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Liu G, Mukherjee B, Lee S, Lee AW, Wu AH, Bandera EV, Jensen A, Rossing MA, Moysich KB, Chang-Claude J, Doherty JA, Gentry-Maharaj A, Kiemeney L, Gayther SA, Modugno F, Massuger L, Goode EL, Fridley BL, Terry KL, Cramer DW, Ramus SJ, Anton-Culver H, Ziogas A, Tyrer JP, Schildkraut JM, Kjaer SK, Webb PM, Ness RB, Menon U, Berchuck A, Pharoah PD, Risch H, Pearce CL. Robust Tests for Additive Gene-Environment Interaction in Case-Control Studies Using Gene-Environment Independence. Am J Epidemiol 2018; 187:366-377. [PMID: 28633381 PMCID: PMC5860584 DOI: 10.1093/aje/kwx243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 05/24/2017] [Accepted: 06/02/2017] [Indexed: 12/20/2022] Open
Abstract
There have been recent proposals advocating the use of additive gene-environment interaction instead of the widely used multiplicative scale, as a more relevant public health measure. Using gene-environment independence enhances statistical power for testing multiplicative interaction in case-control studies. However, under departure from this assumption, substantial bias in the estimates and inflated type I error in the corresponding tests can occur. In this paper, we extend the empirical Bayes (EB) approach previously developed for multiplicative interaction, which trades off between bias and efficiency in a data-adaptive way, to the additive scale. An EB estimator of the relative excess risk due to interaction is derived, and the corresponding Wald test is proposed with a general regression setting under a retrospective likelihood framework. We study the impact of gene-environment association on the resultant test with case-control data. Our simulation studies suggest that the EB approach uses the gene-environment independence assumption in a data-adaptive way and provides a gain in power compared with the standard logistic regression analysis and better control of type I error when compared with the analysis assuming gene-environment independence. We illustrate the methods with data from the Ovarian Cancer Association Consortium.
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Affiliation(s)
- Gang Liu
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Seunggeun Lee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Alice W Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elisa V Bandera
- Cancer Prevention and Control Research Program, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer A Doherty
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Women’s Cancer, Institute for Women’s Health, University College London, London, United Kingdom
| | - Lambertus Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Leon Massuger
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ellen L Goode
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | | | - Kathryn L Terry
- Obstetrics and Gynecology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Daniel W Cramer
- Obstetrics and Gynecology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
- Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Hoda Anton-Culver
- Genetic Epidemiology Research Institute, Center for Cancer Genetics Research and Prevention, School of Medicine, University of California, Irvine, Irvine, California
| | - Argyrios Ziogas
- Genetic Epidemiology Research Institute, Center for Cancer Genetics Research and Prevention, School of Medicine, University of California, Irvine, Irvine, California
| | - Jonathan P Tyrer
- Strangeways Research Laboratory, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joellen M Schildkraut
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Roberta B Ness
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas, Houston, Texas
| | - Usha Menon
- Gynaecological Cancer Research Centre, Women’s Cancer, Institute for Women’s Health, University College London, London, United Kingdom
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
| | - Paul D Pharoah
- Strangeways Research Laboratory, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Center for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Harvey Risch
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut
| | - Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Terry KL, Babic A, Karlan BY, Goodman MT, Lambrechts D, Heitz F, Matsuo K, McNeish I, Pejovic T, Kjaer SK, Webb PM, Hogdall E, Goode EL, Cramer DW. Abstract AS13: Epidemiologic predictors of pre-treatment CA125 in women with ovarian cancer. Clin Cancer Res 2015. [DOI: 10.1158/1557-3265.ovcasymp14-as13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CA125 is elevated in 80% of ovarian cancer cases and has proven utility in assessing response to therapy and prognosis. Unfortunately, CA125 is elevated in a variety of benign conditions and only in 50% of early stage ovarian cancers, resulting in a sensitivity and specificity unacceptable for population-based screening. Therefore, understanding factors that influence CA125 at presentation could provide important insights for interpreting CA125 values.
Methods: Using pre-treatment CA125 and detailed epidemiologic data from 12 studies participating in the Ovarian Cancer Association Consortium (OCAC), we evaluated factors previously reported to influence CA125 levels, including age, race, oral contraceptive use, parity, tubal ligation, endometriosis, body mass index (BMI), personal history of breast cancer, or a family history of breast or ovarian cancer. We used linear regression to estimate the association between each variable and CA125 probit scores, which we used to standardize values between studies. Secondary analyses included adjustment for histologic subtype. We also estimated the associations within each study using log-transformed CA125 as the outcome and estimated summary measures using random effects meta-analyses.
Results: Of the 4417 cases included in the analysis, 2918 (66%) were serous, 227 (5%) were mucinous, 484 (11%) were endometrioid, and 258 (6%) were clear cell carcinomas. Median CA125 values varied between studies with a high of 831 U/mL and a low of 271 U/mL. We observed no association between race, oral contraceptive use, tubal ligation, endometriosis, prior breast cancer, and family history of breast cancer and pre-treatment CA125. However, we observed increased pre-treatment CA125 levels with older age (>70 vs. < 50, p=0.03), parity (p=0.01), number of children (p=0.02), obesity (BMI>30 vs. 21-25, p=0.03), and family history of ovarian cancer (p=0.05). Results were similar but attenuated when we calculated summary estimates of the association using meta-analysis of study specific estimates of the association with log-transformed CA125 rather than probit scores. Age and BMI remained predictive of pre-treatment CA125 values after adjustment for histologic subtype. Our data are limited by between site variability in CA125 assays; therefore, validation of these findings is needed with adjustment for type of assay used or in a study population in which all cases had pre-treatment CA125 values measured with the same assay.
Conclusions: Despite these limitations, results from this analysis of over 4000 ovarian cancer cases suggest that age and body size may influence pre-treatment CA125 values.
Citation Format: KL Terry, A Babic, BY Karlan, MT Goodman, D Lambrechts, F Heitz, K Matsuo, I McNeish, T Pejovic, S Kruger Kjaer, PM Webb, E Hogdall, EL Goode, DW Cramer, for the Ovarian Cancer Association Consortium. Epidemiologic predictors of pre-treatment CA125 in women with ovarian cancer [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr AS13.
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Affiliation(s)
- KL Terry
- 1Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,
- 2Harvard School of Public Health, Boston, MA, USA,
| | - A Babic
- 2Harvard School of Public Health, Boston, MA, USA,
| | - BY Karlan
- 3Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
| | - MT Goodman
- 3Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
| | - D Lambrechts
- 4Vesalius Research Center, VIB, KU Leuven, Leuven, Belgium,
| | - F Heitz
- 5Dr. Horst Schmidt KlinikWiesbaden, Wiesbaden, Germany,
| | - K Matsuo
- 6Aichi Cancer Center Research Institute, Nagoya 464–8681, Japan,
| | - I McNeish
- 7Barts Cancer Institute, Queen Mary, University of London, London, England,
| | - T Pejovic
- 8Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA,
| | - S Kruger Kjaer
- 9Copenhagen University Hospital, Rigshospitalet, Denmark,
| | - PM Webb
- 10QIMR Berghofer Institute of Medical Research, Brisbane, Australia,
| | - E Hogdall
- 11Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,
| | - EL Goode
- 12Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - DW Cramer
- 1Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,
- 2Harvard School of Public Health, Boston, MA, USA,
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