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Huh DA, Kang MS, Lee J, Choi JY, Moon KW, Lee YJ. Occupational and environmental asbestos exposure and the risk of lung cancer in Korea: A case-control study in South Chungcheong Province of Korea. PLoS One 2021; 16:e0249790. [PMID: 33831090 PMCID: PMC8031370 DOI: 10.1371/journal.pone.0249790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/24/2021] [Indexed: 11/21/2022] Open
Abstract
Despite the use of large amounts of asbestos in the 1990s, few studies have been conducted in Korea on occupational and environmental asbestos exposure and lung cancer risk. The main aim of this study was to estimate the risk of lung cancer development caused by occupational and environmental asbestos exposures in residents of South Chungcheong Province, where about half of the asbestos mines in Korea operated. We conducted a case-control study, for which the information on asbestos exposure history and demographic characteristics was provided by the Environmental Health Center for asbestos of Soonchunhyang University Cheonan Hospital. After adjusting for all covariates, the odds ratios for lung cancer tended to increase with higher exposure probability for both occupational as well as environmental asbestos. The relative risk of occupational asbestos exposure was higher than that of environmental exposure; the interaction of co-exposure was not statistically significant. The estimated means of the latency period were significantly shorter in participants who were engaged in the production of asbestos-containing products and in those who lived near asbestos industries as compared to other groups.
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Affiliation(s)
- Da-An Huh
- Department of Health Science, Graduate School at Korea University, Seoul, Republic of Korea
| | - Min-Sung Kang
- Department of Health Science, Graduate School at Korea University, Seoul, Republic of Korea
- Asbestos Environmental Health Center, Soonchunhyang University Cheonan Hospital, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - Jiyun Lee
- Department of Health and Safety Convergence Science, Graduate School at Korea University, Seoul, Republic of Korea
| | - Ji Yoon Choi
- Department of Health and Safety Convergence Science, Graduate School at Korea University, Seoul, Republic of Korea
| | - Kyong Whan Moon
- Department of Health and Safety Convergence Science, Graduate School at Korea University, Seoul, Republic of Korea
- BK21 FOUR R&E Center for Learning Health System & Department of Health and Environmental Science, Graduate School at Korea University, Seoul, Republic of Korea
| | - Yong-Jin Lee
- Asbestos Environmental Health Center, Soonchunhyang University Cheonan Hospital, Cheonan-si, Chungcheongnam-do, Republic of Korea
- Department of Occupational & Environmental Medicine, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, Republic of Korea
- * E-mail:
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Klebe S, Leigh J, Henderson DW, Nurminen M. Asbestos, Smoking and Lung Cancer: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010258. [PMID: 31905913 PMCID: PMC6982078 DOI: 10.3390/ijerph17010258] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/17/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023]
Abstract
This review updates the scientific literature concerning asbestos and lung cancer, emphasizing cumulative exposure and synergism between asbestos exposure and tobacco smoke, and proposes an evidence-based and equitable approach to compensation for asbestos-related lung cancer cases. This update is based on several earlier reviews written by the second and third authors on asbestos and lung cancer since 1995. We reevaluated the peer-reviewed epidemiologic studies. In addition, selected in vivo and in vitro animal studies and molecular and cellular studies in humans were included. We conclude that the mechanism of lung cancer causation induced by the interdependent coaction of asbestos fibers and tobacco smoke at a biological level is a multistage stochastic process with both agents acting conjointly at all times. The new knowledge gained through this review provides the evidence for synergism between asbestos exposure and tobacco smoke in lung cancer causation at a biological level. The evaluated statistical data conform best to a multiplicative model for the interaction effects of asbestos and smoking on the lung cancer risk, with no requirement for asbestosis. Any asbestos exposure, even in a heavy smoker, contributes to causation. Based on this information, we propose criteria for the attribution of lung cancer to asbestos in smokers and non-smokers.
