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American Journal of Epidemiology Advance Access originally published online on April 19, 2006
American Journal of Epidemiology 2006 163(11):1053-1064; doi:10.1093/aje/kwj127
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Practice of Epidemiology

Methods for Pooling Results of Epidemiologic Studies

The Pooling Project of Prospective Studies of Diet and Cancer

Stephanie A. Smith-Warner1,2, Donna Spiegelman2,3, John Ritz2,3, Demetrius Albanes4, W. Lawrence Beeson5, Leslie Bernstein6, Franco Berrino7, Piet A. van den Brandt8, Julie E. Buring2,9, Eunyoung Cho10, Graham A. Colditz2,10,11, Aaron R. Folsom12, Jo L. Freudenheim13, Edward Giovannucci1,2,10, R. Alexandra Goldbohm14, Saxon Graham13, Lisa Harnack12, Pamela L. Horn-Ross15, Vittorio Krogh7, Michael F. Leitzmann16, Marjorie L. McCullough17, Anthony B. Miller18, Carmen Rodriguez17, Thomas E. Rohan19, Arthur Schatzkin16, Roy Shore20, Mikko Virtanen21, Walter C. Willett1,2,10, Alicja Wolk22, Anne Zeleniuch-Jacquotte20, Shumin M. Zhang2,9 and David J. Hunter1,2,10,11

1 Department of Nutrition, Harvard School of Public Health, Boston, MA
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA
3 Department of Biostatistics, Harvard School of Public Health, Boston, MA
4 Nutritional Epidemiology Branch, National Cancer Institute, Bethesda, MD
5 Center for Health Research, School of Medicine, Loma Linda University, Loma Linda, CA
6 Department of Preventive Medicine and USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
7 Epidemiology Unit, National Cancer Institute, Milan, Italy
8 Department of Epidemiology, Faculty of Health Sciences, Maastricht University, Maastricht, the Netherlands
9 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
10 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
11 Harvard Center for Cancer Prevention, Boston, MA
12 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
13 Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY
14 Department of Epidemiology, TNO Quality of Life, Zeist, the Netherlands
15 Northern California Cancer Center, Fremont, CA
16 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
17 Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
18 Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
19 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
20 Department of Environmental Medicine, School of Medicine, New York University, New York, NY
21 Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
22 Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden

Correspondence to Dr. Stephanie Smith-Warner, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (e-mail: pooling{at}hsphsun2.harvard.edu).

With the growing number of epidemiologic publications on the relation between dietary factors and cancer risk, pooled analyses that summarize results from multiple studies are becoming more common. Here, the authors describe the methods being used to summarize data on diet-cancer associations within the ongoing Pooling Project of Prospective Studies of Diet and Cancer, begun in 1991. In the Pooling Project, the primary data from prospective cohort studies meeting prespecified inclusion criteria are analyzed using standardized criteria for modeling of exposure, confounding, and outcome variables. In addition to evaluating main exposure-disease associations, analyses are also conducted to evaluate whether exposure-disease associations are modified by other dietary and nondietary factors or vary among population subgroups or particular cancer subtypes. Study-specific relative risks are calculated using the Cox proportional hazards model and then pooled using a random- or mixed-effects model. The study-specific estimates are weighted by the inverse of their variances in forming summary estimates. Most of the methods used in the Pooling Project may be adapted for examining associations with dietary and nondietary factors in pooled analyses of case-control studies or case-control and cohort studies combined.

cohort studies; diet; epidemiologic methods; meta-analysis; neoplasms


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