American Journal of Epidemiology Vol. 122, No. 5: 904-914
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
ESTIMATING THE POPULATION ATTRIBUTABLE RISK FOR MULTIPLE RISK FACTORS USING CASE-CONTROL DATA
1Istituto Scientifico Tumori Genova, Italy
2Biometry Branch, National Cancer Institute, National Institutes of Health Bethesda, MD 20205
4Environmental Epidemiology Branch, National Cancer Institute NIH, Bethesda, MD
Rprint requests to Dr.David P.Byar
A straightforward and unified approach is presented for the calculation of the population attributable risk per cent (etiologic fraction) in the general muftivariate setting, with emphasis on using data from case-control studies. The summary attributable risk for multiple factors can be estimated, with or without adjustment for other (confounding) risk factors. The relation of this approach to procedures in the literature is discussed. Given values of the relative risks for various combinations of factors, all that is required is the distribution of these factors among the cases only. The required information can often be estimated solely from case-control data, and in some situations relative risk estimates from one population can be applied to calculation of attributable risk for another population. The authors emphasize the benefits to be obtained from logistic regression models, so that risks need not be estimated separately in a large number of strata, some of which may contain inadequate numbers of individuals. This approach allows incorporation of important interactions between factors, but does not require that all possible interactions be included. The approach is illustrated with data on four risk factors from a pair-matched case-control study of participants in a multicenter breast cancer screening project.
breast neoplasms; epidemiologic methods; risk; statistics
3Present address: Section on Medical Statistics, National Eye Institute, NIH, Bethesda, MD.
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C. A. McCarty, B. N. Mukesh, C. L. Fu, P. Mitchell, J. J. Wang, and H. R. Taylor Risk Factors for Age-Related Maculopathy: The Visual Impairment Project Arch Ophthalmol, October 1, 2001; 119(10): 1455 - 1462. [Abstract] [Full Text] [PDF]
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C. Luxemburger, R. McGready, A. Kham, L. Morison, T. Cho, T. Chongsuphajaisiddhi, N. J. White, and F. Nosten Effects of Malaria during Pregnancy on Infant Mortality in an Area of Low Malaria Transmission Am. J. Epidemiol., September 1, 2001; 154(5): 459 - 465. [Abstract] [Full Text] [PDF]
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Y. Mao, J. Hu, A.-M. Ugnat, R. Semenciw, and S. Fincham Socioeconomic status and lung cancer risk in Canada Int. J. Epidemiol., August 1, 2001; 30(4): 809 - 817. [Abstract] [Full Text] [PDF]
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J A Hanley A heuristic approach to the formulas for population attributable fraction J Epidemiol Community Health, July 1, 2001; 55(7): 508 - 514. [Abstract] [Full Text] [PDF]
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C. B. PEDERSEN and P. B. MORTENSEN Family history, place and season of birth as risk factors for schizophrenia in Denmark: a replication and reanalysis The British Journal of Psychiatry, July 1, 2001; 179(1): 46 - 52. [Abstract] [Full Text] [PDF]
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 G. E. Eide and I. Heuch Attributable fractions: fundamental concepts and their visualization Statistical Methods in Medical Research, June 1, 2001; 10(3): 159 - 193. [Abstract] [PDF]
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J. Benichou A review of adjusted estimators of attributable risk Statistical Methods in Medical Research, June 1, 2001; 10(3): 195 - 216. [Abstract] [PDF]
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W Uter and A Pfahlberg The application of methods to quantify attributable risk in medical practice Statistical Methods in Medical Research, June 1, 2001; 10(3): 231 - 237. [Abstract] [PDF]
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D. R. Urbach, L. D. Marrett, R. Kung, and M. M. Cohen Association of Perforation of the Appendix with Female Tubal Infertility Am. J. Epidemiol., March 15, 2001; 153(6): 566 - 571. [Abstract] [Full Text] [PDF]
