利用前列腺癌病例对照研究的数据计算癌症潜伏期

David F. Goldsmith
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引用次数: 9

摘要

评估肿瘤疾病的潜伏期对于确定复杂的致癌暴露组合的因果效应至关重要。对美国一家轮胎和橡胶工厂癌症风险的初步评估显示,前列腺癌的SMR为140。使用基于行业的前列腺恶性肿瘤病例对照死亡证明研究,我们发现匹配的优势比约为3 (p <0.025)用于批量制备,与炭黑、溶剂和重金属氧化物接触最多的工作区域。为了评估潜伏期,我们使用匹配的病例-对照序列,通过确定研究中每年在批制剂中使用超过1个月的病例和对照的比例,来计算优势比的年度估计值。这种方法产生了一个波动很大的图。为了减少结果曲线的可变性,开发了一种测量“病因分数”的方法,即其最高点代表潜伏期分布的峰值。对于批量制备,模态点是死亡前29年,最大的风险发生在20世纪40年代中期的就业中。潜伏期法允许对暴露差异最大的时间和年份进行风险评估,从而建议适当的预防策略。讨论了该方法在其他类型的研究和暴露中的应用。
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Calculating cancer latency using data from a nested case-control study of prostatic cancer

Assessing latency for neoplastic diseases is crucial for determining the causal effects of a complex mix of carcinogenic exposures. An initial assessment of cancer risks in a U.S. tire and rubber plant revealed a significant SMR of 140 for prostatic cancer. Using an industry-based, case-control death certificate study of prostatic malignancies, we found matched odds ratios of about 3 (p < 0.025) for Batch Preparation, the work area with the greatest exposure to carbon black, solvents, and heavy metal oxides. To assess latency, we used the matched case-control series to calculate annual estimates of the odds ratio by determining the proportion of cases and controls employed for greater than 1 month in Batch Preparation during each year under study. This approach produced a plot with great fluctuations. To reduce variability in the resulting curve, a method was developed that measured the “etiologic fraction,” which is its highest point represents an estimate of the peak of the latency distribution. For Batch Preparation the modal point was 29 years before death with the greatest risk occurring from employment in the mid-1940's. The latency method allows risk assessment for time and year of greatest exposure difference, thus suggesting appropriate prevention strategies. Applications of this method for other types of studies and exposures are discussed.

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