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Vlaanderen, J.* ; Portengen, L.* ; Schüz, J.* ; Olsson, A.* ; Pesch, B.* ; Kendzia, B.* ; Stücker, I.* ; Guida, F.* ; Brüske, I. ; Wichmann, H.-E. ; Consonni, D.* ; Landi, M.T.* ; Caporaso, N.* ; Siemiatycki, J.* ; Merletti, F.* ; Mirabelli, D.* ; Richiardi, L.* ; Gustavsson, P.* ; Plato, N.* ; Jöckel, K.-H.* ; Ahrens, W.* ; Pohlabeln, H.* ; Tardón, A.* ; Zaridze, D.* ; Field, J.K.* ; 't Mannetje, A.* ; Pearce, N.* ; McLaughlin, J.* ; Demers, P.* ; Szeszenia-Dabrowska, N.* ; Lissowska, J.* ; Rudnai, P.* ; Fabianova, E.* ; Dumitru, R.S.* ; Bencko, V.* ; Foretova, L.* ; Janout, V.* ; Boffetta, P.* ; Forastiere, F.* ; Bueno-de-Mesquita, H.B.* ; Peters, S.* ; Brüning, T* ; Kromhout, H.* ; Straif, K.* ; Vermeulen, R.*

Effect modification of the association of cumulative exposure and cancer risk by intensity of exposure and time since exposure cessation: A flexible method applied to cigarette smoking and lung cancer in the SYNERGY study.

Am. J. Epidemiol. 179, 290-298 (2014)

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Open Access Green as soon as Postprint is submitted to ZB.

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The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (19852009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 2030 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Cigarette Smoke ; Cumulative Exposure ; Effect Modification ; Lung Cancer ; Pooled Analysis; Modeling Total Exposure; Occupational-exposure; Pooled Analysis; Europe; Carcinoma; Alcohol; Smokers

ISSN (print) / ISBN 0002-9262

e-ISSN 1476-6256

Journal American Journal of Epidemiology

Quellenangaben Volume: 179, Issue: 3, Pages: 290-298

Publisher Oxford University Press

Publishing Place Cary

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology (EPI)