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A. Koch, M. Melbye, P. Sorensen, P. Homoe, H. O. Madsen, K. Molbak, C. H. Hansen, L. H. Andersen, G. W. Hahn, and P. Garred Acute Respiratory Tract Infections and Mannose-Binding Lectin Insufficiency During Early Childhood JAMA, March 14, 2001; 285(10): 1316 - 1321. [Abstract] [Full Text] [PDF]
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A. Yokoyama, T. Muramatsu, T. Omori, T. Yokoyama, S. Matsushita, S. Higuchi, K. Maruyama, and H. Ishii Alcohol and aldehyde dehydrogenase gene polymorphisms and oropharyngolaryngeal, esophageal and stomach cancers in Japanese alcoholics Carcinogenesis, March 1, 2001; 22(3): 433 - 439. [Abstract] [Full Text] [PDF]
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M. Belfiglio, G. De Berardis, M. Franciosi, D. Cavaliere, B. Di Nardo, S. Greenfield, S. H. Kaplan, F. Pellegrini, M. Sacco, G. Tognoni, et al. The Relationship Between Physicians' Self-Reported Target Fasting Blood Glucose Levels and Metabolic Control in Type 2 Diabetes: The QuED Study Group--Quality of care and outcomes in type 2 diabetes Diabetes Care, March 1, 2001; 24(3): 423 - 429. [Abstract] [Full Text]
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 J Todd, K Munguti, H Grosskurth, J Mngara, J Changalucha, P Mayaud, F Mosha, A Gavyole, D Mabey, and R Hayes Risk factors for active syphilis and TPHA seroconversion in a rural African population Sex Transm Inf, February 1, 2001; 77(1): 37 - 45. [Abstract] [Full Text] [PDF]
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L. Morris Brown, R. Hoover, D. Silverman, D. Baris, R. Hayes, G. M. Swanson, J. Schoenberg, R. Greenberg, J. Liff, A. Schwartz, et al. Excess Incidence of Squamous Cell Esophageal Cancer among US Black Men: Role of Social Class and Other Risk Factors Am. J. Epidemiol., January 15, 2001; 153(2): 114 - 122. [Abstract] [Full Text] [PDF]
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E. B Claus Risk models in genetic epidemiology Statistical Methods in Medical Research, December 1, 2000; 9(6): 589 - 601. [Abstract] [PDF]
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A. W. Hsing, J. Deng, I. A. Sesterhenn, F. K. Mostofi, F. Z. Stanczyk, J. Benichou, T. Xie, and Y.-T. Gao Body Size and Prostate Cancer: A Population-based Case-Control Study in China Cancer Epidemiol. Biomarkers Prev., December 1, 2000; 9(12): 1335 - 1341. [Abstract] [Full Text]
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 C. A. McCarty, M. B. Nanjan, and H. R. Taylor Attributable Risk Estimates for Cataract to Prioritize Medical and Public Health Action Invest. Ophthalmol. Vis. Sci., November 1, 2000; 41(12): 3720 - 3725. [Abstract] [Full Text]
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R. Q. Ivers, R. Norton, R. G. Cumming, M. Butler, and A. J. Campbell Visual Impairment and Hip Fracture Am. J. Epidemiol., October 1, 2000; 152(7): 633 - 639. [Abstract] [Full Text] [PDF]
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A. M. Malarcher, J. Schulman, L. A. Epstein, M. J. Thun, P. Mowery, B. Pierce, L. Escobedo, and G. A. Giovino Methodological Issues in Estimating Smoking-attributable Mortality in the United States Am. J. Epidemiol., September 15, 2000; 152(6): 573 - 584. [Abstract] [Full Text] [PDF]
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B. L. Herwaldt, K. R. de Arroyave, J. M. Roberts, and D. D. Juranek A Multiyear Prospective Study of the Risk Factors for and Incidence of Diarrheal Illness in a Cohort of Peace Corps Volunteers in Guatemala Ann Intern Med, June 20, 2000; 132(12): 982 - 988. [Abstract] [Full Text] [PDF]
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 D. G. PENDRYS RISK OF ENAMEL FLUOROSIS IN NONFLUORIDATED AND OPTIMALLY FLUORIDATED POPULATIONS: CONSIDERATIONS FOR THE DENTAL PROFESSIONAL J Am Dent Assoc, June 1, 2000; 131(6): 746 - 755. [Abstract] [Full Text] [PDF]
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 M.-E. Parent, J. Siemiatycki, and L. Fritschi Workplace exposures and oesophageal cancer Occup. Environ. Med., May 1, 2000; 57(5): 325 - 334. [Abstract] [Full Text] [PDF]
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