Improved estimates of floating absolute risk

Plummer, Martyn

doi:10.1002/sim.1485

Cited by 221 publications

(192 citation statements)

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“…Where results are presented in the form of plots, floating absolute risks (Plummer, 2004) were used to represent the dose -response relationship in a way independent of the choice of reference category. ORs are represented by squares and their corresponding floating CIs by horizontal lines.…”

Section: Discussionmentioning

confidence: 99%

Differences in the risk of cervical cancer and human papillomavirus infection by education level

et al. 2009

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BACKGROUND: Cervical cancer risk is associated with low education even in an unscreened population, but it is not clear whether human papillomavirus (HPV) infection follows the same pattern. METHODS: Two large multicentric studies (case -control studies of cervical cancer and HPV prevalence survey) including nearly 20 000 women. GP5 þ /GP6 þ PCR was used to detect HPV. RESULTS: Education level was consistently associated with cervical cancer risk (odds ratio (OR) for 0 and 45 years vs 1-5 years ¼ 1.50, 95% confidence interval (CI): 1.25 -1.80 and 0.69, 95% CI: 0.57 -0.82, respectively, P for trend o0.0001). In contrast, no association emerged between education level and HPV infection in either of the two IARC studies. A majority of the women studied had never had a Pap smear. The association between low education level and cervical cancer was most strongly attenuated by adjustment for age at first sexual intercourse and first pregnancy. Parity and screening history (but not lifetime number of sexual partners, husband's extramarital sexual relationships, and smoking) also seemed to be important confounding factors. CONCLUSION: The excess of cervical cancer found in women with a low socio-economic status seems, therefore, not to be explained by a concomitant excess of HPV prevalence, but rather by early events in a woman's sexually active life that may modify the cancercausing potential of HPV infection.

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Section: Discussionmentioning

confidence: 99%

Differences in the risk of cervical cancer and human papillomavirus infection by education level

et al. 2009

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“…The variables were analyzed categorically, and when more than two groups were compared, floating CIs (FCI) were estimated by treating ORs as floating absolute risks (44,45). This method assigns a variance to the reference category and reduces unwanted correlation between coefficients, thus reducing the variance of ORs not defined as 1.0.…”

Section: Methodsmentioning

confidence: 99%

Reproductive Factors, Oral Contraceptive Use, and Human Papillomavirus Infection: Pooled Analysis of the IARC HPV Prevalence Surveys

Vaccarella

Herrero²,

Dai³

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

127

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High parity, early age at first full-term pregnancy (FTP), and long-term oral contraceptive (OC) use increase cervical cancer risk, but it is unclear whether these variables are also associated with increased risk of acquisition and persistence of human papillomavirus (HPV) infection, the main cause of cervical cancer. Information on reproductive and menstrual characteristics and OC use were collected from 14 areas worldwide, among population-based, age-stratified random samples of women aged 15 years or older. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate the odds ratios (OR) of being HPV-positive according to reproductive and menstrual factors and corresponding 95% confidence intervals (CI). When more than two groups were compared, floating CIs (FCI) were estimated. A total of 15,145 women (mean age, 40.9 years) were analyzed. Women with z5 FTPs (OR, 0.90; 95% FCI, 0.76-1.06) showed a similar risk of being HPV-positive compared with women with only one FTP (OR, 1.00; 95% FCI, 0.86-1.16). However, nulliparous women showed an OR of 1.40 (95% CI, 1.16-1.69) compared with parous women. Early age at first FTP was not significantly related to HPV positivity. HPV positivity was similar for women who reported z10 years of use of OCs (OR, 1.16; 95% FCI, 0.85-1.58) and never users of OCs (OR, 1.00; 95% FCI, 0.90-1.12). Our study suggests, therefore, that high parity, early age at first FTP, and long-term OC use are not associated with HPV prevalence, but rather these factors might be involved in the transition from HPV infection to neoplastic cervical lesions. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2148 -53)

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“…However, when more than 2 groups are compared variances are estimated by treating the RRs as floating absolute risks. 4 Use of floating methods does not alter the estimates of RR, but yields floated standard errors and floated CIs (FCIs) that enable valid comparisons to be made between any 2 exposure groups, even if neither is the baseline group. The unfloated (i.e.…”

Section: Statistical Methods and Presentation Of Datamentioning

confidence: 99%

Carcinoma of the cervix and tobacco smoking: Collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies

2005

Int. J. Cancer

340

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Carcinoma of the cervix and tobacco smoking: Collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies International Collaboration of Epidemiological Studies of Cervical Cancer* Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR 5 1.60 (95% CI: 1.48-1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR 5 1.12 (1.01-1.25)), and there was no clear trend with time since stopping smoking (p-trend 5 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR 5 0.89 (0.74-1.06) and 0.89 (0.72-1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p 5 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p-trend 5 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR 5 1.95 (1.43-2.65)), but not for adenocarcinoma (RR 5 1.06 (0.14-7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking. ' 2005 Wiley-Liss, Inc.Key words: tobacco; cervical cancer; risk; meta-analysis Cervical infection with high-risk types of human papillomavirus (HPV) is the main cause of most cervical cancers. Although many women get infected with this virus, most do not go on to develop cervical cancer. A number of other factors, such as tobacco smoking, are therefore thought to be involved in the disease process. The International Agency for Research on Cancer (IARC) has classified tobacco smoking as a cause of cervical cancer.1 However, it remains unclear how different patterns of use, such as amount smoked or duration of smoking, affect a woman's risk of developing cervical cancer. Data on individual women from a...

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Improved estimates of floating absolute risk

Cited by 221 publications

References 11 publications

Differences in the risk of cervical cancer and human papillomavirus infection by education level

Differences in the risk of cervical cancer and human papillomavirus infection by education level

Reproductive Factors, Oral Contraceptive Use, and Human Papillomavirus Infection: Pooled Analysis of the IARC HPV Prevalence Surveys

Carcinoma of the cervix and tobacco smoking: Collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies

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