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01.11.2010 | Cancer | Ausgabe 11/2010

European Journal of Epidemiology 11/2010

Attributable risk in men in two French case-control studies on mesothelioma and asbestos

Zeitschrift:
European Journal of Epidemiology > Ausgabe 11/2010
Autoren:
Aude Lacourt, Patrick Rolland, Céline Gramond, Philippe Astoul, Soizick Chamming’s, Stéphane Ducamp, Catherine Frenay, Françoise Galateau-Sallé, Anabelle Gilg Soit Ilg, Ellen Imbernon, Nolwenn Le Stang, Jean Claude Pairon, Marcel Goldberg, Yuriko Iwatsubo, Louis-Rachid Salmi, Patrick Brochard

Abstract

Pleural mesothelioma is a primary tumor of the pleura that is mainly due to asbestos exposure. To study the relationship between mesothelioma and occupational asbestos exposure in France, two case–control studies (A and B) were conducted. A substantial difference in the attributable risk in the population (ARp) was observed among men: 44.5% (95% CI: [32.6–56.4]) in study A and 83.2% (95% CI: [76.8–89.6]) in study B. As different exposure assessment expert methods were used, the main objective of this work was to re-estimate the ARp men in two case–control studies according to a common standardized exposure assessment by using a Job Exposure Matrix (JEM) and to assess the role of subjects’ selection. The initial observed ARp difference was maintained: 36.3% (95% CI: [24.3–50.3]) in study A and 69.7% (95% CI: [51.7–83.2]) in study B. Further investigations highlighted the potential selection bias introduced in both studies, especially among controls. The ARp could be underestimated in study A and overestimated in study B. After weighting subjects according to distribution of socio-economic status in the general population for controls and according to distribution of socio-economic status of cases registered by the French National Mesothelioma Surveillance Program, re-estimated ARp values were 52.4% in study A and 70.2% in study B. These results provide additional information to describe the relationship between pleural mesothelioma and occupational asbestos exposure, but also confirm the importance of subjects’ recruitment in case control studies, particularly control selection.

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