Exposure to Beryllium and Occurrence of Lung Cancer: A Reexamination of Findings From a Nested Case–Control Study
Exposure to Beryllium and Occurrence of Lung Cancer: A Reexamination of Findings From a Nested Case–Control Study
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铍接触与肺癌的发生：对巢式病例对照研究结果的重新检验
DOI：
10.1097/jom.0b013e31802db595
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发表时间：
2007
影响因子：
3.2
通讯作者：
A. Caban
中科院分区：
文献类型：
--
作者：
Judith A. Ricci;Elsbeth Chee;A. Lorandeau;Jan Berger;Michael T. Halpern;R. Dirani;J. Schmier;Theodore Darkow;Pamela J. Kadlubek;Hemal Shah;Amy L. Phillips;JenQ P. Marton;Bert Stover;Thomas M. Wickizer;Fred Zimmerman;;Kehoe;Gary M. Franklin;Philip Harber;Lori Crawford;Amarpreet Cheema;Levanto Schacter;Patricia W. Stone;Yunling Du;D. Margison;Douglas J. French;M. Kivimäki;T. Heponiemi;Marko;Elovainio;M. Virtanen;J. Pentti;A. Linna;J. Vahtera;Lora E. Fleming;W. LeBlanc;A. Caban
目的：我们的目的是对一项铍与肺癌的巢式病例对照研究进行重新分析，因为我们发现了一些分析和研究设计方面的问题，这些问题可能导致该研究中获得的比值比升高。
方法：我们使用未转换的暴露指标而非发表文献中使用的对数转换指标对数据进行了重新分析。我们确定并检验了由对照选择方法导致的病例与对照之间的不平衡对估计比值比的影响。
结果：这次重新分析发现任何暴露变量都没有升高的比值比。
结论：我们的结论与作者的解释不同，作者认为研究结果是由于铍暴露与肺癌之间存在因果关系。我们的另一种解释是，这些结果可能是由于方法学问题导致的，而通过使对照与病例更紧密匹配本可以控制这些问题。
临床意义：这项研究对一项关于铍 - 肺癌关联的大型病例对照研究得出的结论提出了质疑。职业医学从业者可能希望将这项研究的结果纳入他们给担心患肺癌的铍暴露工人的建议中。
Objective: Our aim was to reanalyze a nested case–control study of beryllium and lung cancer because we identified analysis and study design issues that could have led to the elevated odds ratios obtained in the study. Methods: We reanalyzed the data using nontransformed exposure metrics instead of log-transformed metrics used in the publication. We identified and examined effects on estimated odds ratios of imbalances between cases and controls caused by the control selection method. Results: This reanalysis found no elevated odds ratios for any exposure variable. Conclusions: Our conclusions differ from the authors’ interpretation that the findings are due to a causal relationship between beryllium exposure and lung cancer. Our alternative explanation is that they may be due to methodological problems that could have been controlled by closer matching of controls to cases. Clinical Significance: This study challenges conclusions made from a large case–control study concerning beryllium–lung cancer associations. Occupational medicine practitioners may want to integrate findings from this study into advice they give beryllium-exposed workers concerned about lung cancer.