Annals of Epidemiology

Editorial Board

2010-02-01

Fear of Failure: Why American Science Is Not Winning the War on Cancer

Roberta B. Ness — 2010-02-01

Behind many stereotypes there is a truth. The stereotypical epidemiologist is a plodding obsessive who will never file a patent, or at least so my colleagues in molecular biology tell me. Fortunately we are not alone. In June on the front page of the New York Times, in an article entitled, “Forty Years' War: Grant system leads cancer researchers to play it safe,” the entire profession of science was taken to task for having achieved so little in the war on cancer. Why? For lack of innovation.

Past Medical History and Pancreatic Cancer Risk: Results From a Multicenter Case-Control Study

2010-02-01

Purpose: To investigate risk factors that may be linked to pancreatic cancer.Methods: We designed a multicenter population-based case–control (823 cases, 1679 control patients) study with data collection by using a common protocol and questionnaire. Participating centers were located in Australia, Canada, the Netherlands, and Poland.Results: After adjustment for confounding factors, a positive history of pancreatitis was associated with pancreatic cancer (odds ratio [OR], 4.68; 95% confidence interval [95% CI], 2.23−9.84). The risk was especially high in heavy smokers (OR, 15.4; 95% CI, 3.18−74.9). Patients with diabetes had an increased risk of developing pancreatic cancer (OR, 2.16; 95% CI, 1.60−2.91). The risk was highest in the first year after the development of diabetes (OR, 6.68; 95% CI, 3.56−12.6) and decreased over time. A history of allergy was associated with a reduced risk of pancreas cancer (OR, 0.64; 95% CI, 0.50−0.82).Conclusions: Patients with newly diagnosed diabetes and patients with pancreatitis, particularly in heavy smokers, have an increased risk for developing pancreatic cancer. In addition to being risk factors, these conditions could be early manifestations of underlying pancreatic cancer. A history of allergy decreases the risk of pancreatic cancer.

Spatiotemporal Analysis and Mapping of Oral Cancer Risk in Changhua County (Taiwan): An Application of Generalized Bayesian Maximum Entropy Method

Hwa-Lung Yu, Chi-Ting Chiang, Shu-De Lin, Tsun-Kuo Chang — 2010-02-01

Purpose: Incidence rate of oral cancer in Changhua County is the highest among the 23 counties of Taiwan during 2001. However, in health data analysis, crude or adjusted incidence rates of a rare event (e.g., cancer) for small populations often exhibit high variances and are, thus, less reliable.Methods: We proposed a generalized Bayesian Maximum Entropy (GBME) analysis of spatiotemporal disease mapping under conditions of considerable data uncertainty. GBME was used to study the oral cancer population incidence in Changhua County (Taiwan). Methodologically, GBME is based on an epistematics principles framework and generates spatiotemporal estimates of oral cancer incidence rates. In a way, it accounts for the multi-sourced uncertainty of rates, including small population effects, and the composite space-time dependence of rare events in terms of an extended Poisson-based semivariogram.Results: The results showed that GBME analysis alleviates the noises of oral cancer data from population size effect. Comparing to the raw incidence data, the maps of GBME-estimated results can identify high risk oral cancer regions in Changhua County, where the prevalence of betel quid chewing and cigarette smoking is relatively higher than the rest of the areas.Conclusions: GBME method is a valuable tool for spatiotemporal disease mapping under conditions of uncertainty.

Glutathione S–Transferase M1 Polymorphism and Sporadic Colorectal Cancer Risk: An Updating Meta-Analysis and HuGE Review of 36 Case-Control Studies

