Proportion of Disease Caused or Prevented by a Given Exposure, Trait or Intervention1

Miettinen, Olli S.

doi:10.1093/oxfordjournals.aje.a121617

Cited by 901 publications

(573 citation statements)

References 3 publications

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“…Because the risk associated with one HPV type can be confounded by coinfection with other HPV types, we adjusted for infection with other HPV types by including type-specific HPV data as single variables in a multivariate regression model. Population attributable proportions were calculated as p c *(RR-1)/RR where p c is the proportion exposed to an HPV type among cases and RR is the type-specific relative rate adjusted for infection with other HPV types and censoring before or after 6 months of follow-up (Miettinen, 1974). Ninety-five percent CI for population attributable proportions were calculated from the standard error of the log-transformed complement of the population attributable proportions [ln(1-PAF)] (Rothman and Greenland, 1998).…”

Section: Discussionmentioning

confidence: 99%

HPV type-specific risks of high-grade CIN during 4 years of follow-up: A population-based prospective study

et al. 2007

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We followed a population-based cohort of 5696 women, 32 -38 years of age, by registry linkage with cytology and pathology registries during a mean follow-up time of 4.1 years to assess the importance for CIN2 þ development of type-specific HPV DNA positivity at baseline. HPV 16, 31 and 33 conveyed the highest risks and were responsible for 33.1, 18.3 and 7.7% of CIN2 þ cases, respectively. Women infected with HPV 18, 35, 39, 45, 51, 52, 56, 58, 59 and 66 had significantly lower risks of CIN2 þ than women infected with HPV 16. After adjustment for infection with other HPV types, HPV types 35, 45, 59 and 66 had no detectable association with CIN2 þ . In summary, the different HPV types found in cervical cancer show distinctly different CIN2 þ risks, with high risks being restricted to HPV 16 and its close relatives HPV 31 and HPV 33. Infection with 'high-risk' types of HPV is the major cause of cervical cancer, and the distribution of different HPV types in cancer tissue has been extensively analysed (Walboomers et al, 1999;Bosch et al, 2002;Munoz et al, 2003). Fifteen HPV types that infect the genital mucosa have been proposed as 'high-risk' HPV types as they have been found more often in cervical cancers than among healthy subjects . Data on the HPV type-specific risk of cervical neoplasia has hitherto mostly been based on cross-sectional case -control studies (Bosch et al, 1995;Clifford et al, 2003;Munoz et al, 2003). Case -control studies are sensitive to several biases, notably selection bias, differential sampling bias and other reverse causality biases. Absolute risks and population attributable proportions for each HPV type form the basis for decisions regarding which HPV types should be included in HPV screening tests as well as in vaccines and it is therefore important to estimate the type-specific risks using population-based prospective studies, a study design that minimises major sources of bias.Only two previous prospective studies have assessed the risk associated with several individual HPV types Berkhof et al, 2006), while several prospective studies have assessed certain clusters of HPV types (Koutsky et al, 1992;Liaw et al, 1999;Sherman et al, 2003;Szoke et al, 2003;Peto et al, 2004;Winer et al, 2005) or only investigated HPV types 16 and 18 (Khan et al, 2005).Therefore, we HPV-tested a population-based cohort of women and used a comprehensive registry-based follow-up to identify the risks for development of histopathologically verified high-grade cervical intraepithelial neoplasia (CIN2 þ ) associated with infections with 14 different so-called 'high-risk' HPV types. MATERIALS AND METHODS Cohort definitionA population-based multicentre study was started in Sweden in May 1997 with the main purpose to evaluate the effect of HPV testing in primary cervical cancer screening. Women aged between 32 and 38 years (mean age: 35.1 years) in five regions in Sweden (Gothenburg, Malmö, Stockholm, Umeå and Uppsala) who took part in organised cervical screening were invited to take part in the study. Followi...

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Section: Discussionmentioning

confidence: 99%

HPV type-specific risks of high-grade CIN during 4 years of follow-up: A population-based prospective study

et al. 2007

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“…Population attributable fraction (PAF) was used as an index for the research. It was defined as the proportional reduction in population disease or mortality that would occur if exposure to the risk factor was reduced to an alternative exposure scenario [11] and expressed as a percentage.…”

Section: Methodsmentioning

confidence: 99%

Attributable causes of cancer in China: Fruit and vegetable

Xiao

Liang²,

Wang

et al. 2011

Chin. J. Cancer Res.

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Objective: To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods: The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China. Data on the prevalence of exposure were derived from a Chinese nutrition and health survey. Data on relative risks were mainly derived from meta-analysis. Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution.Results: The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths (13.0% of all cancers) and 300,000 cases (11.6% of all cancers) in 2005. Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% (64,000 persons) and 3.4% (88,000 persons). The contributions to cancer burden were higher in rural areas than in urban areas. They have greater influence on men than on women. The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral and pharyngeal cancers.Conclusion: This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden. Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives. Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.

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“…To test whether the association of MetS with risk of CHD were significantly different between men and women we combined the 2 cohorts, and, in addition to the other covariates, adjusted for sex, and included an interaction term (sex x MetS). Population attributable fractions were calculated from equations by Miettinen [20] and Bruzzi et al [21], with 95%-CIs estimated by a variance formula proposed by Whittemore [22]. All p-values presented are two-tailed and p-values below 0.05 were considered statistically significant.…”

Section: Statistical Analysesmentioning

confidence: 99%

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

Pischon

Rexrode

et al. 2008

Atherosclerosis

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Objective-This study examined whether inflammation adds to the prediction of coronary heart disease (CHD) beyond Metabolic Syndrome (MetS), and whether these associations differ between sexes.Methods and Results-Among 30,111 women from the Nurses' Health Study and 16,695 men from the Health Professionals Follow-up Study without prior cardiovascular disease, 249 women and 266 men developed nonfatal myocardial infarction or fatal CHD during 8 and 6 years of followup, respectively. Controls were selected 2:1 within each cohort matched on age, smoking, and date of blood draw. Subjects with MetS had a significantly increased relative risk (RR) of CHD compared to individuals without MetS, and this RR was significantly higher in women (3.01; 95%-CI 1.98-4.57) than in men (1.62; 95%-CI 1.13-2.33; p interaction = 0.03). Adjustment for most inflammatory markers did not substantially attenuate the risk estimates, although the association was no longer significant in men after adjustment for CRP. Vice versa, associations of inflammatory markers with CHD risk among women were no longer significant after further adjustment for MetS. Among men, CRP and sICAM remained significant predictors of CHD independent of MetS.Conclusions-MetS is a stronger predictor of CHD in women than in men. Most inflammatory markers did not add appreciable information beyond MetS to predict CHD; only CRP and sICAM remained independently predictive of CHD among men. The basis for these sex-based differences warrants further study.

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Proportion of Disease Caused or Prevented by a Given Exposure, Trait or Intervention1

Cited by 901 publications

References 3 publications

HPV type-specific risks of high-grade CIN during 4 years of follow-up: A population-based prospective study

HPV type-specific risks of high-grade CIN during 4 years of follow-up: A population-based prospective study

Attributable causes of cancer in China: Fruit and vegetable

Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men

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