LUNG-CANCER AND PASSIVE SMOKING - RECONCILING THE BIOCHEMICAL AND EPIDEMIOLOGIC APPROACHES

被引:27
作者
TWEEDIE, RL [1 ]
MENGERSEN, KL [1 ]
机构
[1] UNIV CENT QUEENSLAND, DEPT MATH & COMP, ROCKHAMPTON, QLD 4702, AUSTRALIA
关键词
D O I
10.1038/bjc.1992.341
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The accurate determination of exposure to environmental tobacco smoke is notoriously difficult. There have been to date two approaches to determining this exposure in the study of association of passive smoking and lung cancer: the biochemical approach, using cotinine in the main as a marker, and the epidemiological approach. Typically results of the former have yielded much lower relative risk than the latter, and have tended to be ignored in favour of the latter, although there has been considerable debate as to the logical basis for this. We settle this question by showing that, using the epidemiologically based meta-analysis technique of Wald et al. (1986), and misclassification models in the EPA Draft Review (1990), one arrives using all current studies at a result which is virtually identical with the biochemically-based conclusions of Darby and Pike (1988) or Repace and Lowry (1990). The conduct of this meta-analysis itself raises a number of important methodological questions, including the validity of inclusion of studies, the use of estimates adjusted for covariates, and the statistical significance of estimates based on meta-analysis of the epidemiological data. The best estimate of relative risk from spousal smoking is shown to be approximately 1.05-1.10, based on either of these approaches: but it is suggested that considerable extra work is needed to establish whether this is significantly raised.
引用
收藏
页码:700 / 705
页数:6
相关论文
共 54 条
[1]  
AHBORN W, 1988, INDOOR AMBIENT AIR Q
[2]  
AKIBA S, 1986, CANCER RES, V46, P4804
[3]   RISK-FACTORS FOR ADENOCARCINOMA OF THE LUNG [J].
BROWNSON, RC ;
REIF, JS ;
KEEFE, TJ ;
FERGUSON, SW ;
PRITZL, JA .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1987, 125 (01) :25-34
[4]  
BUFFLER PA, 1984, LUNG CANCER CAUSES P, P83
[5]  
CHALMERS TC, 1988, DATA ANAL CLIN MED Q, P75
[6]  
CHAN WC, 1982, CANCER CAMPAIGN, V6, P199
[7]  
CORREA P, 1983, LANCET, V2, P595
[8]   LUNG-CANCER AND PASSIVE SMOKING - PREDICTED EFFECTS FROM A MATHEMATICAL-MODEL FOR CIGARETTE-SMOKING AND LUNG-CANCER [J].
DARBY, SC ;
PIKE, MC .
BRITISH JOURNAL OF CANCER, 1988, 58 (06) :825-831
[9]  
FONTHAM ETH, 1991, CANCER EPIDEM BIOMAR, V1, P35
[10]   LUNG-CANCER AMONG CHINESE-WOMEN [J].
GAO, YT ;
BLOT, WJ ;
ZHENG, W ;
ERSHOW, AG ;
CHENG, WH ;
LEVIN, LI ;
RONG, Z ;
FRAUMENI, JF .
INTERNATIONAL JOURNAL OF CANCER, 1987, 40 (05) :604-609