886 884 1 016 968

Increasing deaths from brain tumors of unknown nature

The number of patients who died of brain tumor “of unknown nature” also increased during the same time period. From 2008 through 2013 these patients increased by 157%. The rise is even more pronounced in the age group 0-69 years, where the number of patients who died “of tumor of unknown nature” in the brain multiplied, from 7 persons in 2008 to 82 in 2013. On the contrary, the number of patients reported dead of brain tumors with a confirmed diagnosis declined.

Causes of death, Number of deaths, Age: 0-85+, Both sexes. Source: National Board of Health ( Socialstyrelsen)

Diagnosis 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 C71 Malignant tumor in brain 593 560 627 623 631 597 582 542 494 501 D43 Tumor of unknown nature in brain/CNS 96 126 114 90 89 112 132 225 223 229

No increase in Swedish cancer registry brain tumour incidence trends

In the national Health Board’s cancer registry on the number of people reported to have been diagnosed with a brain tumor in Sweden, no increase is reported during the last 4 years. Although Swedish Radiation Protection Foundation has posed questions about these inconsistencies to both the responsible regional cancer registries and the National Board of Health it is unclear if and how this growing number of patients with unclear brain tumor diagnosis are reported to the cancer registry.

Number of new cancer cases, Age: 0-85+, Diagnosis: 1930 Brain, brain nerves and membrane. Source: National Board of Health (Socialstyrelsen)

Kön 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Men 495 541 569 537 550 558 587 598 622 516 Women 613 546 664 660 648 664 653 720 592 593

Huge differences in brain tumor incidence between regions

The Swedish cancer registry contains amazingly huge disparities between the reported new brain tumor cases from different regions in Sweden. The Gothenburg region has for a series of years during the last decade reported nearly, and one year even more than, twice as many cases of brain tumors per 100 000 inhabitants compared to the Stockholm region. These differences probably reflect problems with reporting to the registry in some regions, rather than that in reality twice the number were diagnosed with brain tumors in Gothenburg compared to Stockholm.

Stockholm and Gothenburg region: Diagnosis:1930 Brain, brain nerves and membrane, per 100 000 inh. Source: National Board of Health (Socialstyrelsen)

Sex 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Men Stockholm 10,38 14,27 9,78 12,44 9,74 9,29 8,61 11,55 11,64 12,71 11,60 8,99 Men Gothenburg 13,86 13,66 13,45 14,58 19,65 18,22 21,49 17,58 16,16 14,39 17,06 15,19 Women Stockholm 14,65 13,28 12,16 10,20 13,47 12,91 11,11 14,56 12,74 16,61 11,94 11,28 Women Gothenburg 12,72 14,25 15,90 15,58 19,82 24,27 21,04 21,82 20,91 21,15 15,36 18,02

Stockholm region has also reported a steep increase in number of patients being treated for brain tumors “of unknown nature” in recent years.

Underreporting of brain tumors in Swedish cancer registry

In 2011 Mona Nilsson, Chairman Swedish Radiation Protection Foundation, interviewed Åsa Klint at the National Health Board about the Swedish cancer registry. Åsa Klint had some years previously reviewed the cancer registry’s reliability. Her conclusion was that that under-reporting was significant for brain tumors.[1] Some cases are reported to the cancer registry only after a pathological examination and ​​ a precise diagnosis has been made:

– Many brain tumors never come to pathology.We have not managed to establish good routines to solve the problem, said Åsa Klint in 2011.

Swedish Radiation Protection Foundation concludes that it is serious if the Swedish cancer statistics on brain tumors is incorrect and misleading. The Swedish cancer statistics of brain tumors is increasingly being used as an argument against increased risk of brain tumors from mobile phone use not only in Sweden, but also on an international level. Epidemiological evidence from case-control studies however now consistently show that a relatively low use 20-30 minutes a day during a longer period of time increase the risk of malignant brain tumor.

Brain tumour incidence trends against mobile phone risks

As an example, Swedish Radiation Security Authority, SSM, claimed in May 2014 that the evidence for increased risk of brain tumors from mobile phone use had become “weaker” referring to the cancer statistics.[2]

Examples can also be found from the Karolinska Institute’s, press release on a study of brain tumor risk in children and adolescents who had used mobile phones in July 2011. The study showed that children who used mobile phone or with the longest mobile phone subscriptions, were at increased risk of brain tumor. But the results were downplayed with reference to the Swedish brain tumor incidence trends from the cancer registry.[3]

Another example is the American Cancer Society that refers to the Swedish cancer statistics to downplay Swedish epidemiologist and oncologist Lennart Hardell’s studies that show an increased risk of brain tumors from mobile phone use.[4]

SCENIHR “ruled out” mobile phone brain tumor risk

Yet another example is the latest SCENIHR report for the EU- commission that repeatedly through the report refers to brain tumor incidence trends, particularly in the combined Nordic countries (Sweden, Norway, Denmark and Finland), as an argument against the observed increased risks of brain tumors from mobile phone use:

“The simulation study in the Nordic countries virtually rules out a doubling in risk even after 15+ years since first mobile phone use” [5]

This argument in the SCNIHR report was put forward although there are considerable and unexplained disparities between the reported brain tumor incidence trends from the various Nordic countries. Unlike Sweden, Denmark displays a steep increasing trend. In the latest report with data until 2012 made available in December 2013, there is a sharp increase in the number of people diagnosed with a brain tumor during the past decade: 55% more women and men got brain cancer in Denmark in 2012 compared to in 2003.

Huge and increasing difference Sweden and Denmark

The huge and by time increasing disparities between Sweden and Denmark national data on brain tumor incidence is exposed below, Source Nordcan[6]

Swedish Radiation Protection Foundation calls again on the Government, authorities and business community to immediately take the necessary measures to alert mobile phone users and prevent a public health disaster, by not waiting until an irrefutable epidemic of brain tumors is an indisputable fact. It is urgent to act now.

Press Contact

Mona Nilsson, Chairman

E-mail: mona@stralskyddsstiftelsen.se

Further reading: Microwave news

Swedish Radiation Protection Foundation aims at better protection for people and the environment from harmful electromagnetic radiation by providing information on the risks and publish recommendations. The Foundation promotes stricter legislation, improved consumer protection and support to those injured. www.stralskyddsstiftelsen.se

Further reading / sources:

Swedish Health Board database: Diagnosesofpatient care; Cancer; Cause of DeathRegistry.http://www.socialstyrelsen.se/statistik/statistikdatabas

[1] [1] Klint, Å. mfl: Rapportering till Cancerregistret kan förbättras; Läkartidningen nr 11, 2009

[2] Strålsäkerhetsmyndigheten, pressmeddelande 21 maj 2014: Mobiltelefoni: Ny forskning tyder inte på hälsorisker; http://www.stralsakerhetsmyndigheten.se/Om-myndigheten/Aktuellt/Nyheter/Mobiltelefoni-ny-forskning-tyder-inte-pa-halsorisker/

[3] Nilsson, Mona: Karolinska Institutet manipulerade studie om hjärntumörrisker för mobilanvändande barn; http://www.svt.se/opinion/karolinska-institutet-manipulerade-studie-om-hjarntumorrisker-for-mobilanvandande-barn

[4] American Cancer Society: Cellular phones: What do studies in humans suggest http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/cellular-phones

[5] SCENIHR 2014: Preliminary opinion on Potential health effects of exposure to electromagnetic fields (EMF), February 2014;

[6] http://www-dep.iarc.fr/NORDCAN

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