Estimating the Population Attributable Risk for Multiple Risk Factors Using Case-Control Data

Bruzzi, Paolo; Green, Sylvan B.; Byar, David P.; Brinton, Louise A.; Schairer, Catherine

doi:10.1093/oxfordjournals.aje.a114174

Cited by 1,105 publications

(780 citation statements)

References 15 publications

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“…In terms of population attributable risk (Bruzzi et al, 1985;Mezzetti et al, 1996), on the theoretical assumption that all women could be shifted to the lowest BMI level, 19.6% of all postmenopausal breast cancer cases and 27.1% of those above age 70 years in this population were attributable to being overweight and obese. This has relevant implications on an individual risk assessment and on a public health scale for weight control in elderly women.…”

Section: Discussionmentioning

confidence: 98%

Body mass index and post-menopausal breast cancer: an age-specific analysis

Vecchia

Negri²,

Franceschi³

et al. 1997

Br J Cancer

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Summary The relationship between body mass index (BMI, Quetelet's index, kg m-2) and post-menopausal breast cancer risk was considered in age-specific strata on the basis of a pooled analysis of three Italian case-control studies, including a total of 3108 postmenopausal breast cancer patients aged 50 years or over and 2664 control subjects. Overall, there was a moderate, but significant, association between BMI and post-menopausal breast cancer: the odds ratios (ORs) were around 1.3 for the three intermediate quintiles compared with the lowest one, and 1.4 for the highest one. The association was moderate among women aged 50-59 years and 60-69 years, with ORs around 1.3 for the highest BMI quintiles, but stronger among elderly women, with ORs of 1.6 for the fourth and 2.1 for the fifth quintile. An 8-unit increase in BMI involved an OR of 1.18 at age 50-59 years, of 1.14 at age 60-69 years and of 1.59 above age 70 years. This pattern of risk is similar to that observed for post-menopausal hormone replacement treatment and is consistent with a duration-risk relationship in the exposure to high oestrogen levels and with a greater differential in oestrogen levels in overweight elderly women. In terms of population attributable risk, 19.6% of all post-menopausal breast cancer patients and 27.1% of those in women above age 70 years were attributable to overweight and obesity in this population. This has, therefore, major preventive implications as to reduce breast cancer risk late in life, it is essentially important to control weight gain in elderly women.

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Section: Discussionmentioning

confidence: 98%

Body mass index and post-menopausal breast cancer: an age-specific analysis

Vecchia

Negri²,

Franceschi³

et al. 1997

Br J Cancer

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“…All regression models were matched on age and study centre, and included terms for education (o7, 7 -o12, X12 years), body mass index (in quintiles), alcohol consumption (in quintiles: for oral/pharyngeal cancer, cut points were 10, 22.5, 37.75, 61 glasses per week, and for oesophageal cancer were 8, 22.5, 35.5, 59 glasses per week, plus a term for ex-drinkers), smoking habits (never, ex, current smokers of o15, 15 -o25, X25 cigarettes per day) and nonalcohol energy intake (in quintiles). Population attributable risks (PAR) were derived from multivariate ORs, using the method described by Bruzzi et al (1985) and Mezzetti et al (1996). Table 1 shows various demographic, lifestyle and dietary characteristics among 634 male cases of oral-pharyngeal cancer and 1252 controls, and 351 male cases of oesophageal cancer and 875 controls.…”

Section: Methodsmentioning

confidence: 99%

Role of fried foods and oral/pharyngeal and oesophageal cancers

et al. 2005

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We investigated the role of fried foods on oral-pharyngeal and oesophageal cancers, using data from two case -control studies conducted in Italy and Switzerland between 1992 and 1999, one with a total of 749 (634 men) cases of oral/pharyngeal cancer and 1772 (1252 men) controls, the other with 395 (351 men) cases of oesophageal cancer and 1066 (875 men) controls. Controls were admitted for acute, non-neoplastic conditions, unrelated to alcohol and smoking consumption. After allowance for sex, age, centre, education, body mass index, tobacco smoking, alcohol drinking and nonalcohol energy intake, the multivariate odds ratios (ORs) for an increment of one portion per week of total fried foods were 1.11 (95% confidence interval (CI): 1.05 -1.17) for oral-pharyngeal and 1.16 (95% CI: 1.08 -1.26) for oesophageal cancer. The ORs were consistent across strata of gender (OR in men only were 1.10 and 1.16, respectively), age, alcohol, tobacco consumption and body mass index.

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“…These OR and their variance covariance matrix were used to calculate values for SI and their 95% CI. 10 In addition, the proportion of esophageal cancer cases attributable to one or all risk factors considered (population attributable risk percent; PAR%) and corresponding 95% CI were calculated according to the Bruzzi et al 11 and Benichou et al methods. 12 This method provides adjusted PAR% estimates by combining adjusted OR estimates and the observed prevalence of the risk factor among case patients.…”

Section: Statistical Analysesmentioning

confidence: 99%

Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

Lee

et al. 2004

Intl Journal of Cancer

211

175

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A multicenter case-control study was conducted in northern and southern Taiwan to clarify the independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer. A total of 513 patients with newly diagnosed and histopathologically confirmed squamous cell carcinoma of the esophagus and 818 gender, age and study hospitalmatched controls were included. We found a significant doseresponse relationship between the duration and intensity of consumption of the 3 substances and the development of this neoplasm in this site. Although the amount of alcohol consumed had a stronger effect on the risk of esophageal cancer than the number of years it was consumed, however, the number of years one smoked had a stronger effect on the risk than the amount of cigarettes consumed. The strongest risk factor of esophageal cancer was alcohol intake, with highest risk (OR ‫؍‬ 13.9) being for those who consumed more than 900 g/day-year. Combined exposure to any 2 of 3 substances brought the risks up to 8.8 -19.7 fold and, to all 3 substances, to 41.2-fold. A multiplicative interaction effect for alcohol drinkers who smoked on cancer risk was detected, whereas an additive interaction effect was found among drinkers who chewed. The combined effect of all 3 substances accounted for 83.7% of the attributable fraction of contracting esophageal cancer in this population. In conclusion, these results suggest that the intensity and the length of time alcohol and tobacco are used play different roles in the etiology of esophageal cancer. Alcohol separately interacts with tobacco and betel quid in a differently synergistic way in determining the development of this site of cancer.

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Estimating the Population Attributable Risk for Multiple Risk Factors Using Case-Control Data

Cited by 1,105 publications

References 15 publications

Body mass index and post-menopausal breast cancer: an age-specific analysis

Body mass index and post-menopausal breast cancer: an age-specific analysis

Role of fried foods and oral/pharyngeal and oesophageal cancers

Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan

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