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Smoking as a confounder in case-control studies of occupational bladder cancer in women.

Abstract：

BACKGROUND:In studies in men, risk estimates on occupation and bladder cancer are distorted by about 10% when not adjusting for smoking. We examined the degree to which occupational risk estimates for bladder cancer in women are confounded by smoking, and the degree of residual confounding by inadequate control of this effect. METHODS:Primary data of 11 case-control studies on occupation and bladder cancer from Denmark, France, Germany, Greece, Italy, and Spain were pooled. Information for smoking and lifetime occupational history for 700 female cases and 2,425 female controls ages 30-79 was abstracted and recoded. Logistic regression was used to calculate odds ratios (OR) by occupation, applying five models which differed in their degree of adjustment for smoking. RESULTS:In major occupational groups, risk estimates were distorted by less than 10% when not adjusting for smoking. A statistically significant excess risk for bladder cancer was found in 13 specific occupations and industries. In most occupations, adjustment for smoking led the ORs towards the null value, but all statistically significant associations were maintained after adjustment. In three occupations (lathe operators, field crop workers, and wood manufacturers), a statistically significant excess risk was masked when not adjusting for smoking. In six occupations, estimates were distorted by more than 10% (-22% up to +40%). In occupations where smoking acted as a positive confounder, the proportion of confounding removed using a dichotomous smoking variable (ever/never) was around 60%. In one occupation (buyers), controlling for smoking status (ever, never) led to over-adjustment, because the percentage of smokers was high but the quantity smoked was low.

journal_name

Am J Ind Med

journal_title

American journal of industrial medicine

authors

't Mannetje A,Kogevinas M,Chang-Claude J,Cordier S,González CA,Hours M,Jöckel KH,Bolm-Audorff U,Lynge E,Porru S,Donato F,Ranft U,Serra C,Tzonou A,Vineis P,Wahrendorf J,Boffetta P

doi

10.1002/(sici)1097-0274(199907)36:1<75::aid-ajim11

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

75-82

issue

eissn

0271-3586

issn

1097-0274

pii

10.1002/(SICI)1097-0274(199907)36:1<75::AID-AJIM11

journal_volume

pub_type

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Smoking as a confounder in case-control studies of occupational bladder cancer in women.