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MEDSCI302 > 29 Cancer Epidemiology > Flashcards

29 Cancer Epidemiology Flashcards

1
Q

What are the 2 FACTORS in cancer epidemiology?

A

Distribution (FREQUENCY)

Determinants (influencing factors)

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2
Q

Epidemiology is at what SCALE

A

Population scale

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3
Q

2 assumptions of cancer epidemiology

A
  1. Cancer is NOT random

2. Cancer has CAUSAL and therefore PREVENTATIVE factors

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4
Q

What is the general AIM in cancer epidemiology?

A

Find ASSOCIATION between a potential RISK FACTOR and CANCER

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5
Q

What are the 2 MEASURES of frequency?

Define

A 
Incidence = number of NEW CASES in a popn, within a TIME frame
Prevalence = TOTAL number of cases in a popn, at a given TIME
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6
Q

What are 3 CONSIDERATIONS when calculating incidence?

A
  • NORMALISE to allow comparison of popns
  • Incidence rate PER PERSON TIME
  • AGE-STANDARDISING of incidence rate
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7
Q

How can we NORMALISE the incidence rate?

A

Divide by total number of people

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8
Q

What is incidence rate PER PERSON TIME

A

Accounts for how long individuals were AVAILABLE TO RESEARCHERS
(populations are NOT STATIC)

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9
Q

Why does incidence rate need to be AGE-standardised?

A

Cancer increases with age

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10
Q

What is a consideration for PREVALENCE measures?

A

DURATION of disease

  • CHRONIC = higher prevalence at given time
  • ACUTE/good CURE = lower prevalence
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11
Q

2 CLASSES of epidemiological studies

What is the difference?

A 
Experimental = INTERVENTION by investigator
Observational = NO intervention (find groups already exposed)
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12
Q

Purpose of an EXAMPLE of experimental studies

A

Randomised clinical trials can evaluate:

  • Effectiveness
  • Side effects
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13
Q

2 sub-groups of observational studies

What is the difference?

A 
Analytical = CONTROL present
Descriptive = NO control group
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14
Q

3 types of ANALYTICAL-observational studies

A

CCE

  1. Cohort
  2. Case-control
  3. Ecological
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15
Q

The 3 types of ANALYTICAL-observational studies differ in what ASPECT?

A

DIRECTION of study

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16
Q

What is the DIRECTION of a cohort vs case-control study?

A

Cohort
= Exposure to Outcome

Case-control
= Outcome to Exposure

17
Q

Give examples of COHORT vs CASE-CONTROL studies

A

Cohort = diet questionnaire about FAT intake, THEN determine cancer incidence (exposure to outcome)

Case-control = diet questionnaire for BREAST CANCER patients, see if they have fat intake differences (outcome to exposure)

18
Q

Disadvantages of COHORT-analytical studies?

A
  • needs MANY participants
  • Lengthy = EXPENSIVE
  • Unexpected CONFOUNDS
  • Loss of FOLLOW-UP
19
Q

COHORT-analytical studies are NOT SUITED for what kinds of dieases?

A

Diseases with

  • Long-latency (eg. Cancer)
  • RARE incidence
20
Q

ADVANTAGES of cohort-analytical studies

A
  • TEMPORAL relationships can be studied
  • RELATIVE RISK can be calculated ACCURATELY
  • MULTIPLE STUDIES can be done with same data
21
Q

Advantages of CASE-CONTROL analytical studies

A

*No need for many aprticipants
*No need to WAIT for disease development
= quicker, cheaper, easier

22
Q

Case control studies are SUITED FOR what kinds of dieases

A

Long-latency

Rare

23
Q

DISADVANTAGES of CASE-CONTROL analytical studies

A

Selection bias = how cases/controls are CHOSEN
Recall bias = cancer patients more sensitive to exposures
= wording of questions

24
Q

What are the 2 statistical measures of OUTCOME

What STUDIES are they used for?

A

Relative Risk = Cohort studies

Odds Ratio = Case-control studies

25
Q

How is RR calculated?

A

Risk of disease WITH exposure/WITHOUT exposure

26
Q

What does a RR mean if it is…
<1
=1
>1

A

RR<1 means ⬇️risk 😄
RR=1 means NO ∆risk
RR>1 means ⬆️risk 😩

27
Q

What is an ECOLOGICAL study?

A

At least 1 variable measured at GROUP level

28
Q

GROUPS in ecological studies are often DEFINED by…

A

Geographical boundaries (COUNTRIES)

29
Q

Advantages of ecological studies

A
  • Quick, cheap, easy
  • Use ROUTINELY COLLECTED data
  • Provide NEW hypotheses about causes
  • Suggest NEW risk factors
30
Q

Disadvantages of ecological studies

A
  • Rely on AVG values
  • ERRORS in recording quality
  • Quality of HEALTHCARE varies
  • POLITICAL influences
31
Q

Name a type of DESCRIPTIVE study

A

Case reports - purely descriptive, NO CTRL

32
Q

3 types of ERROR in epidemiological studies

A

Bias
Chance
Confounds

33
Q

Explain BIAS

A

Systematic error

= NOT REPRESENTATIVE of true relationship

34
Q

Explain CHANCE

A

RANDOM error

= unpredictable (due to protocol OR random nature of disease)

35
Q

How can CHANCE be TESTED for?

A

Use P-value to test whether the result is STATISTICALLY SIGNIFICANT

36
Q

What is a CONFOUND

A

CONFUSES the observation

37
Q

3 criteria for something being a CONFOUND

A
  1. Is a RISK FACTOR for the disease
  2. Is ASSOCIATED with the exposure of interest
  3. Is NOT an INTERMEDIATE in a causal pathway

MEDSCI302 (8 decks)

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