PMID: 9654639Jul 9, 1998Paper

Difficulties in assessing the relationship between passive smoking and lung cancer

Statistical Methods in Medical Research
P N Lee

Abstract

Since 1981, numerous epidemiological studies have investigated the relationship between passive smoking and lung cancer in nonsmokers. The overall evidence, predominantly relating to women, indicates a weak association with the husband's smoking and many reviewers have concluded that this demonstrates a causal effect of exposure to environmental tobacco smoke (ETS). Interpreting weak associations is notoriously difficult, however, and this paper reviews problems specific to the ETS-lung cancer relationship. After describing how to select relevant studies and appropriate data, the methods for combining evidence together ('meta-analysis') are discussed, and the need to investigate sources of heterogeneity is emphasized. Separate consideration is given to various forms of bias that may affect overall relative risk estimates, including misclassification of active smoking status, confounding, systematic case-control differences, recall bias, diagnostic bias and publication bias. Sections on dose-response, multiple ETS exposure sources and other issues follow. The problems are illustrated from the available literature. It is shown there is no significant association of lung cancer with workplace, childhood or social ETS exposure or w...Continue Reading

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Citations

Dec 21, 2000·Current Oncology Reports·P G Shields
Apr 15, 1999·Journal of the National Cancer Institute·P N Lee
Nov 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M S Litwin, K A McGuigan
Oct 4, 2002·Oncogene·Peter G Shields
Nov 25, 1998·Journal of the National Cancer Institute·P N Lee
Jul 9, 2011·International Journal of Epidemiology·George C M Siontis, John P A Ioannidis
Sep 17, 2009·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Jonathan M SametCharles M Rudin

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