Reevaluation of mortality risks from nasopharyngeal cancer in the formaldehyde cohort study of the National Cancer Institute

Marsh, Gary M.; Youk, Ada O.

doi:10.1016/j.yrtph.2005.05.003

Cited by 48 publications

(44 citation statements)

References 24 publications

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“…Follow-up of an expanded cohort of workers from plant 1 of the NCI cohort study yielded an SMR of 4.4 (95% CI, 1.8-9.1) based on 7 NPC cases (41). The elevated SMR in plant 1 of the NCI study was observed despite the fact that no uniquely dangerous characteristics of formaldehyde exposure have been documented in that facility (34). Furthermore, 3 of 7 workers with NPC had formaldehyde exposure of duration 3 months or fewer, and a fourth had formaldehyde exposure of duration 8 months (33).…”

Section: Appendixmentioning

confidence: 90%

“…Formaldehyde was originally placed in category 1 on the basis of evidence of increased nasopharyngeal cancer (NPC) risk, primarily on the basis of a single NCI cohort study of industrial workers with occupational formaldehyde exposure (35). As has been noted previously, however, all of the evidence of increased NPC risk in this study came from only 1 of the 10 plants included in the study (31,33,34). The standardized mortality ratio (SMR) for formaldehyde-exposed workers in plant 1 in the NCI study is 9.1 [95% confidence interval (CI), 3.3-19.8] based on 6 cases.…”

Section: Appendixmentioning

confidence: 96%

“…The interpretation of epidemiologic evidence is particularly problematic for formaldehyde (31,33,34). Formaldehyde was originally placed in category 1 on the basis of evidence of increased nasopharyngeal cancer (NPC) risk, primarily on the basis of a single NCI cohort study of industrial workers with occupational formaldehyde exposure (35).…”

Section: Appendixmentioning

confidence: 99%

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False Positives in Cancer Epidemiology

McLaughlin¹,

Tarone²

2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: A recent attempt to estimate the false-positive rate for cancer epidemiology studies is based on agents in International Agency for Research on Cancer (IARC) category 3 (agent not classifiable as to its carcinogenicity to humans) in the IARC Monographs Program.Methods: The estimation method is critiqued regarding biases caused by its reliance on the IARC classification criteria for assessing carcinogenic potential.Results: The privileged position given to epidemiologic studies by the IARC criteria ensures that the percentage of positive epidemiologic studies for an agent will depend strongly on the IARC category to which the agent is assigned. Because IARC category 3 is composed of agents with the lowest-assessed carcinogenic potential to which the estimation approach in question could be applied, a spuriously low estimated falsepositive rate was necessarily the outcome of this approach.Conclusions: Tendentious estimation approaches like that employed will by necessity produce spuriously low and misleading false positive rates.Impact: The recently reported estimates of the false-positive rate in cancer epidemiology are seriously biased and contribute nothing substantive to the literature on the very real problems related to false-positive findings in epidemiology. Cancer Epidemiol Biomarkers Prev; 22(1); 11-15. Ó2012 AACR.

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Section: Appendixmentioning

confidence: 90%

Section: Appendixmentioning

confidence: 96%

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False Positives in Cancer Epidemiology

McLaughlin¹,

Tarone²

2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…A metaanalysis of 47 available studies a decade ago did not support a causal association between formaldehyde and NPC risk (218), but a more recent evaluation by the IARC did find sufficient evidence of carcinogenicity (219). The study population most extensively examined for a relationship between formaldehyde exposure and NPC is a historical cohort of >25,000 workers employed before 1966 in 10 U.S. facilities that produced or used formaldehyde (220)(221)(222)(223)(224)(225)(226)(227)(228). Compared with the general U.S. population, these workers experienced a significant excess of NPC mortality (220,223), with significant dose-response trends according to estimated peak exposure and cumulative exposure to formaldehyde, but not average intensity or duration of exposure (223).…”

Section: Risk Factorsmentioning

confidence: 99%

The Enigmatic Epidemiology of Nasopharyngeal Carcinoma

Chang

Adami

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

1,160

1,009

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Nasopharyngeal carcinoma (NPC) has a unique and complex etiology that is not completely understood. Although NPC is rare in most populations, it is a leading form of cancer in a few well-defined populations, including natives of southern China, Southeast Asia, the Arctic, and the Middle East/North Africa. The distinctive racial/ethnic and geographic distribution of NPC worldwide suggests that both environmental factors and genetic traits contribute to its development. This review aims to summarize the current knowledge regarding the epidemiology of NPC and to propose new avenues of research that could help illuminate the causes and ultimately the prevention of this remarkable disease. Well-established risk factors for NPC include elevated antibody titers against the Epstein-Barr virus, consumption of salt-preserved fish, a family history of NPC, and certain human leukocyte antigen class I genotypes. Consumption of other preserved foods, tobacco smoking, and a history of chronic respiratory tract conditions may be associated with elevated NPC risk, whereas consumption of fresh fruits and vegetables and other human leukocyte antigen genotypes may be associated with decreased risk. Evidence for a causal role of various inhalants, herbal medicines, and occupational exposures is inconsistent. Other than dietary modification, no concrete preventive measures for NPC exist. Given the unresolved gaps in understanding of NPC, there is a clear need for large-scale, populationbased molecular epidemiologic studies to elucidate how environmental, viral, and genetic factors interact in both the development and the prevention of this disease. PurposeIntriguing hallmarks of nasopharyngeal carcinoma (NPC) include its striking racial/ethnic and geographic variation, as well as its multifactorial etiology involving the interplay of environmental, viral, and genetic risk factors. The precise roles of these factors in the development of NPC, however, remain unknown. The purpose of this review is to highlight what is understood about the epidemiology of NPC, as well as to present unresolved research questions that call for large-scale molecular epidemiologic studies of NPC to illuminate the underlying causes of this fascinating disease. Review MethodsA thorough review of the literature related to the etiology of NPC was undertaken, starting with a Medline search from 1966 onward. Additional papers, book sections, and monographs were identified through examination of reference lists. Because this review aims to present the epidemiologic evidence in a range of topic areas, rather than to calculate overall estimates of effect, formal quantitative methods were not used. All relevant papers have been cited to provide a comprehensive summary of the evidence. Inclusion or exclusion criteria were not applied to individual reports, but the strength, consistency, and relevance of the findings were considered in weighing the evidence.Descriptive Epidemiology

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“…Cigarette smoking, occupational exposure to smoke, chemical fumes, wood dust, formaldehyde and exposure to radiation are other purported risk factors (Yu et al, 1990;Armstrong et al, 2000;Hildesheim et al, 2001). Although formaldehyde has been classified as a carcinogen and linked with NPC, this has been challenged by some investigators (Marsh & Youk, 2005;Marsh et al, 2007).…”

Section: Environmental Factorsmentioning

confidence: 99%