Cigarette Smoking and Lung Cancer

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1、CentersforDiseaseControlandPreventionEpidemiologyProgramOfficeCaseStudiesinAppliedEpidemiologyNo.731-703CigaretteSmokingandLungCancerStudent'sGuideLearningObjectivesAftercompletingthiscasestudy,theparticipantshouldbeableto:GDiscusstheelementsofstudydesign,andtheadvantagesanddisadvantagesofc

2、ase-controlversusprospectivecohortstudies;GDiscusssomeofthebiasesthatmighthaveaffectedthesestudies;GCalculatearateratio,ratedifference,oddsratio,andattributableriskpercent;GInterpreteachmeasureanddescribeeachmeasure'smainuse;andGReviewthecriteriaforcausation.Thiscasestudyisbasedontheclassic

3、studiesbyDollandHillthatdemonstratedarelationshipbetweensmokingandlungcancer.TwocasestudiesweredevelopedbyClarkHeath,GodfreyOakley,DavidErickson,andHowardOryin1973.ThetwocasestudieswerecombinedintooneandsubstantiallyrevisedandupdatedbyNancyBinkinandRichardDickerin1990.Currentversionupdatedb

4、yRichardDickerwithinputfromJulieMagriandthe2003EISSummerCourseinstructors.U.S.DEPARTMENTOFHEALTHANDHUMANSERVICESPublicHealthServiceCDC/EISSummerCourse2003:SmokingandLungCa-Student'sGuidePage2Acausalrelationshipbetweencigarettesmokingovera4-yearperiod(April1948-Februaryandlungcancerwasfirsts

5、uspectedinthe1920s1952).Initially,20hospitals,andlatermore,onthebasisofclinicalobservations.Totestthiswereaskedtonotifytheinvestigatorsofallapparentassociation,numerousepidemiologicpatientsadmittedwithanewdiagnosisoflungstudieswereundertakenbetween1930andcancer.Thesepatientswerethenintervie

6、wed1960.TwostudieswereconductedbyRichardconcerningsmokinghabits,aswerecontrolsDollandAustinBradfordHillinGreatBritain.selectedfrompatientswithotherdisordersThefirstwasacase-controlstudybegunin1947(primarilynon-malignant)whowerehospitalizedcomparingthesmokinghabitsoflungcancerinthesamehospit

7、alsatthesametime.patientswiththesmokinghabitsofotherpatients.ThesecondwasacohortstudybegunDataforthecohortstudywereobtainedfromthein1951recordingcausesofdeathamongBritishpopulationofallphysicianslistedintheBritishphysiciansinrelationtosmokinghabits.ThisM