E
RELATIVE RISKS FOR LUNG CANCER

Table E.1 shows detailed results1 under certain assumptions of the prevalence of smoking in the general population and in the occupational cohort. Some of the scenarios are rather implausible, for example, assuming that 70% of the population is heavy smokers. In cases where the prevalence of smoking in the general population exceeds that of the cohort, the expected relative risks are less than unity, meaning that an observed excess relative risk in the cohort would be underestimated because of confounding by smoking. Expected relative risks greater than unity, as would occur when there are more and heavier smokers in the occupational cohort, are interpreted as meaning that some of an observed effect could be explained by smoking. In the instance where all cohort members smoke heavily, the maximum relative risk that could be observed is 3.1. In general, the table shows that one requires extreme differential smoking patterns to explain observed relative risks above 1.5.

The expected relative risks for lung cancer due solely to smoking presented below. Table E.1 was calculated assuming a relative risk for “moderate” smoking of 10 and for “heavy” smoking of 20.

TABLE E.1 Relative Risks for Lung Cancer

General Population

40% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

1.0

50

10

1.1

60

10

1.3

70

10

1.4

30

20

1.2

40

20

1.3

50

20

1.4

60

20

1.6

20

30

1.3

30

30

1.4

40

30

1.6

50

30

1.7

10

40

1.5

10

50

1.8

10

60

2.0

10

70

2.3

General Population

50% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.9

50

10

1.0

60

10

1.1

70

10

1.2

30

20

1.0

40

20

1.1

50

20

1.3

60

20

1.4

20

30

1.1

30

30

1.3

40

30

1.4

50

30

1.5

10

40

1.3

10

50

1.5

10

60

1.8

10

70

2.1

General Population

60% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.8

50

10

0.9

60

10

1.0

70

10

1.1

30

20

0.9

40

20

1.0

50

20

1.1

60

20

1.2

20

30

1.0

30

30

1.1

40

30

1.2

50

30

1.3

10

40

1.1

10

50

1.4

10

60

1.6

10

70

1.8

1  

Provided by Mark Goldberg, Ph.D.



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OCR for page 570
Gulf War and Health: Insecticides and Solvents, Volume 2 E RELATIVE RISKS FOR LUNG CANCER Table E.1 shows detailed results1 under certain assumptions of the prevalence of smoking in the general population and in the occupational cohort. Some of the scenarios are rather implausible, for example, assuming that 70% of the population is heavy smokers. In cases where the prevalence of smoking in the general population exceeds that of the cohort, the expected relative risks are less than unity, meaning that an observed excess relative risk in the cohort would be underestimated because of confounding by smoking. Expected relative risks greater than unity, as would occur when there are more and heavier smokers in the occupational cohort, are interpreted as meaning that some of an observed effect could be explained by smoking. In the instance where all cohort members smoke heavily, the maximum relative risk that could be observed is 3.1. In general, the table shows that one requires extreme differential smoking patterns to explain observed relative risks above 1.5. The expected relative risks for lung cancer due solely to smoking presented below. Table E.1 was calculated assuming a relative risk for “moderate” smoking of 10 and for “heavy” smoking of 20. TABLE E.1 Relative Risks for Lung Cancer General Population 40% Moderate and 10% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 1.0 50 10 1.1 60 10 1.3 70 10 1.4 30 20 1.2 40 20 1.3 50 20 1.4 60 20 1.6 20 30 1.3 30 30 1.4 40 30 1.6 50 30 1.7 10 40 1.5 10 50 1.8 10 60 2.0 10 70 2.3 General Population 50% Moderate and 10% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.9 50 10 1.0 60 10 1.1 70 10 1.2 30 20 1.0 40 20 1.1 50 20 1.3 60 20 1.4 20 30 1.1 30 30 1.3 40 30 1.4 50 30 1.5 10 40 1.3 10 50 1.5 10 60 1.8 10 70 2.1 General Population 60% Moderate and 10% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.8 50 10 0.9 60 10 1.0 70 10 1.1 30 20 0.9 40 20 1.0 50 20 1.1 60 20 1.2 20 30 1.0 30 30 1.1 40 30 1.2 50 30 1.3 10 40 1.1 10 50 1.4 10 60 1.6 10 70 1.8 1   Provided by Mark Goldberg, Ph.D.