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Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
- Correspondence: ; Tel.: +61-08-820-439-36
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Concord, NSW 2139, Australia;
| | - Douglas W. Henderson
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
| | - Markku Nurminen
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
- MarkStat Consultancy, 00250 Helsinki, Finland
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Kobayashi K, Watanabe N, Oka T, Tomita H, Suzui N, Oumi Y, Hara A, Miyazaki T. A case of lung adenocarcinoma complicated by pulmonary talcosis occurring in a patient employed in the confectionery industry. Pathol Int 2019; 69:229-234. [PMID: 30775827 DOI: 10.1111/pin.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022]
Abstract
A 73-year-old Japanese man, who worked at a confectionery company for more than 20 years, was diagnosed with a 28 mm nodular lesion in the superior lobe of the right lung by whole-body computed tomography examination. A biopsy revealed the presence of adenocarcinoma. With a diagnosis of a primary lung cancer, a right upper lobectomy was performed. A nodular lesion, 25 × 23 mm in size, was observed in the upper right lobe lung field, and was diagnosed histopathologically as a papillary adenocarcinoma. In addition, fibrous scars in the central part of the tumor showed numerous Langhans and/or foreign body giant cells, and histiocytic cells that had phagocytized numerous small transparent crystals, together with coal powder deposition. The extracted crystals were observed with a scanning electron microscope, and although plate-like structures were observed, ferruginous bodies suggestive of asbestos were not found. The crystals were demonstrated to be talc by powder X-ray diffraction. Herein, we investigated a case of lung adenocarcinoma in a patient with talcosis, with discussions based on a literature search. This collision of talcosis and lung adenocarcinoma adds to an increasing body of knowledge on an apparent association between talc and cancer cases.
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Affiliation(s)
| | - Naoki Watanabe
- Division of Pathology, Gifu Municipal Hospital, Gifu-City, Japan
| | - Teruaki Oka
- Division of Pathology, Kanto Central Hospital, Tokyo, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu-City, Japan
| | - Natsuko Suzui
- Department of Pathology, Gifu University Hospital, Gifu-City, Japan
| | - Yasunori Oumi
- Division of Instrumental Analysis, Life Science Research Center, Gifu University, Gifu-City, Japan
| | - Akira Hara
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu-City, Japan
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Tseng CY, Lin CH, Wu LY, Wang JS, Chung MC, Chang JF, Chao MW. Potential Combinational Anti-Cancer Therapy in Non-Small Cell Lung Cancer with Traditional Chinese Medicine Sun-Bai-Pi Extract and Cisplatin. PLoS One 2016; 11:e0155469. [PMID: 27171432 PMCID: PMC4865219 DOI: 10.1371/journal.pone.0155469] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/30/2016] [Indexed: 11/20/2022] Open
Abstract
Traditional lung cancer treatments involve chemical or radiation therapies after surgical tumor removal; however, these procedures often kill normal cells as well. Recent studies indicate that chemotherapies, when combined with Traditional Chinese Medicines, may offer a new way to treat cancer. In vitro tests measuring the induction of autophagy and/or apoptosis were used to examine the cytotoxicity of SBPE, commonly used for lung inflammation on A549 cell line. The results indicated that intercellular levels of p62 and Atg12 were increased, LC3-I was cleaved into LC3-II, and autophagy was induced with SBPE only. After 24 hours, the apoptotic mechanism was induced. If the Cisplatin was added after cells reached the autophagy state, we observed synergistic effects of the two could achieve sufficient death of lung cancer cells. Therefore, the Cisplatin dosage used to induce apoptosis could be reduced by half, and the amount of time needed to achieve the inhibitory concentration of 50% was also half that of the original. In addition to inducing autophagy within a shortened period of time, the SBPE and chemotherapy drug combination therapy was able to achieve the objective of rapid low-dosage cancer cell elimination. Besides, SBPE was applied with Gemcitabine or Paclitaxel, and found that the combination treatment indeed achieve improved lung cancer cell killing effects. However, SBPE may also be less toxic to normal cells.
