MISCLASSIFICATION BIAS RELATED TO DEFINITION OF MENOPAUSAL STATUS IN CASE-CONTROL STUDIES OF BREAST-CANCER
MISCLASSIFICATION BIAS RELATED TO DEFINITION OF MENOPAUSAL STATUS IN CASE-CONTROL STUDIES OF BREAST-CANCER
复制标题
DOI：
10.1093/ije/21.2.222
复制
发表时间：
1992-04-01
影响因子：
7.7
通讯作者：
FLANDRE, P
中科院分区：
文献类型：
--
作者：
MORABIA, A;FLANDRE, P
人们通常认为，生育史的某些特征与绝经前或绝经后发病的乳腺癌有特殊关系，但并未得到一致的观察。为了确定不一致的报告是否可能是由于对更年期的定义不同，我们计算了乳腺癌未生育的相对优势(RO)。分别在绝经前和绝经后妇女中，使用七种不同的绝经定义，研究初产年龄、乳腺癌家族史和良性乳腺疾病病史。结果表明：(I)乳腺癌的相对风险及其可信区间可能因更年期的定义而异；(Ii)基于年龄的更年期定义与病例和对照之间的中度差异错误分类偏差有关：(Iii)当绝经状态的截止日期为最后一次月经后10年或更长时间时，未生育、首次生育年龄较晚和乳腺癌家族史似乎是绝经前但不是绝经后乳腺癌的特定危险因素；(Iv)当没有月经史的信息时，50岁可能是所有基于月经的更年期定义的最佳替代。我们得出结论，绝经状态在乳腺癌与某些生殖因素的关联中的影响的不一致结果部分是由于统计学上的不精确和与不同的基于年龄或月经的绝经定义相关的差异性错误分类偏向。研究人员应该要么使用几种对更年期的定义来测试他们的结论是否成立，要么就是。研究人员要么使用几种更年期定义来检验他们的结论是否成立，要么给出选择一个给定的更年期定义的生物学理由。
It is often assumed, but has not been consistently observed, that some characteristics of reproductive history are specifically related to breast cancer of pre- or postmenopausal onset. To determine whether inconsistent reports may be due to differences in definition of menopause, we computed the relative odds (RO) of breast cancer for nulliparity. age at first live birth, family history of breast cancer and prior history of benign breast disease, separately in pre- and postmenopausal women, using seven different definitions of menopause. Results show that (i) relative odds of breast cancer and their confidence intervals may vary according to definitions of menopause; (ii) age-based definitions of menopause are associated with moderate differential misclassification bias between cases and controls: (iii) nulliparity, late age at first birth and family history of breast cancer seem to be specific risk factors for pre- but not postmenopausal breast cancer when cutoff for menopausal status is 10 years or more after last menses; and (iv) when information on menstrual history is not available, 50 years of age may be the best proxy for all menses-based definitions of menopause. We conclude that inconsistent findings on the effect of menopausal status in the association of breast cancer with some reproductive factors are partly due to statistical imprecision and differential misclassification bias associated with different age-based or menses-based definitions of menopause. Researchers should either test whether their conclusions hold using several definitions of menopause or. Researchers should either test whether their conclusions hold using several definitions of menopause or give a biological rationale for the choice of a given definition of menopause.