Methodological biases in estimating the relationship between alcohol consumption and breast cancer: the role of drinker misclassification errors in meta-analytic results.
Methodological biases in estimating the relationship between alcohol consumption and breast cancer: the role of drinker misclassification errors in meta-analytic results.
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DOI：
10.1111/acer.12479
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Chikritzhs T
中科院分区：
文献类型：
--
作者：
Zeisser C;Stockwell TR;Chikritzhs T
虽然饮酒与女性患乳腺癌有关，但很少有研究能够控制因将曾经饮酒者或偶尔饮酒者纳入戒酒参照组而可能产生的偏见。我们探讨了在估计酒精与乳腺癌的关系时，这种误分类错误作为偏倚来源的可能性。对人群病例对照、医院病例对照和队列研究进行荟萃分析，以检查存在和不存在不同分类错误的研究组中酒精使用水平与乳腺癌发病率和/或死亡率之间的关系。在鉴定的60项研究中，只有6项没有所有误分类错误。不饮酒者参照组有49项研究纳入了前饮酒者，22项研究纳入了偶尔饮酒者（每周酒精含量<10g）， 18项研究纳入了这两组。在21项研究中，偶尔饮酒者也与轻度饮酒者或危险饮酒者混合在一起。在前饮酒者（n= 11）中，乳腺癌的无偏估计OR为1.011 (95% CI: 0.891-1.148)，在偶尔饮酒者（n=17）中，OR为1.034 （95% CI: 1.003-1.064）。在偶尔饮酒者偏倚的研究中，危险饮酒水平（20g<41g乙醇/天）与乳腺癌无显著关联。然而，在没有偶尔饮酒者偏见的研究中，低水平饮酒者（<21g/天）乳腺癌的OR为1.085 (95% CI: 1.015-1.160) (n=17)，危险水平饮酒者（n=26）乳腺癌的OR为1.374 (95% CI: 1.319-1.431)，有害水平饮酒者（n=9）乳腺癌的OR为1.336 （95% CI: 1.228-1.454）。虽然绝大多数关于酒精与乳腺癌之间关系的研究都存在分类错误，但只有偶尔饮酒者的分类错误才会显著影响风险估计。基于无差错研究的估计证实，低水平、危险水平和有害水平的酒精使用都会显著增加患乳腺癌的风险。
While alcohol consumption has been linked to breast cancer in women, few studies have controlled for possible biases created by including former or occasional drinkers in the abstainer reference group. We explored the potential for such misclassification errors as sources of bias in estimates of the alcohol-breast cancer relationship. Meta-analyses of population case-control, hospital case-control, and cohort studies to examine relationships between level of alcohol use and breast cancer morbidity and/or mortality in groups of studies with and without different misclassification errors. Of 60 studies identified, only 6 were free of all misclassification errors. The abstainer reference group was biased by the inclusion of former drinkers in 49 studies, occasional drinkers (<10g ethanol per week) in 22 and by both these groups in 18. Occasional drinkers were also mixed with light or hazardous level drinkers in 21 studies. Unbiased estimates of the OR for breast cancer were 1.011 (95% CI: 0.891-1.148) among former drinkers (n = 11) and 1.034 (95% CI: 1.003-1.064) among occasional drinkers (n=17). Hazardous level drinking (>20g<41g ethanol/day) was not significantly associated with breast cancer in studies with occasional drinker bias. However, in studies free from occasional drinker bias, the OR for breast cancer was 1.085 (95% CI: 1.015-1.160) for low level (<21g/day) drinkers (n=17), 1.374 (95% CI: 1.319-1.431) for hazardous level drinkers (n=26) and 1.336 (95% CI: 1.228-1.454) for harmful level (>40g/day) drinkers (n=9). While the great majority of studies of the alcohol-breast cancer link include misclassification errors, only misclassification of occasional drinkers was found to bias risk estimates significantly. Estimates based on error free studies confirmed that low, hazardous and harmful levels of alcohol use each significantly increase the risk of breast cancer.