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Affiliation(s)
- Chia-Yi Tseng
- Department of Biomedical Engineering, College of Engineering, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
| | - Chin-Hung Lin
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
| | - Lung-Yuan Wu
- School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Dashu District, Kaohsiung, Taiwan
| | - Jhih-Syuan Wang
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
| | - Meng-Chi Chung
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
| | - Jing-Fen Chang
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
| | - Ming-Wei Chao
- Department of Bioscience Technology, College of Science, Chung Yuan Christian University, Zhongli district, Taoyuan city, Taiwan
- * E-mail:
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Nielsen LS, Bælum J, Rasmussen J, Dahl S, Olsen KE, Albin M, Hansen NC, Sherson D. Occupational asbestos exposure and lung cancer--a systematic review of the literature. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 69:191-206. [PMID: 24410115 DOI: 10.1080/19338244.2013.863752] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this study was to evaluate the scientific literature concerning asbestos and lung cancer, emphasizing low-level exposure. A literature search in PubMed and Embase resulted in 5,864 citations. Information from included studies was extracted using SIGN. Twenty-one statements were evidence graded. The results show that histology and location are not helpful in differentiating asbestos-related lung cancer. Pleural plaques, asbestos bodies, or asbestos fibers are useful as markers of asbestos exposure. The interaction between asbestos and smoking regarding lung cancer risk is between additive and multiplicative. The findings indicate that the association between asbestos exposure and lung cancer risk is basically linear, but may level off at very high exposures. The relative risk for lung cancer increases between 1% and 4% per fiber-year (f-y)/mL, corresponding to a doubling of risk at 25-100 f-y/mL. However, one high-quality case-control study showed a doubling at 4 f-y/mL.
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Affiliation(s)
- Lene Snabe Nielsen
- a Department of Occupational and Environmental Medicine , Odense University Hospital , Odense , Denmark
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De Matteis S, Consonni D, Lubin JH, Tucker M, Peters S, Vermeulen RCH, Kromhout H, Bertazzi PA, Caporaso NE, Pesatori AC, Wacholder S, Landi MT. Authors' response to: qualitative job-exposure matrix--a tool for the quantification of population-attributable fractions for occupational lung carcinogens? Int J Epidemiol 2012; 42:357-8. [PMID: 23266616 DOI: 10.1093/ije/dys193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ameille J. Les différentes pathologies pleuropulmonaires liées à l’amiante : définitions, épidémiologie et évolution. Rev Mal Respir 2012; 29:1035-46. [DOI: 10.1016/j.rmr.2012.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 02/17/2012] [Indexed: 01/09/2023]
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Occupational risk factors have to be considered in the definition of high-risk lung cancer populations. Br J Cancer 2012; 106:1346-52. [PMID: 22453127 PMCID: PMC3314791 DOI: 10.1038/bjc.2012.75] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry. METHODS A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models. RESULTS A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos. CONCLUSION These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.
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Felten MK, Knoll L, Eisenhawer C, Ackermann D, Khatab K, Hüdepohl J, Zschiesche W, Kraus T. Retrospective exposure assessment to airborne asbestos among power industry workers. J Occup Med Toxicol 2010; 5:15. [PMID: 20579364 PMCID: PMC2901364 DOI: 10.1186/1745-6673-5-15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 06/25/2010] [Indexed: 11/16/2022] Open
Abstract
Background A method of individually assessing former exposure to asbestos fibres is a precondition of risk-differentiated health surveillance. The main aims of our study were to assess former levels of airborne asbestos exposure in the power industry in Germany and to propose a basic strategy for health surveillance and the early detection of asbestos related diseases. Methods Between March 2002 and the end of 2006, we conducted a retrospective questionnaire based survey of occupational tasks and exposures with airborne asbestos fibres in a cohort of 8632 formerly asbestos exposed power industry workers. The data on exposure and occupation were entered into a specially designed computer programme, based on ambient monitoring of airborne asbestos fibre concentrations. The cumulative asbestos exposure was expressed as the product of the eight-hour time weighted average and the total duration of exposure in fibre years (fibres/cubic centimetre-years). Results Data of 7775 (90% of the total) participants working in installations for power generation, power distribution or gas supply could be evaluated. The power generation group (n = 5284) had a mean age of 56 years, were exposed for 20 years and had an average cumulative asbestos exposure of 42 fibre years. The occupational group of "metalworkers" (n = 1600) had the highest mean value of 79 fibre years. The corresponding results for the power distribution group (n = 2491) were a mean age of 45 years, a mean exposure duration of 12 years and an average cumulative asbestos exposure of only 2.5 fibre years. The gas supply workers (n = 512) had a mean age of 54 years and a mean duration of exposure of 15 years. Conclusions While the surveyed cohort as a whole was heavily exposed to asbestos dust, the power distribution group had a mean cumulative exposure of only 6% of that found in the power generation group. Based on the presented data, risk-differentiated disease surveillance focusing on metalworkers and electricians from the power generating industry seems justified. That combined with a sensitive examination technique would allow detecting asbestos related diseases early and efficiently.
