TY - JOUR
T1 - The Cancer, Lifestyle and Evaluation of Risk Study (CLEAR)
T2 - rationale and design of an unmatched "case-spouse control" study of over 10,000 participants in New South Wales, Australia
AU - Sitas, F.
AU - Yap, S.
AU - Egger, S.
AU - Christian, K.
AU - Hodgkinson, V.
AU - Barton, M.
AU - Banks, E.
AU - Canfell, K.
AU - O'Connell, D. L.
AU - Nair-Shalliker, V.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Introduction: The New South Wales (NSW) Cancer, Lifestyle and Evaluation of Risk Study (CLEAR) is an open epidemiological bioresource, using an all cancer unmatched case-spouse control design. Participant characteristics and selected confirmed associations are compared to published estimates: current smoking and lung cancer; country of birth and melanoma; body mass index (BMI) and bowel cancer; and paternal history of prostate cancer and prostate cancer, to illustrate the validity of this design. Material and methods: Cases are NSW residents, ≫18 years, with an incident cancer of any type. Controls are cancer-free spouses of cases. Participants complete a consent form, a questionnaire, and provide an optional blood sample. For analyses, odds ratios for males and females are calculated for cancers and exposures of interest, by sex-matching controls to cases. Results: 10,816 participants (8569 cases, 2247 controls, 54% female) recruited to-date, median age: 61.6y cases, 61.3y controls. The top five cancer types are female breast (n=1691), prostate (n=1102), bowel (n=888), melanoma (n=608), and lung (n=265). Adjusted odds ratios (OR) were: 20.65 (95% CI: 13.25-32.19) for lung cancer in current versus never smokers; 1.16 (1.05-1.28) for bowel cancer per 5kg/m2 increment in BMI; 1.41 (1.01-1.96) for melanoma in Australian-born compared to those born in UK/Ireland; and 2.47 (1.82-3.37) for prostate cancer in men with versus without a paternal history of prostate cancer. Discussion: This study design, where controls are the spouses of cases diagnosed with a variety of cancers and which are analysed unmatched, avoids potential biases due to overmatching, considered problematic in standard case-spouse control studies, and illustrates that risk estimates analysed are consistent with the published literature. CLEAR methodology provides a practical design to advance local knowledge on the causes of various leading and emerging cancers.
AB - Introduction: The New South Wales (NSW) Cancer, Lifestyle and Evaluation of Risk Study (CLEAR) is an open epidemiological bioresource, using an all cancer unmatched case-spouse control design. Participant characteristics and selected confirmed associations are compared to published estimates: current smoking and lung cancer; country of birth and melanoma; body mass index (BMI) and bowel cancer; and paternal history of prostate cancer and prostate cancer, to illustrate the validity of this design. Material and methods: Cases are NSW residents, ≫18 years, with an incident cancer of any type. Controls are cancer-free spouses of cases. Participants complete a consent form, a questionnaire, and provide an optional blood sample. For analyses, odds ratios for males and females are calculated for cancers and exposures of interest, by sex-matching controls to cases. Results: 10,816 participants (8569 cases, 2247 controls, 54% female) recruited to-date, median age: 61.6y cases, 61.3y controls. The top five cancer types are female breast (n=1691), prostate (n=1102), bowel (n=888), melanoma (n=608), and lung (n=265). Adjusted odds ratios (OR) were: 20.65 (95% CI: 13.25-32.19) for lung cancer in current versus never smokers; 1.16 (1.05-1.28) for bowel cancer per 5kg/m2 increment in BMI; 1.41 (1.01-1.96) for melanoma in Australian-born compared to those born in UK/Ireland; and 2.47 (1.82-3.37) for prostate cancer in men with versus without a paternal history of prostate cancer. Discussion: This study design, where controls are the spouses of cases diagnosed with a variety of cancers and which are analysed unmatched, avoids potential biases due to overmatching, considered problematic in standard case-spouse control studies, and illustrates that risk estimates analysed are consistent with the published literature. CLEAR methodology provides a practical design to advance local knowledge on the causes of various leading and emerging cancers.
KW - Australia
KW - Biobank
KW - Birthplace
KW - BMI
KW - Cancer
KW - Case-control design
KW - Case-spouse control design
KW - Control selection
KW - Family history
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=84929955411&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2015.03.006
DO - 10.1016/j.canep.2015.03.006
M3 - Article
C2 - 25892705
AN - SCOPUS:84929955411
VL - 39
SP - 414
EP - 423
JO - Cancer Epidemiology
JF - Cancer Epidemiology
SN - 1877-7821
IS - 3
ER -