Difficulties in assessing the relationship between passive smoking and lung cancer

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Publicado en:Statistical Methods in Medical Research vol. 7, no. 2 (Feb 1998), p. 137
Autor principal: Lee, P N
Publicado:
Sage Publications Ltd.
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Acceso en línea:Citation/Abstract
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100 1 |a Lee, P N 
245 1 |a Difficulties in assessing the relationship between passive smoking and lung cancer 
260 |b Sage Publications Ltd.  |c Feb 1998 
513 |a Journal Article 
520 3 |a 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 with smoking by the wife. Though statistically significant, the association with husband's smoking is weak and heterogeneous and varies widely according to various study characteristics. The association is markedly weakened by the adjustment for smoking misclassification bias and is likely to be affected by confounding and other sources of bias. While the precise extent of all the biases remains unclear, it seems impossible to conclude with any certainty that ETS causes lung cancer. 
650 2 2 |a Adult 
650 2 2 |a Aged 
650 2 2 |a Data Interpretation, Statistical 
650 2 2 |a Epidemiologic Factors 
650 1 2 |a Epidemiologic Methods 
650 2 2 |a Female 
650 2 2 |a Humans 
650 1 2 |a Lung Neoplasms  |x epidemiology 
650 2 2 |a Male 
650 2 2 |a Middle Aged 
650 2 2 |a Research Design 
650 2 2 |a Risk 
650 1 2 |a Tobacco Smoke Pollution  |x adverse effects 
653 |a Lung cancer 
653 |a Recall 
653 |a Tobacco smoke 
653 |a Smoking 
653 |a Passive smoking 
653 |a Meta-analysis 
653 |a Risk factors 
653 |a Associations 
653 |a Adjustment 
653 |a Childhood 
653 |a Women 
653 |a Workplaces 
653 |a Tobacco 
653 |a Response bias 
653 |a Nonsmokers 
653 |a Husbands 
653 |a Epidemiology 
653 |a Spouses 
653 |a Cancer 
653 |a Uncertainty 
653 |a Causality 
653 |a Bias 
653 |a Literary criticism 
653 |a Literary characters 
773 0 |t Statistical Methods in Medical Research  |g vol. 7, no. 2 (Feb 1998), p. 137 
786 0 |d ProQuest  |t Science Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/217694213/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/217694213/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch