痴呆症和癌症:在基于人口的队列中揭开方法学偏见
Amber P Selie1,2, Kimberly D van der Willik3, M Arfan Ikram4
1Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands, a.selie@nki.nl.
痴呆症和癌症之间的反向关联可能是由于研究偏见,而不是生物学. 纠正这些偏见表明痴呆症可能会增加癌症风险,强调需要谨慎的流行病学方法.
科学领域:
- 流行病学 流行病学
- 老年学是一门学科.
- 在瘤学瘤学.
背景情况:
- 据报道,痴呆症和癌症之间存在着一致的反向关联,通常归因于相反的生物机制.
- 方法偏差,包括碰撞机分层和监测偏差,可能会混这种观察到的关联.
研究的目的:
- 重新检查痴呆症和随后的癌症诊断之间的关联.
- 研究方法偏差在痴呆症与癌症关系中的作用.
主要方法:
- 利用了4532名参与者在基于人口的鹿特丹研究的数据.
- 将患有发病性痴呆症的个体与没有痴呆症的对照人匹配,调整随访时间以减少不朽时间偏差.
- 包括病理确认和非病理确认的癌症诊断,以解决监测偏差.
- 采用特定原因的考克斯比例危险和细分和灰分发危险模型.
主要成果:
- 最初的分析复制了相反的关联 (HR 0.58).
- 在偏差校正 (匹配,对齐的随访) 后,痴呆与患癌症的可能性更高有关 (HR 5.23).
- 这种增加的风险在竞争性风险分析中仍然存在 (sHR 2.54),表明它不仅仅是由于死亡率差异.
结论:
- 据报道,痴呆症和癌症之间的反向关联可能是方法学偏见的产物.
- 对碰撞器分层和监测偏差的考虑表明,痴呆症和癌症风险之间存在潜在的积极联系.
- 强调了偏见意识的流行病学方法在研究衰老的并发症的重要性.
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