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Affiliation(s)
- Michael K Felten
- Institute of Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
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Épidémiologie et traçabilité des expositions professionnelles à des substances chimiques cancérogènes. ARCH MAL PROF ENVIRO 2010. [DOI: 10.1016/j.admp.2010.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kishimoto T, Gemba K, Fujimoto N, Onishi K, Usami I, Mizuhashi K, Kimura K. Clinical study of asbestos-related lung cancer in Japan with special reference to occupational history. Cancer Sci 2010; 101:1194-8. [PMID: 20331622 PMCID: PMC11158610 DOI: 10.1111/j.1349-7006.2010.01509.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A total of 152 patients with asbestos-related lung cancer recognized by the criteria of Japanese compensation law for asbestos-related diseases were examined and compared with 431 patients with non-asbestos-related lung cancer. Male comprised 96% of patients. Ages ranged from 50 to 91 years with a median of 72 years. Eighty-nine percent were smokers or ex-smokers. Almost all patients had occupational histories of asbestos exposure. The median duration of asbestos exposure was 31 years and the median latency period was 47 years. Thirty-four percent of patients exhibited asbestosis and 81% exhibited pleural plaques by radiography. Regarding asbestos particles in the lung for 73 operated or autopsied patients, 62% had more than 5,000 particles per gram. On the other hand, 100% of non-asbestos-related lung cancer patients had <5000 particles per gram with a median of 554 particles. The number of asbestos bodies in the lung, male gender, absence of symptoms, smoking index, and early stage of cancer were significantly much more than those of non-asbestos-related lung cancer. In this study, a diagnosis of asbestos-related lung cancer was made in 34% of patients by asbestosis, in 62% by presence of both pleural plaques and more than 10 years' occupational asbestos exposure, and in 4% by more than 5000 asbestos particles per gram of lung tissue. Occupational histories, duration of asbestos exposure, and pleural plaques are common categories for the recognition of asbestos-related lung cancer in Japan.
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Cancer mortality in a surveillance cohort of German males formerly exposed to asbestos. Int J Hyg Environ Health 2010; 213:44-51. [DOI: 10.1016/j.ijheh.2009.09.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 08/18/2009] [Accepted: 09/09/2009] [Indexed: 11/20/2022]
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Wild P, Andrieu N, Goldstein AM, Schill W. Flexible Two-Phase studies for rare exposures: Feasibility, planning and efficiency issues of a new variant. EPIDEMIOLOGIC PERSPECTIVES & INNOVATIONS : EP+I 2008; 5:4. [PMID: 18828892 PMCID: PMC2602593 DOI: 10.1186/1742-5573-5-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 10/01/2008] [Indexed: 11/30/2022]
Abstract
The two-phase design consists of an initial (Phase One) study with known disease status and inexpensive covariate information. Within this initial study one selects a subsample on which to collect detailed covariate data. Two-phase studies have been shown to be efficient compared to standard case-control designs. However, potential problems arise if one cannot assure minimum sample sizes in the rarest categories or if recontact of subjects is difficult. In the case of a rare exposure with an inexpensive proxy, the authors propose the flexible two-phase design for which there is a single time of contact, at which a decision about full covariate ascertainment is made based on the proxy. Subjects are screened until the desired numbers of cases and controls have been selected for full data collection. Strategies for optimizing the cost/efficiency of this design and corresponding software are presented. The design is applied to two examples from occupational and genetic epidemiology. By ensuring minimum numbers for the rarest disease-covariate combination(s), we obtain considerable efficiency gains over standard two-phase studies with an improved practical feasibility. The flexible two-phase design may be the design of choice in the case of well targeted studies of the effect of rare exposures with an inexpensive proxy.