OCR for page 570
Gulf War and Health: Insecticides and Solvents, Volume 2 General Population 70% Moderate and 10% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.7 50 10 0.8 60 10 0.9 70 10 1.0 30 20 0.8 40 20 0.9 50 20 1.0 60 20 1.1 20 30 0.9 30 30 1.0 40 30 1.1 50 30 1.2 10 40 1.0 10 50 1.2 10 60 1.4 10 70 1.7 General Population 30% Moderate and 20% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.9 50 10 1.0 60 10 1.1 70 10 1.2 30 20 1.0 40 20 1.1 50 20 1.2 60 20 1.4 20 30 1.1 30 30 1.3 40 30 1.4 50 30 1.5 10 40 1.3 10 50 1.5 10 60 1.8 10 70 2.0 General Population 40% Moderate and 20% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.8 50 10 0.9 60 10 1.0 70 10 1.1 30 20 0.9 40 20 1.0 50 20 1.1 60 20 1.2 20 30 1.0 30 30 1.1 40 30 1.2 50 30 1.3 10 40 1.1 10 50 1.4 10 60 1.6 10 70 1.8 General Population 50% Moderate and 20% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.7 50 10 0.8 60 10 0.9 70 10 1.0 30 20 0.8 40 20 0.9 50 20 1.0 60 20 1.1 20 30 0.9 30 30 1.0 40 30 1.1 50 30 1.2 10 40 1.0 10 50 1.2 10 60 1.4 10 70 1.6 General Population 60% Moderate and 20% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.6 50 10 0.7 60 10 0.8 70 10 0.9 30 20 0.7 40 20 0.8 50 20 0.9 60 20 1.0 20 30 0.8 30 30 0.9 40 30 1.0 50 30 1.1 10 40 0.9 10 50 1.1 10 60 1.3 10 70 1.5 General Population 20% Moderate and 30% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.8 50 10 0.9 60 10 1.0 70 10 1.1 30 20 0.9 40 20 1.0 50 20 1.1 60 20 1.2 20 30 1.0 30 30 1.1 40 30 1.2 50 30 1.3 10 40 1.1 10 50 1.3 10 60 1.6 10 70 1.8

OCR for page 570
Gulf War and Health: Insecticides and Solvents, Volume 2 General Population 30% Moderate and 30% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.7 50 10 0.8 60 10 0.9 70 10 1.0 30 20 0.8 40 20 0.9 50 20 1.0 60 20 1.1 20 30 0.9 30 30 1.0 40 30 1.1 50 30 1.2 10 40 1.0 10 50 1.2 10 60 1.4 10 70 1.6 General Population 40% Moderate and 30% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.6 50 10 0.7 60 10 0.8 70 10 0.9 30 20 0.7 40 20 0.8 50 20 0.9 60 20 1.0 20 30 0.8 30 30 0.9 40 30 1.0 50 30 1.1 10 40 0.9 10 50 1.1 10 60 1.3 10 70 1.5 General Population 50% Moderate and 30% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.6 50 10 0.7 60 10 0.7 70 10 0.8 30 20 0.7 40 20 0.8 50 20 0.8 60 20 0.9 20 30 0.8 30 30 0.8 40 30 0.9 50 30 1.0 10 40 0.8 10 50 1.0 10 60 1.2 10 70 1.4 General Population 10% Moderate and 40% Heavy Moderate (RR=10) Heavy (RR=20 Expected RR 40 10 0.7 50 10 0.8 60 10 0.9 70 10 1.0 30 20 0.8 40 20 0.9 50 20 1.0 60 20 1.1 20 30 0.9 30 30 1.0 40 30 1.1 50 30 1.2 10 40 1.0 10 50 1.2 10 60 1.4 10 70 1.6 General Population 10% Moderate and 50% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.6 50 10 0.6 60 10 0.7 70 10 0.8 30 20 0.7 40 20 0.7 50 20 0.8 60 20 0.9 20 30 0.7 30 30 0.8 40 30 0.9 50 30 1.0 10 40 0.8 10 50 1.0 10 60 1.2 10 70 1.3 General Population 10% Moderate and 60% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.5 50 10 0.6 60 10 0.6 70 10 0.7 30 20 0.6 40 20 0.6 50 20 0.7 60 20 0.8 20 30 0.6 30 30 0.7 40 30 0.8 50 30 0.8 10 40 0.7 10 50 0.9 10 60 1.0 10 70 1.1

OCR for page 570
Gulf War and Health: Insecticides and Solvents, Volume 2 General Population 10% Moderate and 70% Heavy Moderate (RR=10) Heavy (RR=20) Expected RR 40 10 0.4 50 10 0.5 60 10 0.5 70 10 0.6 30 20 0.5 40 20 0.6 50 20 0.6 60 20 0.7 20 30 0.6 30 30 0.6 40 30 0.7 50 30 0.7 10 40 0.6 10 50 0.8 10 60 0.9 10 70 1.0