On the Discrepancy Between Epidemiologic Studies in Individuals of Lung Cancer and Residential Radon and Cohen's Ecologic Regression
On the Discrepancy Between Epidemiologic Studies in Individuals of Lung Cancer and Residential Radon and Cohen's Ecologic Regression
复制标题
肺癌个体流行病学研究与住宅氡气与科恩生态回归的差异
作者：
J. Lubin
在辐射影响界，对生态分析的固有局限性仍有很大的困惑。因此，过度关注科恩的不一致结果，其中观察到县肺癌死亡率对估计县氡水平的回归的负估计。本文证明，科恩的生态分析不能产生有效的推论，对个人的风险反应关系，除非肺癌的危险因素（吸烟，年龄，职业等）。对个人来说，在统计上与县内的室内氡水平无关，或者除非氡和其他因素的风险效应是加性的。这两个假设在文献中都是相互矛盾的。因此，与通常的假设相反，当线性无阈值模型是个人氡风险的真实模型时，一个县的较高平均氡浓度并不一定意味着该县的较高肺癌率。此外，从县级生态分析和消除生态偏见的有效推断不能实现与县范围内的汇总变量（包括“分层”变量）的回归方程。使用假设的数据吸烟和氡，并假设一个真正的正相关氡和肺癌的个人，分析表明，一个负的县级生态回归时，可以诱导县内吸烟和氡的相关系数在0.05至0.05的范围内。由于氡在低暴露下的不利影响得到了矿工数据分析（所有数据和数据仅限于低累积暴露）、室内氡研究荟萃分析以及分子和细胞研究的支持，并且由于生态回归受到严重限制，科恩分析的负面结果很可能是由于偏见造成的，应予以拒绝。
There is still substantial confusion in the radiation effects community about the inherent limitations of ecologic analysis. As a result, inordinate attention has been given to the discrepant results of Cohen, in which a negative estimate is observed for the regression of county mortality rates for lung cancer on estimated county radon levels. This paper demonstrates that Cohen's ecologic analysis cannot produce valid inference on the exposure-response relationship for individuals unless lung cancer risk factors (smoking, age, occupation, etc.) for individuals are statistically uncorrelated with indoor radon level within counties or unless risk effects for radon and other factors are additive. Both of these assumptions are contradicted in the literature. Thus, contrary to common assumption, when a linear no-threshold model is the true model for radon risk for individuals, higher average radon concentration for a county does not necessarily imply a higher lung cancer rate for the county. In addition, valid inference from county-level ecologic analysis and the elimination of the ecologic bias cannot be achieved with the addition of county-wide summary variables (including “stratification” variables) to the regression equation. Using hypothetical data for smoking and radon and assuming a true positive association for radon and lung cancer for individuals, the analysis demonstrates that a negative county-level ecologic regression can be induced when correlation coefficients for smoking and radon within county are in the range 0.05 to 0.05. Since adverse effects for radon at low exposures are supported by analysis of miner data (all data and data restricted only to low cumulative exposures), a meta-analysis of indoor radon studies, and molecular and cellular studies, and since ecologic regressions are burdened by severe limitations, the negative results from Cohen's analysis are most likely due to bias and should be rejected.
影响因子：
5
作者：
Stidley,CA;Samet,JM
通讯作者：
Samet,JM
DOI：
10.1093/jnci/87.11.817
发表时间：
1995-06-07
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
LUBIN, JH;BOICE, JD;PIERCE, DA
通讯作者：
PIERCE, DA