Yong Gao, Yunfei Cao, Aihua Tan, Cun Liao, Zengnan Mo, Feng Gao — 2010-02-01

Purpose: Sporadic colorectal cancer (CRC) is considered to be a multifactorial disease, in which multiple exposures to endogenous factors interact with individual genetic background in a complex manner, resulting in modulation of the risk. The glutathione S-transferase M1 gene (GSTM1) is a particularly attractive candidate for CRC susceptibility because it codes an enzyme involved in the metabolism of environmental carcinogens. However, the epidemiological findings have been inconsistent.Methods: To evaluate this association, we performed an extensive meta-analysis of 36 case-control studies (including 10,009 cases and 15,070 controls).Results: Overall, the combined data showed that GSTM1 deficiency is associated with a marginal effect on CRC risk (odds ratio [OR] = 1.13; 95% confidence interval [CI]: 1.03–1.23; P for heterogeneity <0.001). When stratified by race and tumor site, significant results were only observed in Caucasians (OR = 1.14, 95% CI: 1.01–1.27; P for heterogeneity <0.001), whereas no increased risk was detected in other subgroups.Conclusions: The findings of our study support the suggestion that GSTM1 polymorphism is associated with an increased risk of CRC, especially in the Caucasian population. Further investigation into the association between GSTM1 polymorphism and the risk of CRC is warranted and should include larger sample sizes and other genetic polymorphisms in metabolism of environmental carcinogens.

Alcohol Consumption, Serum Gamma-Glutamyltransferase, and Helicobacter Pylori Infection in a Population-Based Study Among 9733 Older Adults

2010-02-01

Purpose: Moderate alcohol consumption has been suggested to facilitate the elimination of Helicobacter pylori infection as the result of its antibacterial effect. We aimed to assess the associations of current and lifetime alcohol consumption as well as serum gamma-glutamyltransferase (GGT), an established biomarker of alcohol consumption, with H. pylori infection in a large population-based study.Methods: In the baseline examination of the ESTHER study, serological measurements of antibodies against H. pylori and GGT measurements were taken in 9733 subjects ages 50 to 74 years. Information on lifestyle factors and medical history were obtained by self-administered standardized questionnaire.Results: A significant inverse association, in dose-response manner, was observed between both current and lifetime alcohol consumption and H. pylori seropositivity. The estimates based on lifetime consumption were more pronounced than the results for current consumption, and such inverse associations were found both for men and women. Stronger relations were observed for those who only drank wine or mixed drinkers compare with those who only drank beer. Furthermore, there was a significant inverse dose-response relationship between serum GGT levels and H. pylori seropositivity, which was selectively observed among alcohol drinkers.Conclusions: In conclusion, our results support the hypothesis that moderate alcohol consumption may facilitate elimination of H. pylori.

Risk Factors and Impacts of Incident Tinnitus in Older Adults

2010-02-01

Purpose: We used a representative older population-based cohort to establish the predictors and impacts of tinnitus.Methods: A total of 1,214 participants of the Blue Mountains Hearing Study were followed for 5 years (1997−1999 to 2002−2004). The presence of tinnitus was assessed by an audiologist-administered questionnaire. Hearing impairment was defined as the pure tone average (PTA)0.5–4KHz>25 dB HL, in the better ear. Quality of life was measured by use of the Short Form 36-item Health Survey (SF-36). Depression was assessed using either the SF-36 (Mental Health Index, subscale) and the Center for Epidemiologic Studies Depression Scale.Results: Symptomatic dizziness and hearing loss were significant risk factors for incident tinnitus, multivariable-adjusted odds ratio, 2.41 (95% confidence interval, 1.62–3.58) and odds ratio 2.31 (95% confidence interval, 1.46–3.66), respectively. Incident tinnitus cases demonstrated significantly lower mean SF-36 scores compared with subjects without tinnitus and were more likely to be depressed as assessed by both the Mental Health Index and Center for Epidemiologic Studies Depression Scale.Conclusions: Incident tinnitus was predicted by two otological risk factors, dizziness and hearing loss. Temporal data documented diminished quality of life and psychological well-being in those subjects experiencing tinnitus. This finding highlights the importance of effective intervention strategies to prevent potentially debilitating morbidity associated with tinnitus.

