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Investigating the detectability of e...
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Kuruchittham, Vipat.
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Investigating the detectability of environmental risk in breast cancer surveillance data: A simulation study.
Record Type:
Electronic resources : Monograph/item
Title/Author:
Investigating the detectability of environmental risk in breast cancer surveillance data: A simulation study./
Author:
Kuruchittham, Vipat.
Description:
172 p.
Notes:
Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4181.
Contained By:
Dissertation Abstracts International66-08B.
Subject:
Health Sciences, Public Health. -
Online resource:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3186169
ISBN:
9780542281990
Investigating the detectability of environmental risk in breast cancer surveillance data: A simulation study.
Kuruchittham, Vipat.
Investigating the detectability of environmental risk in breast cancer surveillance data: A simulation study.
- 172 p.
Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4181.
Thesis (Ph.D.)--The University of Wisconsin - Madison, 2005.
Breast cancer incidence rates vary widely among geographic locations in the United States and the world. Environmental contaminants in the air, soil, and water have been suggested as sources of these variations. Results of past association studies between breast cancer and environmental risk factors have been inconclusive. With simulation and statistical detection tools, I investigated the detectability of elevated breast cancer risks associated with environmental hazards.
ISBN: 9780542281990Subjects--Topical Terms:
1017659
Health Sciences, Public Health.
Investigating the detectability of environmental risk in breast cancer surveillance data: A simulation study.
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172 p.
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Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4181.
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Supervisor: Dennis G. Fryback.
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Thesis (Ph.D.)--The University of Wisconsin - Madison, 2005.
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Breast cancer incidence rates vary widely among geographic locations in the United States and the world. Environmental contaminants in the air, soil, and water have been suggested as sources of these variations. Results of past association studies between breast cancer and environmental risk factors have been inconclusive. With simulation and statistical detection tools, I investigated the detectability of elevated breast cancer risks associated with environmental hazards.
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I used a discrete-event simulation model of the natural history of breast cancer, screening, treatment, and other causes of mortality. An environmental risk dispersion model was integrated into the simulation model to generate realistic breast cancer incidence based on various hypothetical environmental risk conditions analyzed at the census tract level. A spatial scan statistic was employed to determine whether relative risks of varying magnitudes associated with environmental hazards could be detected in spatially analyzed cancer surveillance data for the period 1992--2000.
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The magnitude of detectable relative risks varies depending on how the environmental hazard affects breast cancer, and the size of the population affected by the hazard. The minimal detectable relative risk ranges from 1.28 (415,000 simulated women in a 10km-radius affected area) to 568 (600 simulated women). Other research indicates environmental factors with relative risks above 2.2 are unlikely. Hence, this dissertation shows we are unlikely to detect realistic environmental hazards affecting breast cancer incidence except in densely populated areas. If the population affected by the hazard is 36,000 women or fewer, surveillance data are under-powered to detect any realistically elevated relative risks associated with point-source hazards.
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Annual mammography screening improves detection, finding relative risks 10% smaller than screening at rates prevalent in 2000. Aggregating data from census tract to the county level decreases detectability of environmental risks by as much as 90%. Detectability also diminishes by up to 20% when more than one point-source is present in a relatively small region.
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In conclusion, this study demonstrates that an area with elevated risk of breast cancer associated with an environmental hazard is unlikely to be established using cancer surveillance data unless the association is very strong or a very large population is affected.
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http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3186169
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