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Affiliation(s)
- Pascal Wild
- INRS, French National Institute for Research and Safety, Department of Epidemiology, France.
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Schill W, Wild P, Pigeot I. A planning tool for two-phase case-control studies. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2007; 88:175-81. [PMID: 17869374 DOI: 10.1016/j.cmpb.2007.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 08/06/2007] [Accepted: 08/06/2007] [Indexed: 05/17/2023]
Abstract
We present a software tool for planning two-phase case-control studies assuming categorical covariates. Two-phase designs, in which validation or complete information data are sampled stratified both on a dichotomous outcome and a covariate from a first-phase study with incomplete data, result in efficient estimates compared to standard designs. Efficiency and power depend on sample size, sampling fractions within each stratum x outcome cell, distributional assumptions and the regression model. Our software, called Two-Phase Planning Tool (or 2P Planning Tool), offers a graphical user interface (GUI) to organize and input the relevant anticipated entities and calculates a normed, expected two-phase case-control study. The 2P Planning Tool is especially helpful in selecting a stratification. The data are output into an Excel-sheet, which in turn can be read into a standard statistics package to perform "experimental" power calculations. Its use is illustrated by an example from epidemiology. Software for analyzing logistic two-phase studies is also provided.
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Affiliation(s)
- Walter Schill
- Bremer Institut für Präventionsforschung und Sozialmedizin, Linzer Str. 10, D-28359 Bremen, Germany.
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Gibbs A, Attanoos RL, Churg A, Weill H. The "Helsinki criteria" for attribution of lung cancer to asbestos exposure: how robust are the criteria? Arch Pathol Lab Med 2007; 131:181-3. [PMID: 17284100 DOI: 10.5858/2007-131-181-thcfao] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2006] [Indexed: 11/06/2022]
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Wellmann J, Weiland SK, Neiteler G, Klein G, Straif K. Cancer mortality in German carbon black workers 1976-98. Occup Environ Med 2006; 63:513-21. [PMID: 16497850 PMCID: PMC2078133 DOI: 10.1136/oem.2006.026526] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have investigated cancer risks in carbon black workers and the findings were inconclusive. METHODS The current study explores the mortality of a cohort of 1535 male German blue-collar workers employed at a carbon black manufacturing plant for at least one year between 1960 and 1998. Vital status and causes of death were assessed for the period 1976-98. Occupational histories and information on smoking were abstracted from company records. Standardised mortality ratios (SMR) and Poisson regression models were calculated. RESULTS The SMRs for all cause mortality (observed deaths (obs) 332, SMR 120, 95% CI 108 to 134), and mortality from lung cancer (obs 50, SMR 218, 95% CI 161 to 287) were increased using national rates as reference. Comparisons to regional rates from the federal state gave SMRs of 120 (95% CI 107 to 133) and 183 (95% CI 136 to 241), respectively. However, there was no apparent dose response relationship between lung cancer mortality and several indicators of occupational exposure, including years of employment and carbon black exposure. CONCLUSIONS The mortality from lung cancer among German carbon black workers was increased. The high lung cancer SMR can not fully be explained by selection, smoking, or other occupational risk factors, but the results also provide little evidence for an effect of carbon black exposure.
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Affiliation(s)
- J Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
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Schill W, Wild P. Minmax designs for planning the second phase in a two-phase case–control study. Stat Med 2006; 25:1646-59. [PMID: 16158403 DOI: 10.1002/sim.2307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Two-phase designs, in which a subsample with validation or complete information data is sampled stratified both on outcome and covariate from a first-phase study with incomplete data, have been proposed over 10 years ago and have been proven to result in efficient estimates with respect to standard designs. The efficiency depends, however, on the sampling fractions within each stratum. Our aim is to present a strategy for obtaining an optimized design, i.e. sampling fractions, that makes use of available phase-one data of an existing case-control study considered as the first-phase sample when the focus is on estimating a parameter vector. No global optimal design exists and local optimal designs depend on scenarios comprising the true disease model and the association between the phase-one and phase-two information. We develop an admissibility test that rejects scenarios inconsistent with the phase-one data and, for the selected scenarios, determine a minmax D- or A-optimal design that protects against worst-case scenarios. This work is applied on two examples.