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影响因子：
8.8
作者：
Beral, V;Hamajima, N;Hirose, K;Rohan, T;Calle, EE;Heath, CW;Coates, RJ;Liff, JM;Talamini, R;Chantarakul, N;Koetsawang, S;Rachawat, D;Morabia, A;Schuman, L;Stewart, W;Szklo, M;Bain, C;Schofield, F;Siskind, V;Band, P;Coldman, AJ;Gallagher, RP;Hislop, TG;Yang, P;Kolonel, LM;Nomura, AMY;Hu, J;Johnson, KC;Mao, Y;De Sanjose, S;Lee, N;Marchbanks, P;Ory, HW;Peterson, HB;Wilson, HG;Wingo, PA;Ebeling, K;Kunde, D;Nishan, P;Hopper, JL;Colditz, G;Gajalakshmi, V;Martin, N;Pardthaisong, T;Solpisornkosol, S;Theetranont, C;Boosiri, B;Chutivongse, S;Jimakorn, P;Virutamasen, P;Wongsrichanalai, C;Ewertz, M;Adami, HO;Bergkvist, L;Magnusson, C;Persson, I;Chang-Claude, J;Paul, C;Skegg, DCG;Spears, GFS;Boyle, P;Evstifeeva, T;Daling, JR;Hutchinson, WB;Malone, K;Noonan, EA;Stanford, JL;Thomas, DB;Weiss, NS;White, E;Andrieu, N;Brêmond, A;Clavel, F;Gairard, B;Lansac, J;Piana, L;Renaud, R;Izquierdo, A;Viladiu, P;Cuevas, HR;Ontiveros, P;Palet, A;Salazar, SB;Arsitizabal, N;Cuadros, A;Tryggvadottir, L;Tulinius, H;Bachelot, A;Lê, MG;Peto, J;Franceschi, S;Lubin, F;Modan, B;Ron, E;Wax, Y;Friedman, GD;Hiatt, RA;Levi, F;Bishop, T;Kosmelj, K;Primic-Zakelj, M;Ravnihar, B;Stare, J;Beeson, WL;Fraser, G;Bulbrook, RD;Cuzick, J;Duffy, SW;Fentiman, IS;Hayward, JL;Wang, DY;McMichael, AJ;McPherson, K;Hanson, RL;Leske, MC;Mahoney, MC;Nasca, PC;Varma, AO;Weinstein, AL;Moller, TR;Olsson, H;Ranstam, J;Goldbohm, RA;van den Brandt, PA;Apelo, RA;Baens, J;de la Cruz, JR;Javier, B;Lacaya, LB;Ngelangel, CA;La Vecchia, C;Negri, E;Marubini, E;Ferraroni, M;Gerber, M;Richardson, S;Segala, C;Gatei, D;Kenya, P;Kungu, A;Mati, JG;Brinton, LA;Hoover, R;Schairer, C;Spirtas, R;Lee, HP;Rookus, MA;van Leeuwen, FE;Schoenberg, JA;McCredie, M;Gammon, MD;Clarke, EA;Jones, L;Neil, A;Vessey, M;Yeates, D;Appleby, P;Banks, E;Bull, D;Crossley, B;Goodill, A;Green, J;Hermon, C;Key, T;Langston, N;Lewis, C;Reeves, G;Collins, R;Doll, R;Peto, R;Mabuchi, K;Preston, D;Hannaford, P;Kay, C;Rosero-Bixby, L;Gao, YT;Jin, F;Yuan, JM;Wei, HY;Yun, T;Zhiheng, C;Berry, G;Cooper Booth, J;Jelihovsky, T;MacLennan, R;Shearman, R;Wang, QS;Baines, CJ;Miller, AB;Wall, C;Lund, E;Stalsberg, H;Shu, XO;Zheng, W;Katsouyanni, K;Trichopoulou, A;Trichopoulos, D;Dabancens, A;Martinez, L;Molina, R;Salas, O;Alexander, XE;Anderson, K;Folsom, AR;Hulka, BS;Bernstein, L;Enger, S;Haile, RW;Paganini-Hill, A;Pike, MC;Ross, RK;Ursin, G;Yu, MC;Longnecker, MP;Newcomb, P;Bergkvist, L;Kalache, A;Farley, TMM;Holck, S;Meirik, O
通讯作者：
Meirik, O
影响因子：
6
作者：
Fillmore, KM;Golding, JM;Ferrer, HP
通讯作者：
Ferrer, HP
影响因子：
3.8
作者：
Brown, Linda Morris;Gridley, Gloria;Wu, Anna H.;Falk, Roni T.;Hauptmann, Michael;Kolonel, Laurence N.;West, Dee W.;Nomura, Abraham M. Y.;Pike, Malcolm C.;Hoover, Robert N.;Ziegler, Regina G.
通讯作者：
Ziegler, Regina G.
影响因子：
5
作者：
Ellison, RC;Zhang, YQ;Rothman, KJ
通讯作者：
Rothman, KJ
影响因子：
2.4
作者：
Nagata, Chisato;Mizoue, Tetsuya;Tsugane, Shoichiro
通讯作者：
Tsugane, Shoichiro