Is residual confounding a reasonable explanation for the apparent protective effects of beta-carotene found in epidemiologic studies of lung cancer in smokers?
Is residual confounding a reasonable explanation for the apparent protective effects of beta-carotene found in epidemiologic studies of lung cancer in smokers?
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对于吸烟者肺癌流行病学研究中发现的β-胡萝卜素的明显保护作用，残余混杂因素是否是合理的解释？
DOI：
10.1093/aje/155.7.622
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发表时间：
2002
影响因子：
5
通讯作者：
Wu,AnnaH
中科院分区：
文献类型：
--
作者：
Stram,DanielO;Huberman,Mark;Wu,AnnaH
三项关于补充β-胡萝卜素预防吸烟者肺癌的随机试验的结果与大量流行病学证据相矛盾，这些证据表明，较高摄入量和/或较高血清β-胡萝卜素水平的吸烟者患肺癌的风险降低。使这一问题复杂化的是，人们广泛注意到烟草使用与β-胡萝卜素摄入量或血清水平之间存在负相关。虽然观察性研究试图控制报告的吸烟史，但自我报告的吸烟的准确性是不确定的;报告和真实吸烟暴露之间的相关性低至0.5与香烟暴露生物标志物的研究并不矛盾。作者开发了一个简单的统计模型，用于报告吸烟（相对于真实烟草暴露）的随机误差，并假设真实烟草暴露与血清β-胡萝卜素之间存在适度（反向）关系。根据该模型的计算，结合Doll和Peto（J Epidemiol Community Health 1978;78：303-13）所考虑的肺癌模型，表明低β-胡萝卜素摄入量与高β-胡萝卜素摄入量吸烟者之间吸烟暴露评估的偏差可能合理地解释了高β-胡萝卜素水平的大部分或全部观察到的保护作用。需要利用吸烟生物标志物对吸烟者进行适当的肺癌队列研究，目前正在进行中。
The results of three randomized trials of beta-carotene supplementation for the prevention of lung cancer among smokers are in contradiction to a large body of epidemiologic evidence for the reduction of risk of lung cancer among smokers with higher intake and/or higher serum levels of beta-carotene. Complicating this issue are widely noted negative associations between tobacco use and intake or serum levels of beta-carotene. Although observational studies attempt to control for reported smoking histories, the accuracy of self-reported smoking is uncertain; correlations as low as 0.5 between reported and true smoking exposure are not inconsistent with studies of biomarkers of cigarette exposure. The authors developed a simple statistical model for random errors in reported smoking (relative to true tobacco exposure) and assumed a modest (inverse) relation between true tobacco exposure and serum beta-carotene. Calculations from this model, combined with a model for lung cancer contemplated by Doll and Peto (J Epidemiol Community Health 1978;78:303–13), suggest that biases in assessment of smoking exposure between smokers with low versus high beta-carotene intake may plausibly explain much or all of the observed protective effect of high beta-carotene levels. Appropriate cohort studies of lung cancer in smokers, utilizing biomarkers of smoking, are needed and are presently ongoing.
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影响因子：
5
作者：
J. R. Marshall;J. Hastrup
通讯作者：
J. Hastrup
影响因子：
5
作者：
STRYKER, WS;KAPLAN, LA;WILLETT, WC
通讯作者：
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影响因子：
10.3
作者：
Feskanich, D;Ziegler, RG;Colditz, GA
通讯作者：
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DOI：
10.1016/0021-9681(87)90105-6
发表时间：
1987
期刊：
Journal of chronic diseases
影响因子：
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作者：
J. Pierce;T. Dwyer;E. Digiusto;T. Carpenter;C. Hannam;A. Amin;C. Yong;G. Sarfaty;J. Shaw;N. Burke
通讯作者：
N. Burke
影响因子：
12.7
作者：
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通讯作者：
KINNE, S