Estimating the burden of occupational cancer: assessing bias and uncertainty.
File(s)OEM BiasUncertainty paper 01.03.2017.doc (175 KB) Supplementary material_200217.docx (96.69 KB)
Accepted version
Supporting information
Author(s)
Hutchings, S
Rushton, L
Type
Journal Article
Abstract
BACKGROUND AND OBJECTIVES: We aimed to estimate credibility intervals for the British occupational cancer burden to account for bias uncertainty, using a method adapted from Greenland's Monte Carlo sensitivity analysis. METHODS: The attributable fraction (AF) methodology used for our cancer burden estimates requires risk estimates and population proportions exposed for each agent/cancer pair. Sources of bias operating on AF estimator components include non-portability of risk estimates, inadequate models, inaccurate data including unknown cancer latency and employment turnover and compromises in using the available estimators. Each source of bias operates on a component of the AF estimator. Independent prior distributions were estimated for each bias, or graphical sensitivity analysis was used to identify plausible distribution ranges for the component variables, with AF recalculated following Monte Carlo repeated sampling from these distributions. The methods are illustrated using the example of lung cancer due to occupational exposure to respirable crystalline silica in men. RESULTS: Results are presented graphically for a hierarchy of biases contributing to an overall credibility interval for lung cancer and respirable crystalline silica exposure. An overall credibility interval of 2.0% to 16.2% was estimated for an AF of 3.9% in men. Choice of relative risk and employment turnover were shown to contribute most to overall estimate uncertainty. Bias from using an incorrect estimator makes a much lower contribution. CONCLUSIONS: The method illustrates the use of credibility intervals to indicate relative contributions of important sources of uncertainty and identifies important data gaps; results depend greatly on the priors chosen.
Date Issued
2017-04-17
Date Acceptance
2017-03-21
Citation
Occupational and Environmental Medicine, 2017, 74 (8), pp.604-611
ISSN
1470-7926
Publisher
BMJ Publishing Group
Start Page
604
End Page
611
Journal / Book Title
Occupational and Environmental Medicine
Volume
74
Issue
8
Copyright Statement
© 2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the
article). All rights reserved. No commercial use is permitted unless otherwise
expressly granted. This article has been accepted for publication in Occupational and Environmental Medicine following peer review. The definitive copyedited, typeset version Hutchings S, Rushton L Estimating the burden of occupational cancer: assessing bias and uncertainty Occup Environ Med 2017;74:604-611 is available online at: https://dx.doi.org/10.1136/oemed-2016-103810
article). All rights reserved. No commercial use is permitted unless otherwise
expressly granted. This article has been accepted for publication in Occupational and Environmental Medicine following peer review. The definitive copyedited, typeset version Hutchings S, Rushton L Estimating the burden of occupational cancer: assessing bias and uncertainty Occup Environ Med 2017;74:604-611 is available online at: https://dx.doi.org/10.1136/oemed-2016-103810
Sponsor
Health & Safety Executive
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/28416642
PII: oemed-2016-103810
Grant Number
JN3117
Subjects
Attributable fraction
MCSA
bias
occupational cancer burden
uncertainty
Environmental & Occupational Health
1103 Clinical Sciences
1117 Public Health And Health Services
1599 Other Commerce, Management, Tourism And Services
Publication Status
Published
Coverage Spatial
England