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. 1981 Dec;35(4):281–287. doi: 10.1136/jech.35.4.281

The limitations of case-control studies in the detection of environmental carcinogens.

I K Crombie
PMCID: PMC1052178  PMID: 7338704

Abstract

The ability of the case-control study to detect human carcinogens has been investigated theoretically for varying fractions of the population exposed to hazards carrying different relative risks. The method is shown to be useful for the investigation of factors to which exposure is widespread (for example, common foods or beverages) but it is of limited use for the study of uncommon types of exposure, such as those associated with occupation. The case-control study is unable to detect very small relative risks (less than 1.5) even where exposure is widespread and large numbers of cases of cancer are occurring in the population. The principal limitation of the method is the maximum number of cases which can be recruited and analysed. It will only be through large-scale collaborative multicentre or international studies that important risk factors will be detected.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown W. M., Doll R. Mortality from cancer and other causes after radiotherapy for ankylosing spondylitis. Br Med J. 1965 Dec 4;2(5474):1327–1332. doi: 10.1136/bmj.2.5474.1327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CASE R. A., HOSKER M. E., McDONALD D. B., PEARSON J. T. Tumours of the urinary bladder in workmen engaged in the manufacture and use of certain dyestuff intermediates in the British chemical industry. I. The role of aniline, benzidine, alpha-naphthylamine, and beta-naphthylamine. Br J Ind Med. 1954 Apr;11(2):75–104. doi: 10.1136/oem.11.2.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Copeland K. T., Checkoway H., McMichael A. J., Holbrook R. H. Bias due to misclassification in the estimation of relative risk. Am J Epidemiol. 1977 May;105(5):488–495. doi: 10.1093/oxfordjournals.aje.a112408. [DOI] [PubMed] [Google Scholar]
  4. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Doll R. Strategy for detection of cancer hazards to man. Nature. 1977 Feb 17;265(5595):589–596. doi: 10.1038/265589a0. [DOI] [PubMed] [Google Scholar]
  6. Enterline P. E. Pitfalls in epidemiological research. An examination of the asbestos literature. J Occup Med. 1976 Mar;18(3):150–156. [PubMed] [Google Scholar]
  7. Fleiss J. L. Confidence intervals for the odds ratio in case-control studies: the state of the art. J Chronic Dis. 1979;32(1-2):69–77. doi: 10.1016/0021-9681(79)90015-8. [DOI] [PubMed] [Google Scholar]
  8. Fox A. J., Collier P. F. A survey of occupational cancer in the rubber and cablemaking industries: analysis of deaths occurring in 1972-74. Br J Ind Med. 1976 Nov;33(4):249–264. doi: 10.1136/oem.33.4.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gail M., Williams R., Byar D. P., Brown C. How many controls? J Chronic Dis. 1976 Nov;29(11):723–731. doi: 10.1016/0021-9681(76)90073-4. [DOI] [PubMed] [Google Scholar]
  10. Higginson J. Present trends in cancer epidemiology. Proc Can Cancer Conf. 1969;8:40–75. [PubMed] [Google Scholar]
  11. Horwitz R. I., Feinstein A. R. Methodologic standards and contradictory results in case-control research. Am J Med. 1979 Apr;66(4):556–564. doi: 10.1016/0002-9343(79)91164-1. [DOI] [PubMed] [Google Scholar]
  12. Labarthe D. R. Methodologic variation in case-control studies of reserpine and breast cancer. J Chronic Dis. 1979;32(1-2):95–104. doi: 10.1016/0021-9681(79)90021-3. [DOI] [PubMed] [Google Scholar]
  13. MANTEL N., HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed] [Google Scholar]
  14. McMichael A. J., Spirtas R., Gamble J. F., Tousey P. M. Mortality among rubber workers: Relationship to specific jobs. J Occup Med. 1976 Mar;18(3):178–185. doi: 10.1097/00043764-197603000-00012. [DOI] [PubMed] [Google Scholar]
  15. Sackett D. L. Bias in analytic research. J Chronic Dis. 1979;32(1-2):51–63. doi: 10.1016/0021-9681(79)90012-2. [DOI] [PubMed] [Google Scholar]
  16. Schlesselman J. J. Assessing effects of confounding variables. Am J Epidemiol. 1978 Jul;108(1):3–8. [PubMed] [Google Scholar]
  17. Schlesselman J. J. Sample size requirements in cohort and case-control studies of disease. Am J Epidemiol. 1974 Jun;99(6):381–384. doi: 10.1093/oxfordjournals.aje.a121625. [DOI] [PubMed] [Google Scholar]
  18. Tomatis L., Agthe C., Bartsch H., Huff J., Montesano R., Saracci R., Walker E., Wilbourn J. Evaluation of the carcinogenicity of chemicals: a review of the Monograph Program of the International Agency for Research on Cancer (1971 to 1977). Cancer Res. 1978 Apr;38(4):877–885. [PubMed] [Google Scholar]
  19. Walter S. D. Determination of significant relative risks and optimal sampling procedures in prospective and retrospective comparative studies of various sizes. Am J Epidemiol. 1977 Apr;105(4):387–397. doi: 10.1093/oxfordjournals.aje.a112395. [DOI] [PubMed] [Google Scholar]

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