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Adjusting morbidity ratios in two communities using risk factor prevalence in cases.
A G Dean1, H H Imrey, K Dusich
1Division of Disease Prevention and Control, Department of Health, Minneapolis.
American Journal of Epidemiology
|March 1, 1988
Summary
Elevated breast cancer rates in St. Louis Park were investigated. After accounting for known risk factors, the observed cancer incidence aligned with expectations, suggesting water contamination may not be the primary driver.
Area of Science:
- Environmental epidemiology
- Public health
- Oncology
Background:
- Statistically elevated breast cancer incidence was observed in St. Louis Park, Minnesota (1969-1971).
- This community experienced creosote contamination of its water supply.
- Comparison was made against the broader Minneapolis-St. Paul area as a reference population.
Purpose of the Study:
- To assess the impact of known breast cancer risk factors on observed incidence.
- To evaluate the role of creosote water contamination in elevated breast cancer rates.
- To refine community cancer rate evaluation beyond age- and sex-specific calculations.
Main Methods:
- Interviewed 75 breast cancer patients from St. Louis Park and 75 from the reference population.
- Collected data on frequencies of known breast cancer risk factors.
- Calculated adjusted morbidity ratios using relative risk values from medical literature.
Main Results:
- The adjusted morbidity ratio was below 1.0.
- Observed breast cancer rates closely matched the calculated expectations.
- Age-adjusted rates alone had initially suggested a significant incidence difference.
Conclusions:
- The study's method allows for a more refined evaluation of community cancer rate differences.
- Utilizing published relative risks can enhance analysis when local data is limited.
- This approach may be valuable for studies constrained by cost, time, or population size.