Persistence with Statins and Incident Cataract: A Population-Based Historical Cohort Study

Gabriel Chodick, Anthony D. Heymann, Shira Flash, Ehud Kokia, Varda Shalev — 2010-02-01

Purpose: In recent years, there is a growing body of evidence suggesting that statins may have anti-inflammatory effects; consequently, it was hypothesized that statins may have a preventive effect against cataract.Methods: The study was carried out on a retrospective cohort of 180,291 new statin users in a large health organization in Israel. Study participants were followed between 1998 and 2007 for incident cataract or cataract extraction.Results: During the study period 27,301 cataracts were diagnosed and 6,976 cataract extractions were performed among study participants. Persistence with statins was associated significantly (P < 0.001) with a reduced risk of cataract in men and women aged 45 to 74. Men aged 45–54 with a high (>80%) proportion of follow-up days covered with statins had an adjusted hazard ratio of 0.62 (95% confidence interval: 0.54–0.72), compared with patients with low persistence with statins. In elderly patients, no relationship or a positive relationship was observed.Conclusions: Persistent statin use was significantly protective for the incidence of cataract in men and women under 75 years of age.

Military Combat and Risk of Coronary Heart Disease and Ischemic Stroke in Aging Men: The Atherosclerosis Risk in Communities (ARIC) Study

2010-02-01

Purpose: To assess the long-term association of military combat stress with coronary heart disease (CHD) and ischemic stroke (IS).Methods: The association between exposure to military combat and the occurrence of CHD and IS was assessed among 5,347 men in the Atherosclerosis Risk in Communities (ARIC) study. Outcomes were assessed an average of 36 years after entry into military service during the eras of World War II, the Korean War, and the Vietnam conflict.Results: Veterans were more likely to be older, white, and of higher socioeconomic status than non-veterans. No differences in CHD period prevalence rates were noted among the three exposure groups, overall or by era of service. Associations between combat and ischemic stroke period prevalence may be modified by father's education, although confidence intervals were wide and event rates small.Conclusions: Overall, middle-aged veterans with distant combat exposure are not at increased cardiovascular risk compared to those without combat exposure.

Comparison of Two Types of Epidemiological Surveys Aimed at Collecting Daily Clinical Symptoms in Community-Based Longitudinal Studies

2010-02-01

Background: Investigators use prospective community-based studies to collect longitudinal information on childhood diarrhea. The interval in which data are collected may affect the accuracy and interpretation of results. Our objective was to compare data of reported daily clinical symptoms from surveys conducted daily versus twice-weekly surveys.Methods: We conducted our study in Lima, Peru, between October and December 2007. We asked 134 mothers to report daily symptoms by using a twice-weekly survey. We conducted daily surveys for the same data on 25% of participants randomly selected each day. We analyzed intersurvey variability by using Cohen's kappa and Signal Detection Theory (SDT).Results: We collected 6157 and 1181 child-days of data through the twice-weekly and daily surveys, respectively. The prevalence of diarrhea, fever, vomiting, and cough were 6.4%, 1.6%, 2.1%, and 22.7% from the twice-weekly survey and, 6.4%, 2.0%, 2.4%, and 26% from the daily survey, respectively. Despite similar prevalence, 20% of days with reported diarrhea were discrepant between the two surveys, and agreement in the report of diarrhea decreased as time between the interviews increased (p = .03).Conclusions: Although twice-weekly surveys provide an adequate estimate of diarrheal prevalence compared with daily surveys, the prevalence of other symptoms based on dichotomous questions was lower under the former. Additionally, the agreement between the two surveys in the report of diarrhea decreased as the recall period increased, suggesting that data from daily interviews were of greater quality. Our analysis is a novel application of SDT to measure respondent certainty and bias, from which better inference about the quality of collected data may be drawn.

Evaluating Respondent-Driven Sampling in a Major Metropolitan Area: Comparing Injection Drug Users in the 2005 Seattle Area National HIV Behavioral Surveillance System Survey with Participants in the RAVEN and Kiwi Studies

