Is opium a real risk factor for esophageal cancer or just a methodological artifact? Hospital and neighborhood controls in case-control studies.
Is opium a real risk factor for esophageal cancer or just a methodological artifact? Hospital and neighborhood controls in case-control studies.
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DOI：
10.1371/journal.pone.0032711
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Majdzadeh R
中科院分区：
文献类型：
--
作者：
Shakeri R;Kamangar F;Nasrollahzadeh D;Nouraie M;Khademi H;Etemadi A;Islami F;Marjani H;Fahimi S;Sepehr A;Rahmati A;Abnet CC;Dawsey SM;Brennan P;Boffetta P;Malekzadeh R;Majdzadeh R
对照选择是流行病学病例对照研究的主要挑战。我们研究的目的是评估使用医院对照组与社区对照组来研究食管鳞状细胞癌（ESCC）的危险因素。我们比较了同一研究小组在同一地区进行的两项不同的 ESCC 病例对照研究的结果。两项研究中的病例定义和入组相同，但对照选择不同。在第一项研究中，我们从医院的住院受试者中选择了两名年龄和性别匹配的对照，而在第二项研究中，我们从每个受试者的居住社区中选择了两名年龄和性别匹配的对照。我们使用异质性检验来比较两项研究的结果。我们发现烟草相关变量的暴露数据没有显着差异，例如吸烟、咀嚼纳斯（一种烟草产品）和水烟（水烟）的使用，但鸦片使用频率在医院和社区对照之间存在显着差异。因此，各项研究之间得出的食管鳞癌与烟草使用之间的关联的推论没有差异，但鸦片使用却存在差异。在使用邻里对照的研究中，鸦片使用与 ESCC 风险显着增加相关（调整后 OR 1.77，95% CI 1.17–2.68），而在使用医院对照的研究中，情况并非如此（OR 1.09，95% CI 0.63–1.87）。比较两个对照组和来自同一地理区域的队列的鸦片消费流行率表明，邻里对照更能代表这种接触的研究基础人群。对于该人群中食管鳞癌的主要假设危险因素，医院和社区控制并未使我们得出相同的结论。我们的结果表明，对照组的选择对于在观察性研究中得出适当的结论至关重要。
Control selection is a major challenge in epidemiologic case-control studies. The aim of our study was to evaluate using hospital versus neighborhood control groups in studying risk factors of esophageal squamous cell carcinoma (ESCC). We compared the results of two different case-control studies of ESCC conducted in the same region by a single research group. Case definition and enrollment were the same in the two studies, but control selection differed. In the first study, we selected two age- and sex-matched controls from inpatient subjects in hospitals, while for the second we selected two age- and sex-matched controls from each subject's neighborhood of residence. We used the test of heterogeneity to compare the results of the two studies. We found no significant differences in exposure data for tobacco-related variables such as cigarette smoking, chewing Nass (a tobacco product) and hookah (water pipe) usage, but the frequency of opium usage was significantly different between hospital and neighborhood controls. Consequently, the inference drawn for the association between ESCC and tobacco use did not differ between the studies, but it did for opium use. In the study using neighborhood controls, opium use was associated with a significantly increased risk of ESCC (adjusted OR 1.77, 95% CI 1.17–2.68), while in the study using hospital controls, this was not the case (OR 1.09, 95% CI 0.63–1.87). Comparing the prevalence of opium consumption in the two control groups and a cohort enrolled from the same geographic area suggested that the neighborhood controls were more representative of the study base population for this exposure. Hospital and neighborhood controls did not lead us to the same conclusion for a major hypothesized risk factor for ESCC in this population. Our results show that control group selection is critical in drawing appropriate conclusions in observational studies.
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影响因子：
5
作者：
Freedman, Neal D.;Abnet, Christian C.;Schatzkin, Arthur
通讯作者：
Schatzkin, Arthur
影响因子：
--
作者：
Sorensen, LT;Hernmingsen, UB;Jorgensen, LN
通讯作者：
Jorgensen, LN
影响因子：
2
作者：
Majdzadeh, Reza;Feiz-Zadeh, Ali;Ghadirian, Parviz
通讯作者：
Ghadirian, Parviz
影响因子：
6.4
作者：
Carman S;Kamangar F;Freedman ND;Wright ME;Dawsey SM;Dixon LB;Subar A;Schatzkin A;Abnet CC
通讯作者：
Abnet CC
影响因子：
5
作者：
Infante-Rivard, C
通讯作者：
Infante-Rivard, C