Dose-response relationship of lung cancer to amount smoked, duration and age starting

来源 :World Journal of Meta-Analysis | 被引量 : 0次 | 上传用户:w6832793xym
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AIM: To quantify smoking/lung cancer relationships accurately using parametric modelling. METHODS: Using the International Epidemiological Studies on Smoking and Lung Cancer database of all epidemiological studies of 100+ lung cancer cases published before 2000, we analyzed 97 blocks of data for amount smoked, 35 for duration of smoking, and 27 for age started. Pseudo-numbers of cases and controls(or at risk) estimated from RRs by dose level formed the data modelled. We fitted various models relating loge RR to dose(d), including βd, βdY and βloge(1 + Wd),and investigated goodness-of-fit and heterogeneity between studies. RESULTS: The best-fitting models for loge RR were0.833 loge [1 +(8.1c/10)] for cigarettes/d(c), 0.792(y/10)0.74 for years smoked(y) and 0.176 [(70- a)/10]1.44 for age of start(a). Each model fitted well overall, though some blocks misfitted. RRs rose from 3.86 to 22.31 between c = 10 and 50, from 2.21 to 13.54 between y = 10 and 50, and from 3.66 to 8.94 between a = 30 and 12.5. Heterogeneity(P < 0.001) existed by continent for amount, RRs for 50 cigarettes/d being 7.23(Asia), 26.36(North America) and 22.16(Europe). Little heterogeneity was seen for duration of smoking or age started. CONCLUSION: The models describe the dose-relationships well, though may be biased by factors including misclassification of smoking status and dose. METHODS: Using the International Epidemiological Studies on Smoking and Lung Cancer database of all epidemiological studies of 100+ lung cancer cases published before 2000, we analyzed 97 blocks of data for amount smoked , 35 for duration of smoking, and 27 for age started. Pseudo-numbers of cases and controls (or at risk) estimated from RRs by dose level formed the data modelled. We fitted various models about loge RR to dose (d), including RESULTS: The best-fitting models for loge RR were 0.833 loge [1 + (8.1 c / 10)] for cigarettes / Each model fitted well overall, though some blocks misfitted. RRs (d), 0.792 (y / 10) 0.74 for years smoked (y) and 0.176 [(70- a) / 10] 1.44 for age of start rose from 3.86 to 22.31 between c = 10 and 50, from 2.21 to 13.54 between y = 10 and 50, and from 3.66 to 8.94 between a = 30 and 12.5. Heterogeneity (P <0.001) existed by continent for amount of RRs for 50 cigarettes / d being 7.23 (Asia), 26.36 (North America) and 22.16 (Europe). Little heterogeneity was seen for duration of smoking or age started. CONCLUSION: The models describe the dose-relationships well, though may be biased by factors including misclassification of smoking status and dose.
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