Subramaniam Ravi P, White Paul, Cogliano V James
National Center for Environmental Assessment, U.S. EPA, Washington, DC 20460, USA.
Risk Anal. 2006 Jun;26(3):825-30. doi: 10.1111/j.1539-6924.2006.00769.x.
The U.S. Environmental Protection Agency's cancer guidelines (USEPA, 2005) present the default approach for the cancer slope factor (denoted here as s*) as the slope of the linear extrapolation to the origin, generally drawn from the 95% lower confidence limit on dose at the lowest prescribed risk level supported by the data. In the past, the cancer slope factor has been calculated as the upper 95% confidence limit on the coefficient (q1) of the linear term of the multistage model for the extra cancer risk over background. To what extent do the two approaches differ in practice? We addressed this issue by calculating s and q1 for 102 data sets for 60 carcinogens using the constrained multistage model to fit the dose-response data. We also examined how frequently the fitted dose-response curves departed appreciably from linearity at low dose by comparing q1, the coefficient of the linear term in the multistage polynomial, with a slope factor, sc, derived from a point of departure based on the maximum likelihood estimate of the dose-response. Another question we addressed is the extent to which s exceeded sc for various levels of extra risk. For the vast majority of chemicals, the prescribed default EPA methodology for the cancer slope factor provides values very similar to that obtained with the traditionally estimated q1. At 10% extra risk, q1/s* is greater than 0.3 for all except one data set; for 82% of the data sets, q1 is within 0.9 to 1.1 of s. At the 10% response level, the interquartile range of the ratio, s*/sc, is 1.4 to 2.0.
美国环境保护局的癌症指南(美国环境保护局,2005年)提出了癌症斜率因子(此处表示为s*)的默认方法,即线性外推至原点的斜率,通常从数据支持的最低规定风险水平下剂量的95%下限置信区间得出。过去,癌症斜率因子是作为多阶段模型中额外癌症风险相对于背景的线性项系数(q1)的95%上限置信区间来计算的。在实际应用中,这两种方法有多大差异呢?我们通过使用约束多阶段模型拟合剂量反应数据,计算了60种致癌物的102个数据集的s和q1,以此解决这个问题。我们还通过比较多阶段多项式中线性项的系数q1与基于剂量反应最大似然估计得出的起始点斜率因子sc,研究了低剂量下拟合的剂量反应曲线与线性的偏离频率。我们解决的另一个问题是,对于不同水平的额外风险,s超过sc的程度如何。对于绝大多数化学物质,美国环境保护局规定的癌症斜率因子默认方法提供的值与传统估计的q1非常相似。在额外风险为10%时,除一个数据集外,所有数据集的q1/s都大于0.3;82%的数据集,q1在s的0.9至1.1范围内。在10%反应水平下,s/sc比值的四分位距为1.4至2.0。