Richard D. Burt, Holly Hagan, Keith Sabin, Hanne Thiede — 2010-02-01

Purpose: To empirically evaluate respondent-driven sampling (RDS) recruitment methods, which have been proposed as an advantageous means of surveying hidden populations.Methods: The National HIV Behavioral Surveillance system used RDS to recruit 370 injection drug users (IDU) in the Seattle area in 2005 (NHBS-IDU1). We compared the NHBS-IDU1 estimates of participants' area of residence, age, race, sex, and drug most frequently injected to corresponding data from two previous surveys, the RAVEN and Kiwi Studies, and to persons newly diagnosed with HIV/AIDS and reported from 2001 through 2005.Results: The NHBS-IDU1 population was estimated to be more likely to reside in downtown Seattle (52%) than participants in the other data sources (22%–25%), be older than 50 years of age (29% vs. 5%–10%), and report multiple races (12% vs. 3%–5%). The NHBS-IDU1 population resembled persons using the downtown needle exchange in age and race distribution. An examination of cross-group recruitment frequencies in NHBS-IDU1 suggested barriers to recruitment across different areas of residence, races, and drugs most frequently injected.Conclusions: The substantial differences in age and area of residence between NHBS-IDU1 and the other data sources suggest that RDS may not have accessed the full universe of Seattle area injection networks. Further empirical data are needed to guide the evaluation of RDS-generated samples.

Essentials of Infectious Disease Epidemiology & Essential Readings in Infectious Disease Epidemiology by M. Magnus

Richard F. Gillum — 2010-02-01

The occurrence of the H1N1 influenza (swine flu) epidemic of 2009, rather than a long-planned for H5N1 avian influenza epidemic, should disabuse anyone still laboring under the misconception that infectious diseases had once and for all been completely understood, much less conquered in the 20th century (1). Even in the 1960s and 1970s when this view was most prevalent in the United States, it was patently untrue from a global standpoint. This attitude and the resulting lack of shoe-leather epidemiologists working in Africa may have contributed to allowing the HIV/AIDS epidemic to grow for decades unnoticed by the rich nations until it was too late to stop its pandemic spread to rich and poor nations alike. Dr Manya Magnus of George Washington University School of Public Health has produced a new text (Essentials of Infectious Disease Epidemiology) for undergraduate and beginning graduate students of public health to ease their path to basic competency in the methods of infectious disease epidemiology and hopefully attract more of them to careers in the field. New workers will certainly be needed as the 21st century rediscovery of malaria, tuberculosis, and assorted neglected tropical diseases together with HIV/AIDS and pandemic influenza leads to increased funding for research and intervention.

Erratum

2010-02-01

In the article entitled ‘‘Prenatal social support, postnatal social support, and postpartum depression’’ by Wen et al., in the September 2009 issue of Annals of Epidemiology (Volume 19, Number 9, pages 637-643), the first paragraph of the “Results” section should read as follows:

Information for Authors

2010-02-01

Masthead

2010-02-01

Annals of Epidemiology

Editorial Board

Fear of Failure: Why American Science Is Not Winning the War on Cancer

Past Medical History and Pancreatic Cancer Risk: Results From a Multicenter Case-Control Study

Spatiotemporal Analysis and Mapping of Oral Cancer Risk in Changhua County (Taiwan): An Application of Generalized Bayesian Maximum Entropy Method

Glutathione S–Transferase M1 Polymorphism and Sporadic Colorectal Cancer Risk: An Updating Meta-Analysis and HuGE Review of 36 Case-Control Studies

Alcohol Consumption, Serum Gamma-Glutamyltransferase, and Helicobacter Pylori Infection in a Population-Based Study Among 9733 Older Adults

Risk Factors and Impacts of Incident Tinnitus in Older Adults

Persistence with Statins and Incident Cataract: A Population-Based Historical Cohort Study

Military Combat and Risk of Coronary Heart Disease and Ischemic Stroke in Aging Men: The Atherosclerosis Risk in Communities (ARIC) Study

Comparison of Two Types of Epidemiological Surveys Aimed at Collecting Daily Clinical Symptoms in Community-Based Longitudinal Studies

Evaluating Respondent-Driven Sampling in a Major Metropolitan Area: Comparing Injection Drug Users in the 2005 Seattle Area National HIV Behavioral Surveillance System Survey with Participants in the RAVEN and Kiwi Studies

Essentials of Infectious Disease Epidemiology & Essential Readings in Infectious Disease Epidemiology by M. Magnus

Erratum

Information for Authors

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