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Affiliation(s)
- W Schill
- Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS) und Institut für Statistik, Universität Bremen, Germany.
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Henderson DW, Rödelsperger K, Woitowitz HJ, Leigh J. After Helsinki: a multidisciplinary review of the relationship between asbestos exposure and lung cancer, with emphasis on studies published during 1997-2004. Pathology 2005; 36:517-50. [PMID: 15841689 DOI: 10.1080/00313020400010955] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite an extensive literature, the relationship between asbestos exposure and lung cancer remains the subject of controversy, related to the fact that most asbestos-associated lung cancers occur in those who are also cigarette smokers: because smoking represents the strongest identifiable lung cancer risk factor among many others, and lung cancer is not uncommon across industrialised societies, analysis of the combined (synergistic) effects of smoking and asbestos on lung cancer risk is a more complex exercise than the relationship between asbestos inhalation and mesothelioma. As a follow-on from previous reviews of prevailing evidence, this review critically evaluates more recent studies on this relationship--concentrating on those published between 1997 and 2004--including lung cancer to mesothelioma ratios, the interactive effects of cigarette smoke and asbestos in combination, and the cumulative exposure model for lung cancer induction as set forth in The Helsinki Criteria and The AWARD Criteria (as opposed to the asbestosis-->cancer model), together with discussion of differential genetic susceptibility/resistance factors for lung carcinogenesis by both cigarette smoke and asbestos. The authors conclude that: (i) the prevailing evidence strongly supports the cumulative exposure model; (ii) the criteria for probabilistic attribution of lung cancer to mixed asbestos exposures as a consequence of the production and end-use of asbestos-containing products such as insulation and asbestos-cement building materials--as embodied in The Helsinki and AWARD Criteria--conform to, and are further consolidated by, the new evidence discussed in this review; (iii) different attribution criteria (e.g., greater cumulative exposures) are appropriate for chrysotile mining/milling and perhaps for other chrysotile-only exposures, such as friction products manufacture, than for amphibole-only exposures or mixed asbestos exposures; and (iv) emerging evidence on genetic susceptibility/resistance factors for lung cancer risk as a consequence of cigarette smoking, and potentially also asbestos exposure, suggests that genotypic variation may represent an additional confounding factor potentially affecting the strength of association and hence the probability of causal contribution in the individual subject, but at present there is insufficient evidence to draw any meaningful conclusions concerning variation in asbestos-mediated lung cancer risk relative to such resistance/susceptibility factors.
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Affiliation(s)
- Douglas W Henderson
- Department of Anatomical Pathology, Flinders University and Flinders Medical Centre, Bedford Park, Adelaide, South Australia.
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Tyczynski JE, Bray F, Parkin DM. Lung cancer in Europe in 2000: epidemiology, prevention, and early detection. Lancet Oncol 2003; 4:45-55. [PMID: 12517539 DOI: 10.1016/s1470-2045(03)00960-4] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Lung cancer is the most common cancer in the world. In men, the highest incidence rates are seen in Europe (especially eastern Europe) and North America. In women, high incidence rates are found in North America and in Europe, particularly in northern and western Europe. It is estimated that there were about 375000 cases of lung cancer in Europe in 2000; 303000 in men and 72000 in women. The number of resulting deaths was about 347000 (280000 in men and 67000 in women). Tobacco smoking is well established as the main cause of lung cancer and about 90% of cases are thought to be tobacco related. There is a clear dose-response relation between lung-cancer risk and the number of cigarettes smoked per day, degree of inhalation, and age at initiation of smoking. Someone who has smoked all their life has a lung-cancer risk 20-30 times greater than a non-smoker. However, risk of lung cancer decreases with time since smoking cessation. Recently, there has been renewed interest in screening because spiral computerised tomography can detect small asymptomatic lesions more effectively than conventional radiography. Although cure rates for such lesions are very good, there is to date no evidence for effectiveness of mass-screening strategies.
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Affiliation(s)
- Jerzy E Tyczynski
- Unit of Descriptive Epidemiology, International Agency for Research on Cancer, Lyon, France.
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