Selection Bias Due to Differential Participation in a Case–Control Study of Mobile Phone Use and Brain Tumors

Purpose To evaluate the possible selection bias related to the differential participation of mobile phone users and non-users in a Finnish case–control study on mobile phone use and brain tumors. Methods Mobile phone use was investigated among 777 controls and 726 cases participating in the full personal interview (full participants), and 321 controls and 103 cases giving only a brief phone interview (incomplete participants). To assess selection bias, the Mantel-Haenszel estimate of odds ratio was calculated for three different groups: full study participants, incomplete participants, and a combined group consisting of both full and incomplete participants. Results Among controls, 83% of the full participants and 73% of the incomplete participants had regularly used a mobile phone. Among cases, the figures were 76% and 64%, respectively. The odds ratio for brain tumor based on the combined group of full and incomplete participants was slightly closer to unity than that based only on the full participants. Conclusions Selection bias tends to distort the effect estimates below unity, while analyses based on more comprehensive material gave results close to unity.